'Moved by the energy, strength and commitment of midwives': speakers at the ICM Congress: the programme of plenary sessions at the 28th Triennial Congress moved from a rousing opening to a moving close, with a succession of powerful keynotes between.

Two linked and significant themes connected the content of all the keynote speeches given at the Glasgow Congress: the desperate need for action to combat continuing high levels of maternal mortality--and the fact that midwives, working together with global support, should be the people at the heart of that action.

'Top often sorrow and fear replace the joy and celebration that should mark childbirth and babyhood'

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Princess Muna al-Hussein of Jordan, patron of nursing and midwifery for the World Health Organization Eastern Mediterranean region, spoke of the disturbing lack of progress towards the 5th Millennium Development Goal (MDG) of reduced maternal mortality. She said that safe motherhood is a human right--not just a 'component of economic development'. Midwives can not only provide healthcare but encourage better education for girls, which has been shown to help delay early motherhood and reduce numbers of pregnancies. Motherhood, she stressed, should be an expansion of life--not the suspension of life.

'More skilled attendants, greater political will'

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These words were the simple message from Dr Aparjita Gogoi, who began her address with 'Greetings from the White Ribbon Alliance (WRA) and from the midwives of India!'. She listed some of the main obstacles to safe motherhood in her own country--poverty, lack of transport, weak health systems--but also highlighted successful action taken by the WRA to raise awareness of maternal deaths at every level and tackle political inertia. As well as a strong movement in India, the WRA has achieved marked successes elsewhere including Tanzania, Burkina Faso and Indonesia. Her words sparked debate among the audience around issues such as midwives' relationship with traditional caregivers, the need to involve men in this cause at all levels, the dangers of diverting resources from personnel to machinery and the consistent effort needed to combat the spread of HIV. ICM Board member Karen Guilliland explained the recent work carried out at Council towards a positive link with traditional caregivers, and Senior Midwifery Adviser Nester Moyo reminded the audience of ICM's work in strengthening midwives' associations and in training for care of women who are HIV positive.

'Promoting competent midwifery care, dependent on the needs of nations and communities'

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The Princess Royal, patron of the RCM and president of the Save the Children...