A public letter signed “A Voice for the Voiceless” has exposed a growing crisis in Antigua and Barbuda’s maternal healthcare sector, where dozens of fully trained newly graduated midwives have been stuck for months without the professional licenses required to practice, even as the nation publicly acknowledges a critical shortage of midwifery staff.
The affected cohort of midwifery students began their specialized training in January 2024. Over 18 months, they navigated the dual challenge of rigorous academic coursework and hands-on clinical requirements, logging hundreds of hours assisting in deliveries to meet the strict eligibility criteria for their final certification exams. After completing the program in August 2025, the group sat for their licensing exams that December and received preliminary passing results in January 2026. All successful candidates submitted their formal licensure applications shortly after, but more than four months later, no licenses have been issued, and no official timeline has been provided to clear the backlog.
The situation is even more uncertain for graduates who needed to retake portions of their exams earlier this year. To date, these candidates have not received any examination results at all. Repeated inquiries from the midwives to the Antigua and Barbuda Nursing Council and the Ministry of Health have gone unanswered or generated only unhelpful, vague responses, leaving the newly trained professionals feeling disrespected and abandoned. Many are forced to continue working lower-paying roles as general registered nurses, unable to put the advanced specialized skills they spent a year and a half mastering to use.
This administrative logjam extends beyond first-time license applicants, too. Currently practicing midwives who submitted applications for license renewal are also facing lengthy, unexplained delays, putting additional unnecessary strain on an already stretched maternal healthcare system. The letter also highlights longstanding structural flaws in the current licensing framework: outdated paper permits that degrade quickly, calling for a shift to durable, standardized plastic identification cards aligned with other professional licensing standards, such as driver’s licenses, to better reflect the professionalism and critical importance of the midwifery field.
What makes the current gridlock especially concerning, the letter argues, is that a new cohort of midwifery students has already begun their training. The writers question how regulators can justify recruiting and investing in new midwives when the system has failed to move forward with qualified candidates who have already completed all requirements. At present, the thousands of hours of hard work, personal sacrifice from the graduates, and public investment in their training are going unused, at a direct cost to the nation’s healthcare capacity.
The letter frames the issue as far more than a routine administrative backlog. Delays in getting new midwives into practice and keeping existing practicing midwives actively licensed directly undermines the quality of care that expectant mothers and newborns across Antigua and Barbuda can access. Quoting the biblical proverb that “Hope deferred makes the heart sick,” the writers note that the graduates’ hope of a smooth, timely transition into their dream profession has been worn down by ongoing silence and delay.
In closing, the letter calls on regulators and government officials to act immediately: to release full public transparency around the licensing backlog, publish the outstanding examination results for retake candidates, and speed up processing of all pending first-time and renewal midwifery licenses to address both the needs of the qualified professionals and the national demand for more maternal healthcare staff.