One thing that is rarely addressed when discussing issues related to immigration, the unhoused, and global conflicts is maternal care. Everyone becomes so consumed with debating the talking points that align with their political view of the world that they fail to see the pregnant women who are suffering in plain sight. As one observes in Nance Ackerman’s eye-opening documentary The Delivery Line: Midwives on the Frontline, this problem not only spans borders but is also growing more dire with every passing day.
Using the motif of kids playing with a ball like a thread that stitches the various countries together, Ackerman takes viewers to the camps and makeshift shelters at the U.S.-Mexico border, the drought-ravaged regions of Nigeria, the encampment parks in Toronto, the cartel and gang-laden neighbourhoods of Colombia, and the remote mountain regions of Afghanistan. The circumstances in each country may differ, but the role of midwives remains the same. The Delivery Line introduces audiences to five midwives on the frontlines—Ximena (Mexico), Maria (Colombia), Gulbadan (Afghanistan), Hamsatu (Nigeria), and Jay (Canada)—who risk their lives to care for those in need, and it paints a vibrant portrait of the challenges they face.
Already considered the deadliest place on earth to give birth, the women in the remote regions of Nigeria not only have the constant fear of being kidnapped by Boko Haram militants, but they also must deal with the malnutrition that the recent drought has caused. It forces midwives like Hamsatu to find alternative means of getting her patients the nutrients they need. The environmental impact on pregnancy can also be felt in Afghanistan, where the bitter winters hinder essential access to supplies. Observing Gulbadan’s journey from student midwife in classes to a practicing healthcare worker tending to a patient in her 30s who has just had her 16th child, Ackerman’s film expertly drills home the increased risk of death in regions that not only lack resources, but force females into marriage at a young age.
As if death during childbirth was not concerning enough, surviving the dangers of one’s local environment can be just as taxing. In Colombia, Maria must tend to women who are equally worried about the high possibility of being hit by stray bullets from the ongoing gang wars. The visible presence of armed police on the streets does little to quell those concerns. One would think that a woman would be much safer in the parks of Toronto, but, as midwife Jay notes in the film, few realize unhoused women are at a considerably higher risk of danger than their male counterparts. Caught in a perpetual catch-22 scenario, pregnant unhoused woman risk having their child taken away by social services for failing to attend prenatal care; however, the simple act of going to those sessions opens the door to losing their unguarded tents and possessions.
Similar to the unhoused in Toronto, asylum seekers who find themselves in tents at the U.S.-Mexico border also face a rash of safety challenges. As Ximena points out, just making the trek from one’s homeland to another country across harsh terrain can be taxing on the body. Even more astounding is the fact that governments on either side of the border have failed to realize the human rights crisis that occurs when pregnant women, regardless of citizenship, do not have access to care.
Bringing a human face to both the midwives and their patients, The Delivery Line asks audiences to contemplate what care truly looks like in a community. Especially for those who, by circumstances or societal bias, have fallen through the cracks. Understanding that mothers should have access to basic care for themselves and their babies, Ackerman’s film actively calls for change from both those in power and those of us who have, so far, been blind to the plight of others.
In advocating for change, the documentary celebrates midwives across the globe who have taken it upon themselves to take that first, essential step. Along with highlighting that many of those featured felt compelled to this calling at a young age, the film also shows that these midwives face major personal struggles and must overcome them while caring for others. Selflessly giving for the sake of their communities, even when it means carrying the emotional weight of the mothers and babies who might die in their care, these women are a constant reminder of the compassion that we should all be showing to those around us.
Whether highlighting the inequalities stemming from environmental impacts on motherhood or spotlighting how the human element is often left out of global power plays, The Delivery Line: Midwives on the Frontline is a moving portrait of the vital role midwives play in providing care to those who need it most.
The Delivery Line has its world premiere at Hot Docs 2026 on April 30 and screens again on May 1.
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Disclaimer: That Shelf’s Managing Editor Emma Badame was a Social Strategist for the documentary.
