As labor sets in, Florence washes her hands to prepare for childbirth. She is tended to by one of Liberia’s few midwives—just 295 for a 3.8 million population. It is estimated that Liberia needs another 1,000 midwives to meet World Health Organization guidelines. Moreover, Liberia, like many of the world’s fragile states, is at risk of not reaching Millennium Development Goal 5—to reduce maternal deaths by 75 percent by 2015. In 2007, fragile states received just 38.4 percent of overseas development aid despite suffering the highest levels of maternal mortality.