Who publishes new guidance on expanding midwifery care worldwide

Who publishes new guidance on expanding midwifery care worldwide

The World Health Organization (WHO) today released new guidance to help countries adopt and expand midwifery models of care – where midwives act as the primary care provider for women and babies during pregnancy, birth and the postnatal period.

The guidance promotes strong communication and partnership between women and midwives and provides proven health benefits for both women and their babies. Women who received care from trusted midwives are statistically more likely to experience healthy vaginal births and report higher levels of satisfaction with the services they receive.

“Expanding and investing in midwifery models of care is one of the most effective strategies to improve maternal and newborn health worldwide,” said Dr. Anshu Banerjee, director of maternal, newborn, child and adolescent health and aging at WHO. "These approaches improve outcomes, maximize resources and can be adapted to all countries. Crucially, they also improve women's and families' experiences of receiving trusted health partnerships at this critical time in life."

A proven, cost-effective solution

Despite progress, maternal and newborn deaths in low-income and fragile settings remain unacceptably highly particular. Recent modeling suggests that universal access to qualified midwives could prevent over 60% of these deaths, amounting to 4.3 million lives saved annually by 2035.

Models of midwifery care emphasize informed choice, communication, and noninvasive techniques such as mobility during labor, breathing guidance, varied birth positions, and emotional support that empower women and reduce the likelihood of invasive procedures.

Midwifery models of care are also an important response to the growing concern about over-medicalization of childbirth. While medical interventions such as cesarean sections, inductions and the use of forceps are essential and life-saving when clinically indicated, their routine or excessive use creates short and long-term health risks. In some countries, imperial rates now exceed 50%, indicating high rates of medically unnecessary procedures.

Expert midwives help women to be confident in their bodies, their abilities and their care. This is why investing in midwifery models of care is so important – it not only improves health, but also builds a cadre of professionals equipped to provide individualized, respectful care, ensuring women are consistently part of the decision-making process and have access to the information they need, as well as important emotional support. “

Ulrika Rehnstrom Loi, WHO expert and technical lead for the guidance

Practical tools for implementation

The new guidance provides practical tools and real-life examples to help countries structure a transition to midwifery models of care. As part of this process, it calls for strong political commitment, strategic planning and long-term funding for implementation - with specific budgetary limits. It also emphasizes the importance of high-quality midwifery regulation and education in line with international standards and supporting autonomous, evidence-based practice.

Successful implementation requires strong collaboration, the guidelines note. Midwives should be empowered to work independently while being integrated into broader healthcare teams alongside doctors and nurses. In the event of complications, midwives should be able to work in collaboration with these other professionals to ensure high quality, highly interdisciplinary care for every woman and baby.

A global imperative

Millions of women worldwide are still giving birth without a qualified health worker at their side, and a third do not receive even four pregnancy checks recommended by WHO. Progress in reducing maternal and newborn mortality has largely stalled since 2016.

“Midwifery models of care are not just smart solutions – they are a necessity,” said Anna Ugglas, executive director of the International Confederation of Midwives, which supported the development of the guidelines. “In a world where birth is increasingly medicalized, they offer a person-centered, evidence-based approach that respects the physiological process of birth, restores the dignity and autonomy of maternity care, and helps ensure the safety of women and newborns everywhere.”

The guide describes several customizable models of midwifery care, including:

• Kontinuität der Pflegewo Frauen während der gesamten Schwangerschaft, Geburt und der postnatalen Zeit von einer bekannten Hebamme oder einem kleinen Team von Hebammen unterstützt werden.

• Geburtszentren von Hebammeengagierte Einrichtungen, in denen Hebammen Frauen mit geringem Komplikationsrisiko intrapartale Versorgung anbieten. Sie bieten manchmal andere Dienste wie vorgeburtliche und postnatale Versorgung oder Familienplanung an.

• Community-basierte Ansätze Wo Hebammen Dienste direkt in Gemeinden erbringen, zum Beispiel über mobile Einheiten oder lokale Gesundheitszentren.

• Privatpraxiswo private Hebammen unabhängig oder über Organisationen tätig sind. Um effektiv zu sein, müssen diese Dienste reguliert und in nationale Gesundheitssysteme integriert werden.

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