Evidence map›Paper›PMID 40349295›Full record

ArticleCommunity health equity research & policy2026

En Route to Midwifery Professionalisation: Contextualising Midwifery Care in the Indian Public Health System.

Sanjana Santosh

Abstract read
In one paragraph

Article in Community health equity research & policy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

1 author.

Sanjana SantoshNossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia.ORCID 0000-0002-5486-8441

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BackgroundThe 'Guidelines on Midwifery Services Initiative, 2018' introduces the Nurse Practitioner in Midwifery (NPM) cadre to improve maternal mortality rates, quality of care, and reduce overmedicalisation in the Indian public health system. The paper examines how the NPM cadre is envisioned in the guidelines, positioned within the medical hierarchy, and aligned within the existing maternal health context. It also looks at how existing midwives and midwifery advocates perceive the changes introduced and the accompanying professionalisation process.MethodologyThe study employed two methods: (a) qualitative document analysis (QDA) of the midwifery guidelines and (b) semi-structured in-depth interviews with 14 nurse-midwifery leaders and advocates.FindingsThe QDA uncovers the underlying themes of task shifting and institutional deliveries as dominant, discussions on professional autonomy and primary health care receiving less importance and even less reflection on the history of midwifery in India. The interview findings highlight (a) tensions around carving out a separate profession, (b) the implications of midwifery at the primary healthcare level and (c) the need for an enabling environment for midwives. This paper reveals how the guidelines frame midwifery as a cost-effective, specialised nursing care within the institutional delivery framework and distanced from its traditional connotations.DiscussionIt elucidates tensions around autonomous midwifery involving professional boundaries, negotiations with medical professionals, institutional perceptions, and historical stereotypes. It builds on the broader literature on 'professions' in sociology by identifying aspects of 'professional boundary work' embedded in policy documents and experiences of participants - thereby unpacking the midwifery professionalisation process in the Indian context.

Indexed as

MidwiferyNurse MidwivesPublic HealthFemaleHumansIndiaInterviews as TopicMaternal Health ServicesNurse PractitionersPregnancyQualitative ResearchHealth PolicyMaternal HealthMidwiferyProfessional BoundariesProfessionalisation

Identifiers

PMID40349295
PMCPMC12963469

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