ArticleEuropean journal of midwifery2026
Exploring adherence to the International Confederation of Midwives' Essential Competencies in Europe.
Article in European journal of midwifery, 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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Abstract
introductionMidwives play a critical role in improving maternal and neonatal outcomes, with midwifery-led care proven to reduce unnecessary interventions and empower women. Yet, across Europe, systemic and cultural barriers continue to hinder midwives' ability to fully adhere to global standards such as the International Confederation of Midwives (ICM) essential competencies.
methodsA qualitative study captured the perspectives of ten midwives from five European countries: UK, Germany, Belgium, Bulgaria, and Italy. Purposive sampling captured diverse representation from midwives working within national regulatory frameworks and practicing independently. Semi-structured interviews provided rich insights into essential competencies adherence, with thematic analysis revealing key trends.
resultsParticipants identified shared challenges, including societal undervaluation of the midwifery profession, workforce strain, and restrictive legislations, alongside regional differences including governance barriers and lack of regulation of out-of-hospital births. Benefits to adherence to ICM competencies included enhanced autonomy and opportunities for international collaboration. Overarching themes were structural and cultural as external dynamics, and professional as internal dynamics. The former included medicalization, subordinate role of midwives, and regulatory barriers, whereas at a professional level emerged relationship-centered care and theory-practice gap, as key subthemes. Proposed strategies included strengthening adherence, fostering academic and institutional support, and enhancing professional standing.
conclusionsThis study highlights that essential competencies are not fully implemented across Europe. Urgent collaboration among academic and health institutions, as well as midwifery associations, is essential to create enabling environments and strengthen essential competencies' adherence in Europe. Ultimately to fostering professional identity and improving maternal and neonatal health outcomes.
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