Bridging the Gap: The Transition Toward University-Level Midwifery Education and Autonomous Practice in Ukraine.

Midwifery in Ukraine is currently undergoing a transformative shift from deep-seated traditional roots toward professional autonomy and alignment with international standards. Historically, care transitioned from village midwives, known as babas or spovytukhas, to formalized training in the 18th century, and scientific professionalization led by figures such as Ivan Lazarevich, who championed a physiological approach to childbirth. However, the Soviet period introduced a physician-led, medicalized model that often integrated midwifery with nursing at a sub-degree level. Currently, the profession faces acute modern pressures caused by the 2022 full-scale invasion, which has disrupted services, forced births into shelters, and contributed to a rise in pregnancy complications. Systemic challenges include significant workforce shortages and curriculum gaps; a 2023-2024 United Nations Population Fund (UNFPA) assessment found that Ukrainian curricula cover a good percentage of key sexual and reproductive health and rights (SRHR) competencies, but not all. To address these issues, Ukraine is leveraging the Bologna Process and European Union (EU) accession aspirations to modernize education toward Bachelor of Science (BSc), Master of Science (MSc), and doctoral (PhD) levels. International collaborations, such as the 'Midwifery Bridges' project with Sweden, aim to adopt autonomous care models. Furthermore, simulation-based education has emerged as a critical technological tool for safely developing clinical dexterity and emergency preparedness amid wartime disruptions. Ultimately, these reforms seek to establish midwives as independent, responsible birth attendants providing woman-centered, evidence-based care.