The World Health Organisation (WHO) has released new guidance to help countries adopt and expand midwifery models of care — where midwives serve as the main care provider for women and babies throughout pregnancy, childbirth, and the postnatal period.

The guidance promotes strong communication and partnership between women and midwives, and offers proven health benefits for both women and their babies. 

Why WHO supports transition to midwifery models of care?

• Despite progress, maternal and newborn deaths remain unacceptably high — particularly in low-income and fragile settings. 

• Recent modelling suggests that universal access to skilled midwives could prevent over 60 per cent of these deaths, amounting to 4.3 million lives saved annually by 2035.

• Globally, millions of women still give birth without a skilled health worker by their side, and one-third do not receive even four of WHO’s recommended eight pregnancy checks. Progress in reducing maternal and newborn mortality has largely stagnated since 2016.

• To improve maternal and newborn health and well-being outcomes and achieve universal health coverage, the WHO supports the transition to midwifery models of care, a way to optimise service delivery to better meet the needs of women and newborns before, during and after pregnancy and childbirth. 

What is midwifery?

• Midwifery is defined as “skilled, knowledgeable and compassionate care for childbearing women, newborn infants and families across the continuum from pre-pregnancy, pregnancy, birth, postpartum and the early weeks of life”. 

• The evidence shows us that midwifery plays a vital role, and when provided by educated, trained, regulated, licensed midwives, is associated with improved quality of care and rapid and sustained reductions in maternal and newborn mortality.

• All women and newborns have a right to a quality of care that enables a positive childbirth experience that includes respect and dignity, a companion of choice, clear communication by maternity staff, pain relief strategies, mobility in labour and birth position of choice. 

• Midwives are essential to the provision of quality of care, in all settings, globally.

• Currently, the world faces a global shortage of around one million midwives. Concentrated and cross-sectoral action is needed to reverse this shortage.

Midwifery care models

• Midwifery care models emphasize informed choice as well as communication and non-invasive techniques — such as mobility during labour, breathing guidance, varied birthing positions and emotional support— that seek to empower women, and reduce the likelihood of invasive procedures.

• Midwifery models of care are also an important response to the growing concern of over-medicalisation in childbirth. 

• While medical interventions such as caesarean sections, inductions, and 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, caesarean rates now exceed 50 per cent, suggesting high rates of medically unnecessary procedures.

• The new guidance provides practical tools and real-life examples to help countries structure a transition toward midwifery models of care. 

• As part of this process, it calls for strong political commitment, strategic planning and long-term financing for implementation, with dedicated budget lines. 

• It also stresses the importance of high-quality midwifery regulation and education in line with international standards, supporting autonomous, evidence-based practice.

• Successful implementation requires strong collaboration, the guidance notes. 

• Midwives should be empowered to work independently while also integrated into broader healthcare teams alongside doctors and nurses. In the event of complications, midwives should be able to work in partnership with these other professionals to ensure quality multidisciplinary care for every woman and baby.

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