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Guide

Global Standards for Midwife Faculty Development  – Companion Guidelines 

Education, MPath
ICM
Last Edited 9 July 2025 15:45 CEST
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The ICM Global Standards for Midwife Faculty Development are an essential component of ICM’s efforts to strengthen midwifery education worldwide. These standards are a core ICM document and one of the ICM Midwifery Education Development Pathway (MPath) resources, which include standards, guidelines, definitions, position statements and tools related to midwifery education.  High standard midwifery education is essential to producing competent midwives for the future midwifery workforce, providing safe and culturally appropriate care to women, newborns and their families. Appropriately prepared midwife faculty are the backbone of quality midwifery education programmes.  

The ICM Global Standards for Midwife Faculty Development reflect foundational ICM Core Documents including the Definition and Scope of Practice of a Midwife, the Midwifery Philosophy and Model of Practice. They align with the ICM Global Standards for Midwifery Education and the WHO Midwifery Educator Core Competencies. The standards set out the knowledge, skills and experience that midwife educators and clinical preceptors should receive through quality midwife faculty development as preparation for their teaching roles. 

Midwife faculty are registered and professional midwives. As such, they should already meet the ICM Essential Competencies for Midwifery Practice, work to the ICM Midwifery Philosophy and meet ethical standards set by the relevant in-country regulator as part of the midwife registration process. The ICM Global Standards for Midwife Faculty Development build on the competencies, philosophy and ethics of the midwifery profession with focus on the areas of development required for those midwives working as faculty or clinical preceptors and teaching the next generation of midwives.  

The purposes of the ICM Global Standards for Midwife Faculty Development are to:  

  • set benchmarks and quality indicators for midwife faculty development, 
  • provide a framework for designing, implementing and evaluating midwife faculty development, 
  • assist midwife faculty to engage in continuous quality improvement process,  
  • contribute to strengthening midwifery education programmes globally through preparing and improving the capacity of midwife faculty. 

Additionally, the ICM Global Standards for Midwife Faculty Development (2025) may be used by educational institutions/providers to:  

  • support faculty development; 
  • support in-service continuing education (e.g., opportunities) and/or inform a faculty development programme within an institution; and 
  • meet national and global approval and accreditation standards. 

The Global Standards for Midwife Faculty Development provide the minimum standards for quality midwife faculty development. ICM recognises that educational institutions may be at different levels of maturity regarding faculty development and may be supported by other stakeholders (e.g., Regulators, Ministry of Health/Education, Midwives’ Associations, NGOs) in the development and implementation of midwife faculty development programmes and activities. Regardless of stakeholder requirements, ICM recommends that all midwife faculty development be based on the requirements of midwife faculty, as the primary recipients of development programmes. Consideration should also be given to the needs of midwife students as the direct recipients of teaching from midwife faculty and the needs of women and gender diverse people receiving sexual, reproductive, maternal, newborn and adolescent healthcare services (SRMNAH) from midwives.  To meet such diverse needs, the ICM recommends conducting a needs assessment/analysis particularly of midwife faculty, midwife students and the SRMNAH context. The findings of this needs analysis can be used to determine the most effective faculty development activities to support midwife faculty attain competence as teachers and to prepare competent midwife graduates to provide quality care for women and newborns.  

This document serves as a companion to the ICM Global Standards for Midwife Faculty Development, providing supplementary information and insights.

Related Documents

Core Document, Standards

Global Standards for Midwife Faculty Development 

High standard midwifery education is essential to producing competent midwives for the future midwifery workforce. This document provides the minimum standards for quality midwife faculty development.
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Core Document, Standards

Global Standards for Midwife Faculty Development 

Education, MPath
ICM
Last Edited 9 July 2025 15:19 CEST
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The ICM Global Standards for Midwife Faculty Development are an essential component of ICM’s efforts to strengthen midwifery education worldwide. These standards are a core ICM document and one of the ICM Midwifery Education Development Pathway (MPath) resources, which include standards, guidelines, definitions, position statements and tools related to midwifery education. High standard midwifery education is essential to producing competent midwives for the future midwifery workforce, providing safe and culturally appropriate care to women, newborns and their families. Appropriately prepared midwife faculty are the backbone of quality midwifery education programmes.  

The ICM Global Standards for Midwife Faculty Development reflect foundational ICM Core Documents including the Definition and Scope of Practice of a Midwife and the Midwifery Philosophy and Model of Practice. They align with the ICM Global Standards for Midwifery Education and the WHO Midwifery Educator Core Competencies. The standards set out the knowledge, skills and experience that midwife educators and clinical preceptors should receive through quality midwife faculty development as preparation for their teaching roles. 

Midwife faculty are registered and professional midwives. As such, they should already meet the ICM Essential Competencies for Midwifery Practice, work to the ICM Midwifery Philosophy and meet ethical standards set by the relevant in-country regulator as part of the midwife registration process. The ICM Global Standards for Midwife Faculty Development build on the competencies, philosophy and ethics of the midwifery profession with focus on the areas of development required for those midwives working as faculty or clinical preceptors and teaching the next generation of midwives.  

The purposes of the ICM Global Standards for Midwife Faculty Development are to:  

  • set benchmarks and quality indicators for midwife faculty development, 
  • provide a framework for designing, implementing and evaluating midwife faculty development, 
  • assist midwife faculty to engage in continuous quality improvement process,  
  • contribute to strengthening midwifery education programmes globally through preparing and improving the capacity of midwife faculty. 

Additionally, the ICM Global Standards for Midwife Faculty Development (2025) may be used by educational institutions/providers to:  

  • support faculty development; 
  • support in-service continuing education (e.g., opportunities) and/or inform a faculty development programme within an institution; and 
  • meet national and global approval and accreditation standards. 

The Global Standards for Midwife Faculty Development provide the minimum standards for quality midwife faculty development. ICM recognises that educational institutions may be at different levels of maturity regarding faculty development and may be supported by other stakeholders (e.g., Regulators, Ministry of Health/Education, Midwives’ Associations, NGOs) in the development and implementation of midwife faculty development programmes and activities. Regardless of stakeholder requirements, ICM recommends that all midwife faculty development be based on the requirements of midwife faculty, as the primary recipients of development programmes. Consideration should also be given to the needs of midwife students as the direct recipients of teaching from midwife faculty and the needs of women and gender diverse people receiving sexual, reproductive, maternal, newborn and adolescent healthcare services (SRMNAH) from midwives.  To meet such diverse needs, the ICM recommends conducting a needs assessment/analysis particularly of midwife faculty, midwife students and the SRMNAH context. The findings of this needs analysis can be used to determine the most effective faculty development activities to support midwife faculty attain competence as teachers and to prepare competent midwife graduates to provide quality care for women and newborns.  

Related Resources

Guide

Global Standards for Midwife Faculty Development  – Companion Guidelines 

This document serves as a companion to the ICM Global Standards for Midwife Faculty Development, providing supplementary information and insights.
Core Document

Global Standards for Midwifery Education

The ICM Standards for Midwifery Education are an essential pillar of ICM’s efforts to strengthen midwifery worldwide by promoting high quality education programmes that prepare midwives who meet the ICM definition of a midwife.
Guide

Midwifery Education Development Pathway (MPath)

The MPath resources provide midwife educators with practical tools and suggested strategies to strengthen pre-service midwifery education programs.
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Core Document, Standards

Global Standards for Midwifery Regulation

Regulation
ICM
Last Edited 9 July 2025 14:29 CEST
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The primary function of regulation is to protect the public.  Robust regulatory systems also support midwives to work autonomously to their full scope of practice.  By raising the status of midwives through regulation, the standard of care across the sexual, reproductive, maternal, newborn and adolescent health (SRMNAH) services will be improved. 

The ICM sets the global standards for midwifery regulation in alignment with the global evidence-base. The aim of the ICM’s Global Standards for Midwifery Regulation to promote regulatory mechanisms that protect the public by ensuring that safe and competent midwives provide high quality midwifery care to women, gender diverse people, and their newborns.  

The standards have two applications, dependent on whether a country has midwifery regulatory processes in place or not: 

  1. Review of existing regulatory processes. The standards can be used to guide amendments to existing processes and promote regulatory frameworks that support autonomous midwifery practice.  
  2. Development of regulatory processes. The standards can be used to guide health authorities on how to establish regulatory frameworks for midwifery where none currently exist.  

Midwives’ associations are encouraged to advocate for the use of these standards for the improvement or implementation of regulatory legislation, policies, and procedures. The separate professional identity of midwives must be recognised in all regulatory processes.  Where midwives are regulated alongside or together with nurses or other health professionals, the aim is that separate and specific regulatory structures and processes are established to enable autonomous midwifery practice and ensure high quality midwifery care in alignment with ICM Essential Competencies for Midwifery Practice.  

The standards are organised under the following four categories:  

  1. Models of regulation: the type of regulation e.g. via legislation  
  2. Protection of title: who may use the title ‘midwife’  
  3. Governance: the processes for establishing of a regulatory authority and the processes by which the regulatory authority carries out its functions 
  4. Functions: the mechanisms by which a regulatory authority regulates midwives under the sub-categories of:  
    1. Scope of practice 
    2. Pre-service midwifery education 
    3. Registration 
    4. Continuing competence 
    5. Complaints and discipline 
    6. Code of Conduct and Ethics  
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Core Document

Bill of Rights for Women and Midwives

Gender Equality, Human Rights
ICM
Last Edited 9 July 2025 11:35 CEST
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Background

The International Confederation of Midwives (ICM) calls for governments globally to recognise and support accessible midwifery care as a basic human right for all women, girls, and gender diverse people and their newborns. Threats to human rights impact both women and midwives.

Pregnancy and childbirth are significant events that deeply affect the lives of women, families, and communities (1). Women’s experiences of sexual, reproductive, maternal, newborn and adolescent health services (SRMNAH) can include discrimination, coercion, violence, and other forms of ill-treatment (1,2).

The midwifery profession is primarily dominated by women. Midwives also have human rights, however, while working to safeguard the human rights of others, their own human rights are sometimes put at risk (3). Midwives are often exposed to unsafe working environments and experience considerable gendered disparities in pay, career pathways and decision-making power (4).

The Bill of Rights for Women and Midwives highlight the basic human rights that women and midwives are often systematically denied and provides rights-based recommendations for achievement of gender-equity, improvement to SRMNAH services for women and the creation of an enabling environment whereby midwives can work to full scope of practice (5).

 

Bill of Rights

Every midwifery model of care should strive to be informed by the following guiding principles (6):

Equitable and Human-Rights-Based Care – Ensuring that all women and newborns receive respectful, accessible, and high-quality care, regardless of background or circumstances.

Person-Centered and Respectful Care – Fostering a trusting relationship between midwives and women, promoting dignity, informed choice, and individualized support.

High-Quality Care Aligned with the Midwifery Philosophy – Providing evidence-based, woman-centered care that supports physiological birth and minimises unnecessary interventions.

Care Coordinated by Midwives in All Settings – Ensuring midwives lead and deliver care across diverse environments, from homes and communities to hospitals and humanitarian settings.

Integrated and Collaborative Care – Strengthening coordination within health systems, enabling seamless collaboration between midwives and other healthcare professionals.

These rights can be more specifically described for both women and midwives.

 

Women’s Rights

ICM believes that every woman has the right to:

  1. Receive midwifery care from an autonomous and competent midwife for her SRMNAH needs,
  2. Be treated with dignity and respect at all times,
  3. Bodily autonomy
  4. Be free from all forms of discrimination,
  5. Up-to-date, and evidence-based health information about her health and that of her newborn,
  6. Actively participate in decisions about her health care, including the right to informed consent and refusal,
  7. Privacy and confidentiality,
  8. Choose the place where she gives birth,
  9. A birth companion of choice.

Midwives’ Rights

ICM believes that every midwife has the right to:

  1. A midwifery education programme which meets the ICM Global Standards for Midwifery Education, that enables them to develop and maintain competency as a midwife,
  2. Belong to a profession that is nationally recognised as a separate and distinct from other professions,
  3. Practise on their own responsibility within the ICM International Definition and Scope of Practice of a Midwife,
  4. Decent work that is free from stigma, violence and discrimination and to be recognised, respected and supported as a health professional,
  5. Fair and equitable compensation, including salary and working conditions,
  6. Career advancement, work to their full potential and access formal leadership roles in their own profession and in national health systems,
  7. Access a strong midwifery association that is the voice for midwives, supporting midwives, building professionalism and representing the interests of midwives to policymakers and other relevant stakeholders.

 

Women’s and Midwives’ Rights

ICM believes that together, women and midwives have the right to:

  1. A system of regulation that protects the public and ensures a safe, accountable, competent and autonomous midwifery workforce,
  2. National midwifery workforce planning to ensure sufficient midwives to meet the SRMNAH needs of women, girls, and newborns.

References

  1. WRA 2019. Respectful Maternity Care Charter. Available from: https://whiteribbonalliance.org/resources/rmc-charter/
  2. Center for Reproductive Rights 2025. Available from: https://reproductiverights.org/our-issues/maternal-health/
  3. Boydell V, et al. 2023. Hostilities faced by people on the frontlines of sexual and reproductive health and rights: a scoping review: BMJ Global Health;8:e012652.
  4. UNFPA 2021. The State of the World’s Midwifery 2021, Building a health workforce to meet the needs of women, newborns, and adolescents everywhere. Available from: https://www.unfpa.org/sowmy.
  5. ICM 2021. Building the Enabling Environment for Midwives: a call to actions for policy makers. Available from: https://internationalmidwives.org/resources/enabling-environment-policy-brief-2021/
  6. Transitioning to Midwifery Models of Care: Global Position Paper. Geneva: World Health Organization; 2024.

Adopted at Durban Council meeting, 2011

Reviewed and adopted at Toronto Council meeting, 2017
Reviewed and adopted at Virtual Council meeting, 2025
Due for next review 2030

 

© 2025 by the International Confederation of Midwives

Detailed copyright information can be found here.

Suggested Citation: Bill of Rights for Women and Midwives. The Hague: International Confederation of Midwives 2025. 

Relevant ICM Documentation  

Core Document

International Code of Ethics for Midwives 

The International Code of Ethics for Midwives addresses the midwife’s ethical mandates in keeping with the International Definition of the Midwife, and ICM standards.
Midwife Juliya Akter is doing Sathi Akter’s (22) pregnancy routine checkup. Her role involves monitoring the progress of labour, offering guidance, and facilitating a safe and positive birthing experience. She does routine examinations in the female ward and attends to newborn babies and mothers. Keraniganj Upazila Health Complex, Bangladesh.
Core Document, Definition / Glossary

Definition of Midwifery

ICM has developed the definition of midwifery, used around the world as the basis of the profession.
Core Document

Essential Competencies for Midwifery Practice

The essential competences for the practice of midwifery describe the minimum set of knowledge, skills and professional behaviours required by an individual to use the title of midwife as defined by the ICM.
Core Document

Global Standards for Midwifery Education

The ICM Standards for Midwifery Education are an essential pillar of ICM’s efforts to strengthen midwifery worldwide by promoting high quality education programmes that prepare midwives who meet the ICM definition of a midwife.
Core Document, Standards

Global Standards for Midwifery Regulation

The goal of these standards is to promote regulatory mechanisms that protect the public by ensuring that safe and competent midwives provide high standards of midwifery care.
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Core Document, Definition / Glossary

Definition of Midwifery

Model of Care, Philosophy
ICM
Last Edited 9 July 2025 11:06 CEST
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Midwife Juliya Akter is doing Sathi Akter’s (22) pregnancy routine checkup. Her role involves monitoring the progress of labour, offering guidance, and facilitating a safe and positive birthing experience. She does routine examinations in the female ward and attends to newborn babies and mothers. Keraniganj Upazila Health Complex, Bangladesh.

Midwifery is the profession of midwives (1); only midwives practise midwifery. Midwifery has a unique body of knowledge, skills and professional attitudes drawn from disciplines shared by other health professions such as health sciences and sociology but practised by midwives, and based upon principles of autonomy, partnership, ethics and accountability. The Professional Framework for Midwifery defines the different aspects of the profession. 

Midwifery is an approach to care for women, gender diverse people and newborns whereby midwives:  

  • Provide education on sexual and reproductive health, contraception and family planning, administer contraceptives (within scope of practice) and provide comprehensive care, 
  • Optimise the normal biological, psychological, social and cultural processes of pregnancy, childbirth, the postnatal and newborn period, 
  • Work in partnership with women, respecting the individual circumstances and views of each woman,  
  • Promote women’s personal capabilities to care for themselves and their families,  
  • Collaborate with midwives and other health professionals as necessary to provide holistic care that meets every woman’s individual needs.  

Midwifery care is provided by an autonomous midwife who is enabled to work to full scope of practice based on the ICM International Definition and Scope of Practice of a Midwife and ICM Essential Competencies for Midwifery Practice. Midwifery competencies (knowledge, skills and attitudes) are held and practised by midwives, educated through a pre-service/pre-registration midwifery education programme that meets the ICM’s Global Standards for Midwifery Education (2).  

In some countries where the title ‘midwife’ is not yet protected, other health professionals (especially nurses, doctors and midwifery associates (this can include community health workers and maternity support workers)) may be involved in providing care for sexual, reproductive, maternal, newborn and adolescent health (SRMNAH) across the life course. As these health professionals are not midwives, they do not possess the full set of competencies of a midwife and do not provide midwifery care, but rather aspects of SRMNAH care. 

References 

  1. International Confederation of Midwives. 2024. International Definition and Scope of Practice of the Midwife. Available at: https://internationalmidwives.org/resources/international-definition-of-the-midwife/ 
  2. International Confederation of Midwives. 2021. Global Standards for Midwifery Education. Available at: https://internationalmidwives.org/resources/global-standards-for-midwifery-education/ 

Adopted at Toronto Council meeting, 2017 

Reviewed and adopted at virtual council meeting, 2025
Due for next review, 2030 

 

© 2025 by the International Confederation of Midwives

Detailed copyright information can be found here.

Suggested Citation: Definition of Midwifery. The Hague: International Confederation of Midwives 2025. 

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Core Document

Philosophy and Model of Midwifery Care

Model of Care, Philosophy
ICM
Last Edited 8 July 2025 17:24 CEST
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Background

Throughout history, the art and science of midwifery has undergone many transitions. The features and characteristics of midwifery have evolved differently according to local knowledge, cultural and social traditions, with care of the woman being central to the holistic approach to the provision of support and care for reproductive health throughout a woman’s life course (1).

During the modern era, midwifery evolved from a social practice, into a competency-based, regulated profession with its own Professional Framework.

According to the ICM Definition of the Midwife (2):

“A midwife is a person who has successfully completed a midwifery education programme based on the ICM Essential Competencies for Midwifery Practice and the framework of the ICM Global Standards for Midwifery Education, recognised in the country where it is located; who has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery and use the title ‘midwife,’ and who demonstrates competency in the scope of practice of the midwife.”

ICM recognises midwives as the professionals of choice for the provision of sexual, reproductive, maternal, newborn and adolescent health (SRMNAH) care throughout the life course for women, girls, gender diverse people and newborns in all areas of the world.

Midwives offer care based upon a partnership, a relationship of trust, reciprocity, and equity between a midwife and a woman.    Each midwife strives to ensure that they do not impose their professional and personal power onto women; rather, through the provision of respectful, personalised, continuous and non-authoritarian care a midwife seeks to establish relationships in which each woman is the primary decisionmaker (3).

The ICM Philosophy and Model of Midwifery Care builds on this shared experience between women and midwives, emphasising the important role respect for human dignity, compassion and the promotion of human rights plays in ensuring positive experiences for women.

ICM Philosophy of Midwifery Care

  • Pregnancy, childbirth and the postnatal period are usually normal physiological processes.
  • Pregnancy, childbirth and the postnatal period are profound experiences, which carry significant meaning for women, girls, gender diverse people, their families and their communities.
  • Midwives are the most appropriate care providers to attend women during pregnancy, childbirth and the postnatal period.
  • Midwifery care promotes, protects and supports women’s reproductive and sexual health and human rights, and respects ethnic and cultural diversity. It is based on the ethical principles of justice, equity, and respect for human dignity.
  • Midwifery care is holistic and continuous in nature, grounded in an understanding of the social, emotional, cultural, spiritual, psychological and physical experiences of women.
  • Midwifery care is emancipatory as it protects and enhances the health and social status of women and builds women’s self confidence in their ability to cope with pregnancy, childbirth and the postnatal period.
  • Midwifery care takes place in partnership with women, recognising the right to self-determination, and is respectful, personalised, continuous and non-authoritarian.
  • Ethical and competent midwifery care is informed and guided by formal and continuous education, scientific research and application of evidence.

The Midwifery Philosophy is central to the provision of care during pregnancy, childbirth and the postnatal period, as to all other aspects of comprehensive SRMNAH care provided by midwives across the life course.

ICM Model of Midwifery Care

  • Midwives promote and protect the health and rights of women, girls, gender diverse people, adolescents and newborns.
  • Midwives respect and have confidence in women and in their capabilities in childbirth.
  • Midwives promote and advocate for non-intervention in normal childbirth.
  • Midwives provide women with appropriate information and advice in a way that promotes participation and enhances informed decision-making.
  • Midwives offer respectful, anticipatory and flexible care, which encompasses the needs of the woman, her newborn, family and community, and begins with primary attention to the nature of the relationship between the woman seeking midwifery care and the midwife.
  • Midwives empower women to assume responsibility for their health and for the health of their families.
  • Midwives practice in collaboration and consultation with other health professionals to serve the needs of the woman, her newborn, family and community.
  • Midwives maintain their competence and ensure their practice is evidence-based.
  • Midwives use technology appropriately and effect referral in a timely manner when problems arise.
  • Midwives are individually and collectively responsible for the development of midwifery care, educating the new generation of midwives and colleagues in the concept of lifelong learning.

The Midwifery Model of Care is suited to the provision of care during pregnancy, childbirth and the postnatal period, as to all other aspects of comprehensive SRMNAH care provided by midwives across the life course.

Guiding principles

The Philosophy and Model of Midwifery Care was first adopted by ICM Council in 2005 to provide a global description of the guiding principles of midwifery care. The person- and human rights-centred approach inherent in ICM’s Philosophy and Model of Midwifery Care has been adopted as part of collaborative efforts focused on strengthening the midwifery profession.  The WHO Global Position Statement on Transitioning to Midwifery Models of Care (4) confirms the importance of a trusting partnership and relationship between women and midwives as an essential part of efforts to achieve Universal Health Coverage (UHC).

Recommendations

ICM urges member associations to:

  • Use this position statement to guide the relationship between the midwife and the woman and her family, and between the midwife and other health professionals.
  • Use this position statement as a guide in the education of midwives, the organisation of midwifery care, and evaluation of midwifery care.
  • Share this position statement with other health professions and governments during the development of regulations and legislation of midwifery practice.
  • Use this position statement and the WHO Global Position Paper on Midwifery Models of Care and associated implementation documents to promote, advocate for and implement midwifery models of care (4).

References

  1. Barnawi N, Richter S, Habib F. Journal of Research in Nursing and Midwifery (JRNM) (ISSN: 2315-568x) Vol. 2(8) pp. 114-121, December 2013 DOI: http:/dx.doi.org/10.14303/JRNM.2013.064
  2. International Confederation of Midwives. 2024. International Definition and Scope of Practice of the Midwife. Available at: https://internationalmidwives.org/resources/international-definition-of-the-midwife/
  3. Pairman, S. Tracy, S.K. Dahlen, H. Dixon, L. Midwifery Preparation for Practice. 2022. Elsevier Health Sciences. SN 9780729597852
  4. Transitioning to Midwifery Models of Care: Global Position Paper. Geneva: World Health Organization; 2024.

 

Adopted at Brisbane Council meeting, 2005

Revised and adopted at Prague Council meeting, 2014

Revised and adopted at Virtual council meeting 2025

Due for Next Review: 2030

 

© 2025 by the International Confederation of Midwives

Detailed copyright information can be found here.

Suggested Citation: Philosophy and Model of Midwifery Care. The Hague: International Confederation of Midwives 2025. 

 

 

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Position Statement

The Role of Midwives in the Prevention of Antimicrobial Resistance

Midwifery Practice
ICM
Last Edited 4 July 2025 09:51 CEST
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Background 

Antimicrobial resistance (AMR) is a serious and growing threat to public health globally, particularly affecting women, girls, gender-diverse people and newborn infants. AMR occurs when microbes such as bacteria, fungi and viruses adapt to and no longer respond to an antimicrobial drug, leading to treatment of infections becoming less effective, sepsis less preventable and death more likely (1).   

Globally, an estimated 1.27 million deaths a year are attributed to AMR bacterial infections, the burden of which is carried by low- and middle-income countries, due in part to fragile health systems, overuse of antibiotics in health and agriculture, and lack of access to water, sanitation and hygiene (WASH) (1). These all have a detrimental impact on women, the provision of sexual, reproductive, maternal, newborn and adolescent health (SRMNAH) and midwives.  

Globally, infection is the fifth leading cause of maternal death and accounts for at least 252,000 maternal deaths a year (2). These estimates do not include deaths due to other complications of infection across the SRMNAH continuum, including post-abortion or postnatal infection, human immunodeficiency virus (HIV) and communicable diseases such as malaria. Maternal infection (e.g. syphilis) also accounts for 1.9 million stillbirths annually, more than half of all stillbirths globally (3). Estimates reveal that up to 3.9 million newborns develop sepsis each year, with a mortality rate of 18%. The impact of AMR can be catastrophic for newborns (4).   

In view of the severity of the issue, the World Health Organisation (WHO) devised a Global Action Plan on AMR (5) and health-system implementation of this is supported through the People-Centered Approach to Addressing Antimicrobial Resistance in Human Health (6). This position statement outlines ICM’s position on the role of midwives in addressing the risk AMR poses to public health.   

Position 

  • The ICM recognises the immediate and severe threat posed by AMR to the health of women and newborns. 
  • ICM urges midwives to take all necessary actions to prevent, diagnose and treat infections in all healthcare settings.  
  • ICM supports global, regional, and national actions to combat AMR and encourages midwives and member associations to participate in these efforts.  

Recommendations  

Grouped according to the domains of the WHO’s People-Centered Approach to Addressing Antimicrobial Resistance in Human Health (6, 7),  ICM urges member associations to advocate for:   

Effective Governance, Awareness and Education  
  • The inclusion of AMR, WASH, infection prevention and control (IPC) and antimicrobial stewardship in the pre- and in-service midwifery education programmes(3).   
Prevention  
  • The role of the midwife as an educator to provide guidance to women and their families on the importance of IPC including hand-hygiene, signs of infection and adhering to antimicrobial treatment to prevent resistance, including antiretroviral treatment (ART) for HIV (3, 7).  
  • The role of midwives in educating women on menstrual health and hygiene, ensuring that the lack of WASH or menstrual products does not contribute to the spread of drug-resistant infections (7).  
  • The role of midwives in the education on the importance of vaccination in preventing infections, which may require antimicrobial treatment and in the administration of vaccinations to women and newborns (7).  
  • The role of midwives in the prevention, screening and treatment of sexually transmitted infections (STIs), to reduce the development of AMR STI’s (3, 7).  
  • The promotion of immediate and ongoing skin-to-skin contact and breastfeeding, as these have vital roles in supporting the development of a healthy microbiome and immune system for newborns, improving their immunity to infections, including drug-resistant strains.  
  • The availability of WASH, including waste management at community, birth-setting and health-facility level to prevent infection and environmental contamination by antimicrobial agents (3, 7).  
  • The availability and use of appropriate personal protective equipment (PPE) and vaccinations to safeguard midwives, women and their newborns from drug-resistant infections (7).  
Access to Essential Health Services  
  • The role of midwives in advocating for equitable access for women and their families to universal health coverage (UHC), which includes timely and appropriate antimicrobial treatments, vaccination programs, and infection prevention services (3, 7).  
Timely and Accurate Diagnosis  
  • The role of midwives in diagnosis of infection and sepsis, including undertaking sample collection, interpreting results when within their scope of practice and referral to other cadres of health workers as appropriate, including microbiologists (3, 7).  
  • SRMNAH services to have access to the necessary equipment and commodities to utilise diagnostic tools, including access to laboratories (3, 7).  
Appropriate, Quality-Assured Treatment  
  • SRMNAH services to have access to quality antimicrobial drugs and cold-chain storage for these (7).  
  • The judicious use of antimicrobials includes avoiding unnecessary antibiotic prescriptions, when prescribing is within the scope of practice of a midwife (3, 7).  
Strategic Information through Surveillance and Research  
  • The role of midwives in data collection on antimicrobial resistance, including surveillance efforts to monitor the spread of resistant infections; sharing this information with health authorities to inform public health strategies (3, 7).
  • The role of midwives as researchers, studying the impact of AMR on SRMNAH (7).  

References 

  1.  Murray, C., Ikuta, KS., Sharara, F., Swetschinski, L., Aguilar, GR., Gray, A. et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The lancet. (2022). 399(10325), p629-655. Available at: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02724-0/fulltext 
      
  2. Cresswell, JA., Alexander, M., Chong, MYC., Link, H., Pejchinovska, M., Gazeley, U. et al. Global and regional causes of maternal deaths 2009-20: a WHO systematic analysis. Lancet Global Health. (2025). Epub ahead of print PMID: 40064189. Available at:  https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(24)00560-6/fulltext 
     
  3.  UNFPA. (2024). Policy Brief: The Hidden Threat: How Antimicrobial Resistance Undermines Sexual, Maternal, and Newborn Health. New York (US): UNFPA. Available at: https://www.unfpa.org/resources/policy-brief-hidden-threat-how-antimicrobial-resistance-undermines-sexual-maternal-and 
      
  4. WHO. (2020). Global Report on the Epidemiology and Burden of Sepsis: Current evidence, identifying gaps and future directions. Geneva (CH): WHO. Available at: https://www.who.int/publications/i/item/9789240010789 
      
  5. WHO. (2016). Global Action Plan on Antimicrobial Resistance. Geneva (CH): WHO. Available at: https://www.who.int/publications/i/item/9789241509763 
      
  6. WHO. (2023). People-Centered Approach to Addressing Antimicrobial Resistance in Human Health: WHO Core Package of Interventions to Support National Action Plans. Geneva (CH): WHO. Available at: https://www.who.int/publications/i/item/9789240082496 
      
  7. WHO. (2024). Addressing gender inequalities in national action plans on antimicrobial resistance: Guidance to complement the people-centred approach. Geneva (CH): WHO. Available at: https://www.who.int/publications/i/item/9789240097278  

  

Adopted at Toronto Council meeting, 2017  

Reviewed and Adopted at Virtual Council meeting, 2025  

Due for next review, 2028   

 

————————————–

© 2025 by the International Confederation of Midwives

Detailed copyright information can be found here.

Suggested Citation: The Role of Midwives in the Prevention of Antimicrobial Resistance. The Hague: International Confederation of Midwives 2025.

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Report

Annual Report 2024

Last Edited 27 June 2025 21:28 CEST
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In 2024, ICM advanced its mission to strengthen midwifery worldwide through strategic partnerships, bold advocacy, and regional collaboration. Guided by our Triennial Strategy, we supported member associations with new resources, hosted two successful regional conferences, and launched key tools like the updated Essential Competencies and the Midwifery Accelerator. Despite global challenges—including humanitarian crises and growing threats to sexual and reproductive rights—midwives continued to lead with resilience. This year also marked significant internal growth and leadership transition. Our 2024 Annual Report reflects the achievements, challenges, and collective impact of the global midwifery community in improving health for all.

Looking ahead to 2025, ICM remains committed to advancing midwives’ rights and expanding midwifery care models amid funding constraints and threats to sexual and reproductive rights, by building on past achievements and strengthening partnerships with global health stakeholders to address the evolving challenges in today’s dynamic global landscape.

— Sandra Oyarzo Torres President, International Confederation of Midwives
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Guide

Implementation Guidance on Transitioning to Midwifery Models of Care

Model of Care
ICM, UNFPA, UNICEF, WHO
Last Edited 18 June 2025 15:39 CEST
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Enjoying the highest attainable standards of health is a fundamental human right. Despite progress in recent decades, maternal and neonatal mortality, morbidity and stillbirths remain high globally. Many women and newborns experience mistreatment and overmedicalization throughout antenatal, intrapartum and postnatal care, which can severely affect their health and well-being and hinder progress towards achieving universal health coverage.

To improve maternal and newborn health and well-being outcomes and achieve universal health coverage, the World Health Organization (WHO) supports the transition to midwifery models of care; a way to optimize service delivery to better meet the needs of women and newborns before, during and after pregnancy and childbirth. In these models, quality care is coordinated by midwives who make autonomous decisions across their full scope of practice, as part of interdisciplinary teams.

When complications arise, midwives collaborate seamlessly with obstetricians, paediatricians and other specialists, through effective consultation and timely referral systems, jointly ensuring continuous, personalized care to women and newborns.

This document launched by the WHO, in collaboration with UNICEF, UNFPA and ICM, provides strategic and practical guidance to countries transitioning to midwifery models of care.

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Guide

Professional Framework for Midwifery – Implementation Guide

Advocacy, Association, Education, Enabling Environment, Essential Competencies, Gender Equality, Leadership, Model of Care, Philosophy, Regulation, Research
ICM
Last Edited 10 June 2025 10:50 CEST
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The Professional Framework for Midwifery outlines the key elements needed to build and sustain a strong midwifery profession and improve the quality and equity of sexual, reproductive, maternal, newborn and adolescent health (SRMNAH) care.

This Implementation Guide is designed for midwives, policymakers, educators, health system leaders, and others involved in strengthening midwifery services. It provides a step-by-step approach to applying the Framework, along with practical examples and reflection points. The guide supports users in understanding how to engage with the Framework and advocate for its implementation within their own health systems.

Using the Implementation Guide

The Implementation Guide is structured in three sections:

  • Section 1 explains the foundations of the Framework—why the ICM Definition of a Midwife, Midwifery Philosophy and Model of Care, and Essential Competencies are central.
  • Section 2 explores the remaining elements of the Framework, highlighting their interdependence and role in shaping a strong midwifery profession.
  • Section 3 provides a practical approach to implementing the Framework, with country examples that show how it can be applied in different contexts.

Using this guide can help improve midwifery care and create stronger systems to support midwives. With stakeholder engagement and clear measures of progress, the Framework can drive lasting change for midwives, women, and newborns around the world.

 

Related Resources

Core Document

Professional Framework for Midwifery

Every profession needs a structure to support it, strengthen it and guide its development, that includes all the elements required before an occupation can be considered a profession.
A midwife checks a pregnant woman's blood pressure during a prenatal appointment at The Midwives Collective in Victoria, British Columbia, Canada.
Core Document

International Definition and Scope of Practice of the Midwife

This document provides an internationally recognised definition and scope of practice of a midwife.
Core Document

Philosophy and Model of Midwifery Care

This document provides a universal, description of the philosophy and model of midwifery care, without compromising local or regional characteristics of midwifery care.
Core Document

Essential Competencies for Midwifery Practice

The essential competences for the practice of midwifery describe the minimum set of knowledge, skills and professional behaviours required by an individual to use the title of midwife as defined by the ICM.
Core Document

Global Standards for Midwifery Education

The ICM Standards for Midwifery Education are an essential pillar of ICM’s efforts to strengthen midwifery worldwide by promoting high quality education programmes that prepare midwives who meet the ICM definition of a midwife.
Core Document, Standards

Global Standards for Midwifery Regulation

The goal of these standards is to promote regulatory mechanisms that protect the public by ensuring that safe and competent midwives provide high standards of midwifery care.
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Core Document

Professional Framework for Midwifery

Advocacy, Association, Education, Enabling Environment, Essential Competencies, Gender Equality, Leadership, Model of Care, Philosophy, Regulation, Research
ICM
Last Edited 3 June 2025 12:47 CEST
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Drawing on years of conversations and collaborations, we have developed a new and improved Professional Framework for Midwifery to reflect the evolution of our profession and better represent midwifery as it exists today.

Why do we need a Professional Framework for Midwifery?

Every profession needs a structure to support it, strengthen it and guide its development. In most cases, this structure is known as a professional framework and is made up of all the elements required before an occupation can be considered a profession.

As a unique health profession, midwifery has a unique professional framework. Other professions, such as nursing or teaching, have their own frameworks that are specific to the work they do. The ICM Professional Framework for Midwifery acts as an informative and guiding tool for ICM, its members, partners and stakeholders.

What are the elements of the updated Professional Framework for Midwifery?

 

  • Midwifery Philosophy
  • Essential Competencies for Midwifery
  • Education
  • Regulation
  • Association
  • Research
  • Continuity of Midwife Care Model of Practice
  • Leadership
  • Enabling Environment
  • Commitment to Gender Equality and Justice, Equity, Diversity and Inclusion

 

 

The elements of the updated Professional Framework for Midwifery are deeply interwoven and entirely interdependent. This means that by strengthening one we can strengthen all others, just as destabilising one destabilises them all.

Learn more about the Professional Framework through this informative video!

Additional Translations / Traduções Adicionais

ICM’s materials and resources are officially available in our three working languages: English, Spanish, and French. As part of the Collaborate for Women, Abortion and Contraception Care Together Initiative, this resource has been translated into Portuguese. This is not an official ICM translation, and ICM is not responsible for the accuracy of the translation.

Os materiais e recursos da ICM estão oficialmente disponíveis em nossos três idiomas de trabalho: inglês, espanhol e francês. Como parte da Iniciativa Collaborate for Women, Abortion and Contraception Care Together, este recurso foi traduzido para o português. Esta não é uma tradução oficial da ICM, e a ICM não se responsabiliza pela precisão da tradução.

Download in Portuguese / Download em Português
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Position Statement

Midwives’ Provision of Comprehensive Abortion Care

Human Rights, Midwifery Practice
ICM
Last Edited 2 June 2025 23:36 CEST
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Background 

Abortion management is required for both induced and spontaneous abortion, including missed abortion, pregnancy loss and intrauterine fetal death. Midwives play a key role in the provision of safe quality abortion care, offering pre-abortion assessment, information regarding treatment options, referrals, medication and procedural abortions, post-abortion and contraceptive care (1-3).  

The provision of safe comprehensive abortion care services is crucial for the sexual and reproductive health (SRH) of women, girls and gender diverse people. Global estimates show that 61% of unintended pregnancies end in abortion, with 39 abortions per 1,000 women aged 15–49 years, totalling 73.3 million abortions annually (4), 45% of which are unsafe (5).  

The prevalence of unsafe abortion has been shown to be higher in countries where restrictive abortion policies, stigma and the limited expansion of universal health coverage negatively impact on women’s access to comprehensive abortion care (2,4,6). Criminalisation of abortion does not reduce the number of women seeking abortions, but does dramatically reduce access to safe abortion services (2,4).  Complications associated with abortion account for 8% of all maternal deaths (7) and one in four survivors of unsafe abortions suffer long-term health consequences, including internal organ injury, infertility and psychological trauma (6). Given that incorrect classification and underreporting of the causes of maternal deaths is an ongoing challenge globally (7), these statistics likely underestimate the true burden of mortality and morbidity associated with abortion, and in particular unsafe abortion practices performed by unqualified health professionals.  

Access to safe abortion care significantly reduces maternal mortality and morbidity and is a sexual and reproductive right grounded in international human rights law (2). States are required to take a range of steps to protect women from unsafe abortion including a duty to liberalise restrictive policies and ensure timely access to quality care at the woman’s request (2). 

An important step in increasing access is the removal of provider restrictions and the optimisation of workforce whereby midwives are enabled to provide comprehensive abortion care services as per ICM’s Essential Competencies for Midwifery Practice (3) and WHO Comprehensive Abortion Care Guidelines (2). Approaches to service delivery need to be dynamic and allow for a range of pathways to care, including support for self-care interventions which have the potential to increase access to services and empower and enhance women’s health (2,8). Self-management of abortion* reduces barriers related to travel, stigma, and concerns about privacy (2,9). Self-management of post-abortion contraception** can improve the continuation of contraceptive use (2). 

During crises, midwives are often the only available health professionals for SRMNAH needs, and as such need to be competent in providing comprehensive abortion care to all women and gender diverse people who seek it. 

In states that stigmatise, restrict and/or criminalise abortion, midwives and others who provide and enable access to abortion information, services and goods, are often exposed to hostility, physical and/or verbal attacks, threats, smears and intimidation. Some are criminalised through unjust prosecutions, investigations and arrests (10). 

Position 

A woman seeking abortion-related services is entitled to receive care from midwives.  Care should be respectful and tailored to women’s needs; safeguarding rights to information regarding treatment options, to consent or refuse interventions, and safeguard dignity. ICM supports midwives working within their full scope of practice as providers of comprehensive abortion care services as outlined in the ICM Essential Competencies for Midwifery Practice (3) and WHO Abortion Care Guidelines (2). 

Midwives who provide abortion information, services and goods have the right to carry out their work free from physical or mental harm, or fear from such harm, and must be protected by their employers, health and legal systems. 

 

Recommendations 

ICM urges policymakers to stop the criminalisation of health professionals who facilitate or provide abortion mediation and/or services, or who assist those seeking comprehensive abortion information and/or services. 

ICM urges policymakers and all decisionmakers in facilities that provide maternity, sexual and reproductive care services to:  

  • Ensure laws and policies include measures that protect the right to work and right to privacy of midwives providing comprehensive abortion information and services. 
  • Optimise the midwifery workforce to enable midwives to work to their full scope of the Essential Competencies for Midwifery Practice, with appropriate referral systems for complications. 
  • Ensure that there is evidence- and rights-based information readily accessible on contraception and comprehensive abortion care. 

ICM urges midwives’ associations to advocate for: 

  • Legalisation of abortion where it is criminalised, including the removal of sanctions against women, health workers, and accompaniers. 
  • Midwifery pre-service education and continuing professional development which ensures that midwives are equipped with the knowledge and skills needed to provide comprehensive, safe abortion care. 
  • Implementation of services offering the range of comprehensive abortion care  methods as per WHO recommendations, including self-managed abortion. 
  • Improved access to essential medicines and supplies for comprehensive abortion care and contraceptive services. 
  • Accessible, timely abortion services, supporting women’s right to abortion care provided by midwives in all relevant settings. 
  • Interprofessional collaboration between midwives and obstetrician-gynaecologists to improve healthcare access and service user acceptability. 

ICM urges policymakers and midwives’ associations to also address: 

  • Stigma surrounding sexuality, ensuring equitable access to contraceptives. 
  • Stigma surrounding unintended or mistimed pregnancy and abortion and its impact on women’s ability to seek, reach and receive comprehensive abortion care services. 
  • The impact of conscientious objection by healthcare providers on abortion services, ensuring that access to care is not undermined or impeded by lack of access to health professionals. 
  • Gender-based violence, its connection to unintended or mistimed pregnancy, and its impact on the physical, psychological, and cultural well-being of women, girls, and gender-diverse people. 

ICM urges individual midwives to:  

  • Recognise comprehensive abortion care as part of midwifery practice within the framework of local laws and policies. 
  • Uphold a woman’s right to decide to have an abortion without mandatory counselling, waiting periods, or third-party authorisation. 
  • Provide human rights-based, woman-centred care, enabling informed decision-making for the woman’s needs. 
  • Refer women for further treatment outside midwifery practice when necessary. 
  • Offer emotional, psychological, and social support as required. 
  • Ensure privacy, confidentiality, and work to combat stigma surrounding SRH issues. 
  • Support and enable colleagues who provide comprehensive abortion care. 

By ensuring midwives are suitably educated, advocating for legal reforms, and addressing systemic issues such as stigma and conscientious objection, member associations can improve access to safe, effective, and respectful abortion care for women, girls and gender-diverse people. 

 

*Self-management of abortion (SMA) includes one or more of the following, self-assessment of eligibility for medical abortion, self-administration of medicines without the direct supervision of a health worker, and self-assessment of the success of the abortion process (< 12 weeks). 

**Self-management of contraception may include ensuring access to oral contraception without a prescription and self-administration of injectable contraceptives 

Related ICM Documents  

 

Core Document

Essential Competencies for Midwifery Practice

The essential competences for the practice of midwifery describe the minimum set of knowledge, skills and professional behaviours required by an individual to use the title of midwife as defined by the ICM.

References

  1. Fullerton J, Butler MM, Aman C, Reid T, Dowler M. Abortion-related care and the role of the midwife: a global perspective. Int J Womens Health. 2018 Nov 23;10:751-762. doi: 10.2147/IJWH.S178601. PMID: 30538585; PMCID: PMC6260173. 
  2. Abortion care guideline. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO. 
  3. International Confederation of Midwives. Essential Competencies for Midwifery Practice. 2024. Essential Competencies for Midwifery Practice | International Confederation of Midwives 
  4. Bearak J, Popinchalk A, Ganatra B, Moller AB, Tunçalp Ö, Beavin C, Kwok L, Alkema L. Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990-2019. Lancet Glob Health. 2020 Sep;8(9):e1152-e1161. doi: 10.1016/S2214-109X(20)30315-6. Epub 2020 Jul 22. PMID: 32710833.  
  5. Ganatra B, Gerdts C, Rossier C, Johnson BR Jr, Tunçalp Ö, Assifi A, Sedgh G, Singh S, Bankole A, Popinchalk A, Bearak J, Kang Z, Alkema L. Global, regional, and subregional classification of abortions by safety, 2010-14: estimates from a Bayesian hierarchical model. Lancet. 2017 Nov 25;390(10110):2372-2381. doi: 10.1016/S0140-6736(17)31794-4. Epub 2017 Sep 27. Erratum in: Lancet. 2017 Nov 25;390(10110):2346. doi: 10.1016/S0140-6736(17)32608-9. PMID: 28964589; PMCID: PMC5711001.  
  6. Haddad LB, Nour NM. Unsafe abortion: unnecessary maternal mortality. Rev Obstet Gynecol. 2009 Spring;2(2):122-6. PMID: 19609407; PMCID: PMC2709326.  
  7. Cresswell JA, Alexander M, Chong MYC, Link HM, Pejchinovska M, Gazeley U, Ahmed SMA, Chou D, Moller AB, Simpson D, Alkema L, Villanueva G, Sguassero Y, Tunçalp Ö, Long Q, Xiao S, Say L. Global and regional causes of maternal deaths 2009-20: a WHO systematic analysis. Lancet Glob Health. 2025 Mar 7:S2214-109X(24)00560-6. doi: 10.1016/S2214-109X(24)00560-6. Epub ahead of print. PMID: 40064189. 
  8. WHO> Self-care for health and well-being. https://www.who.int/health-topics/self-care#tab=tab_1 
  9. FIGO’s Self-Management of Abortion Project: FIGO Project. https://www.figo.org/what-we-do/figo-programmes/self-management-abortion-project 
  10. Amnesty International. Key principles and actions to safeguard abortion care providers as human rights defenders. 2024. Key principles and actions to safeguard abortion care providers as human rights defenders – Amnesty International 

 

Adopted at Glasgow Council meeting, 2008  

Reviewed and adopted at Prague Council meeting, 2014  
Reviewed and adopted at Virtual Council meeting, 2025
Due for Next Review: 2028 

© 2025 by the International Confederation of Midwives

Detailed copyright information can be found here.

Suggested Citation: Midwives’ Provision of Comprehensive Abortion Care. The Hague: International Confederation of Midwives 2025. 

Additional Translations / Traduções Adicionais

ICM’s materials and resources are officially available in our three working languages: English, Spanish, and French. As part of the Collaborate for Women, Abortion and Contraception Care Together Initiative, this resource has been translated into Portuguese. This is not an official ICM translation, and ICM is not responsible for the accuracy of the translation.

Os materiais e recursos da ICM estão oficialmente disponíveis em nossos três idiomas de trabalho: inglês, espanhol e francês. Como parte da Iniciativa Collaborate for Women, Abortion and Contraception Care Together, este recurso foi traduzido para o português. Esta não é uma tradução oficial da ICM, e a ICM não se responsabiliza pela precisão da tradução.

Download in Portuguese / Download em Português