Over 200 European Midwifery Leaders Urge European Commission to Strengthen EU Midwifery Standards
The Hague, 11 May 2026 – The International Confederation of Midwives (ICM), alongside more than 200 senior midwifery leaders and stakeholders from 27 countries across the EU and EEA, has sent an open letter to the European Commission calling for a stronger and more ambitious revision of Directive 2005/36/EC on the minimum professional qualifications for midwives.
The letter, addressed to President Ursula von der Leyen, Vice-President Roxana Mînzatu and European Commissioners, raises concern that the current update process does not yet reflect the evidence, international standards, or level of ambition needed to prepare Europe’s midwifery workforce for today’s health needs.
Directive 2005/36/EC sets the minimum education and training requirements that allow midwives’ qualifications to be automatically recognised across EU and EEA countries. Yet the Directive’s midwifery provisions have seen almost no substantive change since 1980. Forty-six years later, that text no longer reflects what midwives do, what services the scientific evidence has shown they provide best, or what the international community has recognised as the standard for high-quality sexual, reproductive, maternal, newborn and adolescent health (SRMNAH) care. The open letter warns that updating the text without fully aligning it with current global standards could leave European midwifery education and practice tied to an outdated framework for decades to come.
“Europe has long been recognised as a global leader in midwifery education and regulation. But that leadership depends on standards that reflect the care women and newborns need today. This Directive should not preserve a 1980 standard. It should ensure that every midwife in Europe is educated and recognised according to the best available evidence and international benchmarks,” said Anna af Ugglas, Chief Executive of ICM.
The signatories are calling on the European Commission to ensure that the revised Directive fully aligns with the ICM Global Standards and WHO guidance, supports health systems that can respond to crises, advances gender equality and women’s health, and strengthens the EU’s role as a global leader in sexual, reproductive, maternal, newborn and adolescent health.
The letter warns that when minimum standards are outdated, they can become a ceiling rather than a floor. The Directive is intended to set a minimum level of training for automatic recognition across EU and EEA countries. However, when that minimum is based on an outdated understanding of midwifery, some countries may use it as the full definition of what a midwife is allowed or expected to do. This can limit midwives’ ability to practise to their full scope, create differences in the care women receive across Member States, and weaken professional mobility within Europe.
“Women in Europe should not receive different levels of midwifery care because the legal standard has failed to keep pace with evidence,” said Professor Jacqueline Dunkley-Bent OBE, Chief Midwife at ICM. “The Directive must recognise the full range of care they can provide across sexual, reproductive, maternal, newborn and adolescent health.”
The letter also notes that Europe’s standards influence health workforce development beyond the EU. As countries and development partners look to Europe when reforming midwifery education and regulation, an outdated Directive could weaken the EU’s credibility in global health.
The signatories include Presidents and board members of national midwives’ associations, senior midwifery educators, clinical leaders, and civil society organisations working across women’s health, reproductive rights, respectful maternity care, nursing and midwifery, and family planning.
The open letter concludes with a clear call for urgent action: the European Commission must use this revision to raise standards, support midwives to work to their full scope, and ensure that women, newborns and families across Europe can benefit from high-quality midwifery care.
ENDS
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Media contact
Daniela Drandic, Head of Advocacy and Communications
International Confederation of Midwives
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About the International Confederation of Midwives
The International Confederation of Midwives (ICM) is the global voice for midwives, representing more than 135 midwives’ associations across over 115 countries. ICM works to strengthen midwives’ associations and advance the profession worldwide by promoting autonomous midwives as the most appropriate caregivers for childbearing women.