Essential Competencies for Midwifery Practice
The ICM Essential Competencies for Midwifery Practice (2024) outline the minimum set of knowledge, skills and professional behaviours required to use the designation of midwife as defined by ICM1 when entering midwifery practice. The Competencies are presented in five categories that set out those competencies considered to be essential and that “represent those that should be an expected outcome of midwifery pre-service education”. The Competencies are linked to authoritative clinical practice guidance documents used by the World Health Organization” and ICM’s core documents and position statements.
Background
In 2023 ICM commenced its five-year review and update of the competency framework to reflect changes in midwifery practices, ICM core documents and position statements, guidance documents, climate adaptation and humanitarian issues. A learning design consultant and midwifery education expert were contracted to undertake an iterative review and modified Delphi process involving two rounds of feedback from ICM Member Associations, midwifery educators, midwifery regulators, ICM Regional Professional Committees, the ICM Board and partner organisations, including WHO and UNFPA.
A comparison between the 2019 and 2024 Essential Competencies
Between 2019 and 2024, the primary change to the Essential Competencies was the addition of category 2 focusing specifically on sexual and reproductive health and rights (SRHR), contraception and pre-conception care. The 2019 ICM Essential Competencies addressed SRHR; however, with new guidance documents published by the World Health Organization (WHO) and requests for more clarity and specificity regarding SRHR competencies the new category was added, described in the table below:
| 2019 | 2024 | ||
| Title | Title | ||
| Category 1 | General competencies | Category 1 | Cross-functional Competencies for Midwifery Practice |
| Category 2 | Sexual and Reproductive Health and Rights | ||
| Category 2 | Pre-pregnancy and antenatal | Category 3 | Antenatal Care |
| Category 3 | Care During Labour and Birth | Category 4 | Care During Labour and Birth |
| Category 4 | Ongoing Care of Women and Newborns | Category 5 | Ongoing Care of Women and Newborns |
It is important to note that the ICM International Definition and Scope of Practice of the Midwife remains the same. Even with the additional category, competencies and supporting knowledge, skills and behaviour indicators there is no increase to the ICM scope of practice of the midwife. Instead, the additions and revisions to the Essential Competencies provide more specificity and clarity on the requirements for a midwife graduate to practise across the full scope at a level necessary for entry to practice.
The Structure of the Essential Competencies
There are five categories of competencies. Category 1 is a set of cross-functional competencies that apply to each of the other four categories. They are categorised in this way to prevent the need to duplicate in the other categories. Category 1 competencies relate to the midwife’s autonomy and accountability as a health professional, the relationships with women and other care providers, and care activities that apply to all aspects of midwifery practice. Categories 2 to 5 are more specific in outlining the midwife’s competence across the scope of practice.
There are 37 competency statements that are written as holistic statements of competence that reflect the ICM’s Philosophy and Model of Midwifery Care in addition to the ICM International Definition and Scope of Practice of a Midwife.
Each competency statement is further described by a list of knowledge, skills and behavioural indicators that provide guidance on what is required to achieve the competency. These components are not exhaustive, but they are the minimum required to achieve competence. The knowledge, skill and behavioural indicators represent the key components required to achieve the competency but depending on context and practice requirements within each country there may be a need for additional indicators. ICM encourages midwifery educators, regulators, and policy makers to add to these indicators as needed to meet the in-country practice requirements.
Please note: The examples listed in the indicators are to guide the interpretation of the indicator and competency. These examples are meant to provide guidance and are not exhaustive.
