Global Competencies for Midwife Leaders
The Global Competencies for Midwife Leaders recognise midwives as autonomous, highly skilled health professionals whose leadership is essential to advancing sexual, reproductive, maternal, newborn and adolescent health (SRMNAH). Through their expert knowledge, independent practice (1), clinical expertise, and advocacy, midwives shape and strengthen health policy, health systems, improve the quality of care, and directly influence the outcomes and lived experiences of women, newborns, adolescents, and
families.
Midwife leadership is present across multiple settings and encompasses six key domains:
- Political-strategic
- Operational
- Regulatory
- Educational
- Research
- Clinical
Leadership is not confined to positional authority or managerial designation; it is intrinsic to midwifery practice. Every midwife shapes clinical decisions, advocates for women and families, influences care environments, and contribute to the performance, integrity and resilience of health systems. The journey to become a midwife leader begins during pre-service education, is further developed at entry into the profession and is intentionally cultivated through education aligned with ICM Global Standards.
The ICM Essential Competencies for Midwifery Practice provide the foundation for safe, autonomous, independent, evidence-based care across SRMNAH services. The Essential Competencies extend beyond clinical proficiency to encompass professional behaviours that are inherently leadership oriented: ethical practice, accountability, communication, shared decision-making, cultural humility, quality improvement, and advocacy. In this way, leadership is embedded within everyday midwifery practice.
Within the Global Competencies for Midwife Leaders (here after referred to as the Leadership Competencies), leadership encompasses relational capability, quality improvement, advocacy, cultural safety, and strategic influence within health systems.
It recognises that leadership is developmental and progressive across a midwife’s career. From the point of initial qualification, midwives exercise clinical judgement, professional autonomy, and collaborative practice. As experience and expertise deepen, leadership expands to include mentorship, service development and improvement, research, and research translation, workforce strengthening, and policy engagement.
The Leadership Competencies outline a structured set of competencies that include entry-level midwifery roles up to senior management. It articulates graduated levels of proficiency that reflect increasing responsibility, autonomy, influence, and health system impact. These levels enable midwives to understand leadership expectations associated with their role and stage of professional development, while providing clear pathways for growth across their career trajectory.
Leadership in midwifery is therefore not episodic, but cumulative. It is expressed through:
- Clinical judgement, autonomous and independent practice
- Respectful, ethical rights and evidence-based midwifery care
- Interdisciplinary collaboration, team and stakeholder influence
- Community engagement and health promotion
- Quality improvement and safety leadership
- Policy contribution and system strenghtening
As midwives progress in their careers, these capabilities evolve from direct clinical leadership at the point of care, to broader organisational and strategic influence. At its most advanced levels, midwifery leadership contributes to shaping regulatory environments, informing national health strategies, and more.
By defining leadership across progressive levels, the Leadership Competencies affirm ICM’s position that all midwives are leaders, while recognising that leadership matures in scope, complexity, and impact over time. It provides a coherent structure to guide educators, regulators, employers, and professional associations in developing, supporting, and sustaining midwifery leadership at all levels.