Philosophy and Model of Midwifery Care

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.