Strengthening Midwifery Regulation: Updated ICM Global Standards for Midwifery Regulation
ICM is pleased to announce the publication of the ICM Global Standards for Midwifery Regulation Companion Guide to support implementation of the recently updated ICM Global Standards for Midwifery Regulation (2025). These important resources aim to strengthen regulatory systems globally, enhance public safety, and advance the autonomy and credibility of midwifery practice.
A recent ICM webinar explored these updates in detail. Readers wishing to learn more about the changes and hear directly from countries implementing the standards are invited to access the recording.
Why Strong Midwifery Regulation Matters
Regulation is one of the key elements of the ICM Professional Framework for Midwifery. The elements of the framework are interconnected; strengthening any one of them reinforces the others. Regulation plays a particularly critical role in shaping the environment in which midwives practise, influencing not only professional accountability but also public trust in the profession and the quality of sexual, reproductive, maternal, newborn and adolescent health (SRMNAH) care.
Effective regulation ensures that:
- The public is protected by ensuring only competent, qualified midwives are authorised to practise
- The status of midwives is raised, supporting them to work autonomously within their full scope of practice
- Through standards for education, registration and conduct, the quality of midwifery practice is raised
- Systems exist for addressing concerns about competence, conduct, or health of a midwife
The updated ICM Standards and Companion Guide provide a comprehensive foundation for building and sustaining such systems.
The ICM Global Standards for Midwifery Regulation
Originally published in 2011, the ICM Global Standards for Midwifery Regulation were created in response to requests from ICM members, governments, regulatory authorities, UN partners, and other stakeholders. They were published in tandem with the development of the ICM Global Standards for Midwifery Education and the revision of the ICM Essential Competencies for Midwifery Practice.
Their intent was to standardise midwifery regulatory mechanisms globally; ensuring that women, girls, gender diverse people and their newborns benefit from care provided by safe, competent, autonomous midwives.
The ICM Global Standards for Midwifery Regulation are organised across four categories:
- Models of regulation: the type of regulation; recommending midwifery-specific and national level regulatory mechanisms.
- Protection of title: who may use the title ‘midwife’; ensuring that only authorised individuals may use the title.
- Governance: the processes for establishing of a regulatory authority and the processes by which the regulatory authority carries out its functions, including organisational structure, membership, funding, and accountability mechanisms.
- Functions: the mechanisms by which a regulatory authority regulates midwives under the sub-categories of:
- Scope of practice
- Pre-service midwifery education
- Registration
- Continuing competence
- Complaints and discipline
- Code of Conduct and Ethics
ICM recently convened a group of midwifery regulatory experts to review and revise the Standards, which were approved by the ICM Council in 2025. While there are minor changes to wording, there are a few significant updates, strengthening the global applicability and clarity of the Standards.
Key Updates in the 2025 Standards
1. Broader terminology
Throughout the updated Standards, the term “regulatory authority” replaces “midwifery regulatory authority.” This change recognises that in many countries, midwifery is regulated alongside other professions. The new terminology ensures the Standards remain relevant regardless of the regulatory model, while still emphasising the need for profession-specific oversight.
2. New requirement for midwifery-specific committees
A major addition is Standard 3.5, which states that:
Where midwives are regulated alongside other professions, a separate board or committee should be established that is responsible for midwifery standards and guidance.
This ensures that regulatory decisions affecting midwives are informed by midwifery expertise and grounded in the realities of midwifery practice. It also helps protect the credibility of the midwifery profession within multi-professional regulators.
3. Emphasis on collaboration with Ministries of Health
Another important addition is Standard 3.9, which highlights the critical role of: The regulatory authority work[ing] in collaboration with key stakeholders such as Ministries and Departments of Health.
In some countries, the Ministry holds direct responsibility for regulatory functions; in others, partnership is essential for legislative alignment, policy development, effective oversight, and resource allocation. The new standard acknowledges that sustainable regulation cannot occur in isolation from national health systems.
4. Strengthening requirements for midwifery educators
Under the function relating to pre-service midwifery education, the updated Standards now include (Standard 4.2.5) an explicit requirement that: Midwife teachers and midwifery clinical preceptor/clinical teachers must have completed a programme of study in teaching.
This aligns with the new ICM Global Standards for Midwife Faculty Development, ensuring consistency across the ICM Professional Framework. The change reflects global recognition that educator preparation is essential for producing competent midwifery graduates.
Introducing the Companion Guide
Alongside the updated Standards, ICM has launched the Global Standards for Midwifery Regulation Companion Guide, a guide designed to support implementation of the Standards. This marks the first time such a guide has been developed for the ICM Global Standards for Midwifery Regulation, building on the success of the ICM Global Standards for Midwifery Education Companion Guide.
The Companion Guide helps midwifery regulators, policymakers, educators, and associations to:
- Understand each standard in detail
- Apply standards in practice
- Identify evidence that demonstrates compliance of a standard
- Review and strengthen existing regulatory frameworks
- Advocate for and establish regulation in settings where it does not yet exist
The Companion Guide is designed for global use. While legislation, terminology, and regulatory mechanism differ across countries, the foundational principles of effective regulation are universal. The guide therefore encourages regulators to adapt approaches to their local context, while maintaining alignment with these international standards.
Additional ICM Regulation Resources
The updated Standards and Companion Guide sit within ICM’s Regulation Resources. These resources provide additional support for countries seeking to establish or strengthen regulatory systems and include:
- The ICM Regulation Toolkit (currently under revision)
By strengthening regulation, we strengthen the profession, improving SRMNAH care for women, girls, gender-diverse people and their newborns worldwide. ICM welcomes feedback from members, regulators, and partners as these updated Standards are put into practice. Feedback can be provided via email: [email protected]
