WHO Calls for Global Shift to Midwifery Care to Save Lives and Empower Women

According to WHO, midwifery-led models deliver superior outcomes, foster trusting patient-provider relationships, and offer a sustainable, cost-effective solution to the ongoing crisis in maternal and neonatal care.

In a pivotal move to address stagnant maternal and newborn health progress globally, the World Health Organization (WHO) has released new guidance urging countries to adopt and scale midwifery models of care. This transformative approach places midwives as the primary care providers for women and babies throughout the entire maternity journey — from pregnancy and childbirth to the postnatal period.

According to WHO, midwifery-led models deliver superior outcomes, foster trusting patient-provider relationships, and offer a sustainable, cost-effective solution to the ongoing crisis in maternal and neonatal care.

“Expanding and investing in midwifery models of care is one of the most effective strategies to improve maternal and newborn health globally,” said Dr Anshu Banerjee, WHO Director for Maternal, Newborn, Child and Adolescent Health and Ageing.

The Global Health Context: A Call to Action

Despite years of investment, maternal and newborn mortality remains unacceptably high, particularly in low-resource and conflict-affected settings. One in three women globally do not receive the minimum recommended number of antenatal visits, and millions still give birth without a skilled health worker present. Since 2016, global progress in reducing maternal and newborn deaths has slowed significantly.

Recent WHO data shows that universal access to skilled midwives could prevent over 60% of maternal and newborn deaths, potentially saving 4.3 million lives per year by 2035.

Why Midwifery Models of Care Work

Midwifery care is anchored in person-centred, holistic, and evidence-based practices. Women cared for primarily by midwives are:

• More likely to experience spontaneous vaginal births

• Less likely to undergo unnecessary interventions such as C-sections or inductions

• More satisfied with their maternity care experiences

• Better supported emotionally and physically during labor

WHO midwifery expert Ulrika Rehnstrom Loi, the technical lead for the guidance, emphasized that skilled midwives do more than provide clinical care:

“Midwives help women trust in their bodies, their abilities, and their care. Investing in midwifery models builds a cadre of experts who deliver individualized, respectful support while making women partners in their health decisions.”

Midwifery-led care emphasizes techniques such as mobility during labor, natural birthing positions, breathing guidance, and continuous emotional support—interventions that can reduce complications, improve maternal autonomy, and foster safer outcomes.

Combating the Risks of Over-Medicalization

A significant motivation behind the WHO’s push is growing concern over the excessive medicalization of childbirth. In some countries, caesarean section rates exceed 50%, far beyond the medically necessary threshold. These high rates are often driven by institutional norms rather than clinical need, and may expose women and infants to unnecessary short- and long-term health risks.

Midwifery models counter this trend by ensuring interventions are only used when clinically justified, offering a physiologically respectful and safer alternative for low-risk pregnancies.

Practical Tools and Real-World Applications

The guidance is not just theoretical—it provides practical frameworks, case studies, and adaptable strategies to help countries transition toward midwifery-led models. Key components include:

• Strong political leadership and long-term financing, with dedicated budget lines for midwifery services

• Regulation and education that align with international standards to ensure quality midwifery practice

• Integration of midwives into wider healthcare systems, while preserving their autonomy

• Collaborative care, enabling midwives to partner with obstetricians, pediatricians, and nurses for complex cases

Models of Midwifery Care Highlighted in the Guidance

1. Continuity of Care: A woman is supported by a known midwife or team throughout pregnancy, childbirth, and postpartum.

2. Midwife-Led Birth Centres: Dedicated facilities offering natural birthing care for low-risk women, often supplemented with antenatal, postnatal, and family planning services.

3. Community-Based Midwifery: Services delivered directly to communities via mobile clinics, home visits, or local health centres—crucial for remote and underserved populations.

4. Private Midwifery Practice: Regulated independent practice that is integrated with public health systems, ensuring accessibility and quality standards.

A Global Health Imperative

WHO’s guidance aligns with broader efforts to address inequities in reproductive and maternal healthcare, especially in areas where health worker shortages persist. It also seeks to elevate midwifery as a professional, respected, and vital health discipline, deserving of investment, autonomy, and leadership roles.

Anna Ugglas, CEO of the International Confederation of Midwives, which co-developed the guidance, stated:

“Midwifery models of care are not just smart solutions—they are a necessity. They restore dignity and autonomy to childbirth, respect the physiology of birth, and ensure the safety and well-being of women and newborns everywhere.”

Looking Ahead: A Sustainable Path Forward

As nations aim to meet Sustainable Development Goal targets for maternal and child health (SDG 3), the WHO guidance represents a crucial step forward. Countries that embrace midwifery-led models can optimize health outcomes, reduce healthcare costs, and ensure that no woman or baby is left behind.

With supportive policies, dedicated funding, and a global shift in mindset, midwives can lead the way in transforming maternity care into a more empowering, respectful, and effective experience for millions around the world.