WHO releases new guidance to expand midwifery care worldwide

SWITZERLAND—The World Health Organization (WHO) has issued new guidelines aimed at helping countries adopt and expand midwifery models of care.

These models position midwives as the primary caregivers for women and babies throughout pregnancy, childbirth, and the postnatal period, promoting a more personalized and supportive approach to maternal and newborn health.

This guidance follows the recent release of WHO’s first-ever global guideline on managing sickle cell disease (SCD) during pregnancy, addressing a serious health challenge that poses life-threatening risks for both mothers and babies.

Benefits of Midwifery Models of Care

The new WHO guidance emphasizes strong communication and partnership between women and midwives.

Research shows that women who receive care from trusted midwives are more likely to have healthy vaginal births and report higher satisfaction with their care.

Dr. Anshu Banerjee, WHO Director for Maternal, Newborn, Child and Adolescent Health and Ageing, highlighted that investing in midwifery care is one of the most effective ways to improve maternal and newborn outcomes globally.

He noted that these models maximize resources, can be adapted to any country, and importantly, enhance the experience of care for women and families during this critical life stage.

Despite progress, maternal and newborn deaths remain unacceptably high, especially in low-income and fragile settings.

Recent estimates suggest that universal access to skilled midwives could prevent over 60% of these deaths, potentially saving 4.3 million lives annually by 2035.

Empowering women through Midwifery

Midwifery care focuses on informed choice, communication, and non-invasive techniques such as encouraging mobility during labor, breathing guidance, varied birthing positions, and emotional support.

These approaches empower women and reduce the need for invasive procedures.

The guidance also addresses concerns about the over-medicalization of childbirth.

While medical interventions like cesarean sections, inductions, and forceps deliveries are crucial when necessary, their overuse can cause short- and long-term health risks.

In some countries, cesarean rates exceed 50%, indicating many procedures may be unnecessary.

Ulrika Rehnstrom Loi, WHO midwifery expert and technical lead for the guidance, explained that skilled midwives help women trust their bodies and abilities.

Investing in midwifery builds a workforce capable of providing respectful, individualized care, ensuring women are actively involved in decision-making and receive vital emotional support.

Practical steps for implementation

The new guidance offers practical tools and real-life examples to assist countries in transitioning toward midwifery models of care.

It calls for strong political commitment, strategic planning, and long-term funding with dedicated budget lines.

High-quality midwifery education and regulation aligned with international standards are also essential to support autonomous, evidence-based practice.

Successful implementation requires collaboration. Midwives should be empowered to work independently but also integrated into healthcare teams alongside doctors and nurses.

 In cases of complications, midwives must be able to collaborate closely with other health professionals to ensure comprehensive care.

Addressing Global Challenges

Currently, millions of women worldwide give birth without a skilled health worker present, and about one-third do not receive even four of WHO’s recommended eight pregnancy check-ups.

Progress in reducing maternal and newborn mortality has largely stalled since 2016.

Anna Ugglas, Chief Executive of the International Confederation of Midwives, which supported the development of the guidance, emphasized that midwifery models of care are not just smart solutions—they are essential.

She stated that in an era of increasing medicalization, midwifery offers a person-centered, evidence-based approach that respects the natural process of birth, restores dignity and autonomy, and ensures safety for women and newborns worldwide.

Focus areas of the Guidance

The guidance highlights several key approaches, including continuity of care—where women are supported by a known midwife or small team throughout pregnancy, birth, and postpartum.

It also supports midwife-led birth centers for low-risk women, community-based services delivered through mobile units or local clinics, and regulated private midwifery practices integrated into national health systems.

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