As we welcome 2025 and begin celebrating 70 years of the American College of Nurse-Midwives (ACNM) and the Journal of Midwifery & Women's Health (JMWH), a recent World Health Organization (WHO) report1 should be in the hands of every practicing midwife. In the United States in particular, this position paper can help promote midwifery care models at the federal, state, local, and health system practice levels. WHO recommends a transition to midwifery care models worldwide, linked to a strategy of primary health care as part of attaining universal health coverage.
WHO urges moving from fragmented and risk-focused care approaches to midwifery models of care so that women and newborns receive “equitable, person-centred, respectful, integrated and high-quality care, provided and coordinated by midwives working within collaborative interdisciplinary teams”1(p8) prior to pregnancy through the postpartum period. The report notes that while the terms women and mothers are used, the recommendations are inclusive of all individuals identifying as women and all persons who give birth. Although improvements have been made in maternal and neonatal outcomes globally, many challenges remain. Improvements are needed in both access to health care and the provision of high-quality care. In addition, inappropriate use of medical interventions is highlighted as a barrier to improving perinatal outcomes.
Midwifery models of care are defined as those consistent with midwifery philosophy and where the care is provided by autonomous midwives who are educated, licensed, and regulated. Midwives provide high-quality care that is person-centered, based on a relationship between the midwife and the woman, promotes physiologic processes, with interventions used only when needed. Care is coordinated within resourced and functional health systems where interprofessional teams function with respect and trust. These care models are modifiable to be used in all care settings and related contexts.1
Principles of midwifery models of care include (1) access to equitable and human rights–based care for all women and newborns, (2) person-centered and respectful care in a partnership between women and midwives, (3) high-quality care consistent with midwifery philosophy, (4) care provided by autonomous, educated, regulated midwives throughout health systems, and (5) midwives are integrated into interprofessional care teams.1 By using models incorporating these principles, WHO believes a transition to midwifery models can save lives, improve women's and newborns' health outcomes, improve satisfaction with care, reduce health inequities, promote women's rights, and maximize the use of health care resources.1
In making the case for midwifery care models, the WHO report synthesizes recent research and other repo