- Definition of the midwifery profession
- “A midwife is a person who has successfully completed a publicly recognized midwifery study program based on the ICM Essential Competencies for Midwifery Practice and the ICM Global Standards for Midwifery Education; is entered in the register of healthcare professionals, has obtained a license to practice midwifery, uses the professional title midwife, and demonstrates competence to provide midwifery care.”
- A midwife is recognized as a responsible and reliable professional who works in partnership with the woman, supporting, caring for, and advising her during pregnancy, birth, and the postpartum period. She accompanies the woman during labor, aware of her own responsibility, and also provides midwifery care for the newborn and infant. This care includes preventive measures, promoting normal birth, recognizing complications in the mother and baby, access to healthcare or other appropriate assistance, and carrying out emergency measures.
- A midwife plays an important role in health education and training for the woman, the family, and the wider community. Her work includes perinatal education and preparation for responsible parenthood, and also extends to women’s health, sexual and reproductive health, and children’s health. A midwife may work at home, in the community, in hospitals, clinics, or health centers.” (ICM, 2017)
In 2021, new “Competencies and Professional Activities of Midwifery Practitioners” were published, available at this link.
Minimum competencies for midwives:
EU Directive 2013/55/EU, in Article 42, sets out the minimum educational requirements for qualified midwives and includes the following competencies:
- providing information and counseling related to family planning;
- diagnosing pregnancy and monitoring the normal course of pregnancy, carrying out the examinations needed to monitor the development of a normal pregnancy;
- prescribing and advising on examinations needed for the earliest possible diagnosis of high-risk pregnancies;
- running parent education programs and comprehensive childbirth preparation, including advice on hygiene and nutrition;
- caring for the mother and assisting during labor, and monitoring the condition of the fetus in the uterus using appropriate clinical methods and technical means;
- conducting spontaneous births, including episiotomy when necessary, and, in emergencies, breech delivery;
- recognizing warning signs of abnormalities in the mother or child that require referral to a doctor, and assisting that doctor when appropriate; carrying out appropriate emergency measures in the doctor’s absence, in particular manual removal of the placenta, which may be followed by manual examination of the uterus;
- examining and caring for the newborn, acting at her own discretion when needed, and performing immediate resuscitation when necessary;
- caring for the mother and monitoring her progress in the postpartum period, and giving all necessary advice on baby care so that she can ensure optimal development for her newborn;
- carrying out treatment prescribed by a doctor;
- preparing the necessary written reports (Directive of the European Parliament and of the Council, 2013).
Definition of midwifery
Midwifery is a professional field that cares for women during normal pregnancy, birth, and the postpartum period, as well as for the newborn and infant, with the aim of maintaining or achieving the best possible health for the family. It also overlaps with certain areas of reproduction, obstetrics, gynecology, neonatology, social sciences, spa/rehabilitation services, public health, ethics, and more. Midwifery is an important part of the Slovenian healthcare system, which views pregnancy, birth, and the postpartum period as a natural part of the human life cycle on which the health of the family and the whole community is built. As providers of midwifery care, midwives are involved in healthcare at the primary, secondary, and tertiary levels. Midwives advocate for continuous midwifery care.
In the Republic of Slovenia, midwifery may be practiced only by persons who are entered in the register of providers in healthcare or midwifery nursing and who hold a valid license for independent midwifery practice, as defined in the Rules on the Register and Licenses of Providers in Healthcare or Midwifery Nursing (2016).
Providers of independent midwifery practice may also provide healthcare services as private healthcare professionals. Under Article 35 of the Health Services Act (ZZDej), a private healthcare professional is an individual who has obtained permission from the ministry responsible for health to provide healthcare services. If the conditions under Article 3.a of the ZZDej are met, the private healthcare professional is issued a permit to provide healthcare services in the form of a decision on entry in the register of private healthcare professionals (Act Amending the Health Services Act, 2020).
The philosophy of midwifery (ICM, 2014) is based on the fact that:
- pregnancy and childbirth are normal physiological processes;
- pregnancy and childbirth are a fundamental experience and essential for the woman, her family, and the community;
- midwives are the most appropriate professionals for caring for women during pregnancy, birth, and the postpartum period;
- midwifery care promotes, protects, and supports women’s reproductive and sexual health and rights, and respects ethnic and cultural diversity. It is grounded in the ethical principles of justice, equality, and respect for human dignity;
- midwifery care is comprehensive and continuous, and is based on an understanding of women’s social, emotional, cultural, spiritual, psychological, and physical experiences;
- midwifery care protects and strengthens women’s health and social status, and builds women’s confidence in their ability to cope with childbirth;
- midwifery care is provided in partnership with women, recognizes the right to self-determination, and is respectful, woman-centered, and continuous;
- ethical and competent midwifery care, gained through formal education and lifelong learning, is supported by scientific research and the use of evidence in practice.
- The midwifery model of care (ICM, 2014) ensures that:
- midwives promote and protect the health and rights of women and newborns;
- midwives respect and trust women’s abilities during pregnancy, birth, and the postpartum period;
- midwives promote and advocate for physiological birth without unnecessary interventions;
- midwives provide appropriate information and advice in a way that encourages participation and improves informed decision-making;
- midwives offer respectful, predictable, and flexible care that addresses the needs of the woman, newborn, family, and community;
- midwives support women in making decisions for their own health and their families’ health;
- midwives collaborate and consult with other healthcare professionals to meet the needs of the woman, newborn, family, and community;
- midwives maintain their competencies and ensure evidence-based practice;
- midwives use appropriate measures to ensure timely recognition of possible complications;
- midwives, individually and collectively, are responsible for developing the midwifery model of care, educating new generations of midwives, and the lifelong learning of colleagues.
International Confederation of Midwives competencies ICM (2019) translated in the document
GENERAL COMPETENCIES
Competencies in this category relate to the midwife’s autonomy and responsibilities as a healthcare professional, their relationships with women and other professionals, and all activities in midwifery. All general competencies should be applied in every activity in midwifery practice, and in specific areas they are complemented by competencies from categories 2, 3, and 4. Educational institutions must ensure that the general competencies are integrated into the midwifery study program.
- 1.a Taking responsibility for one’s own decisions and actions as an independent healthcare professional
- 1.b Taking responsibility for one’s own development and health
- 1.c Appropriate handover of aspects of care and ensuring supervision
- 1.d Applying new findings and research in practice
- 1.e Respecting individuals’ fundamental human rights during midwifery care
- 1.f Complying with applicable healthcare legislation, including regulation and the code of ethics for midwives
- 1.g Encouraging women to receive individualized midwifery care
- 1.h Effective interpersonal communication with women and families, healthcare teams, and the local community
- 1.i Supporting the physiological course of labor in clinical settings and in different birth environments, including home births
- 1.j Assessment of health
status, health risk factors, and promoting overall health and well-being for women and babies - 1.k Preventing and treating common health issues related to reproductive health and early life
- 1.l Recognizing conditions beyond midwives’ competencies and making appropriate referrals
- 1.m Caring for women who experience physical and sexual violence
COMPETENCIES SPECIFIC TO THE PRECONCEPTION AND PREGNANCY PERIOD
Competencies in this category relate to assessing the health of the woman and fetus, promoting health and well-being, detecting complications during pregnancy, and caring for women with an unplanned pregnancy.
2.a Providing preconception care
2.b Assessing the woman’s health status
2.c Assessing fetal status
2.d Monitoring pregnancy progress
2.e Promoting and supporting activities that improve health and well-being
2.f Providing guidance/recommendations related to pregnancy, birth, breastfeeding, parenting, and family changes
2.g Detecting, stabilizing, and referring women with pregnancy complications
2.h Helping the woman and her family plan an appropriate place of birth
2.i Providing care for women with an unwanted pregnancy or after pregnancy loss.
COMPETENCIES SPECIFIC TO THE INTRAPARTUM PERIOD
Competencies in this category relate to assessment and care for women during labor, promoting physiological processes and safe birth, immediate newborn care, and detecting and resolving complications in the mother or newborn.
3.a Promoting physiological birth
3.b Providing safe, spontaneous vaginal birth; preventing, detecting, and stabilizing complications
COMPETENCIES SPECIFIC TO THE POSTPARTUM PERIOD
Competencies in this category address ongoing monitoring of the health status of mothers and babies, health education, promoting breastfeeding, detecting complications, and counseling on family planning.
4.a Providing postpartum care for a healthy woman
4.b Caring for a healthy newborn and infant
4.c Promoting and supporting breastfeeding
4.d Detecting, treating, and
stabilizing postpartum complications in the woman and transferring when needed
4.e Detecting and preventing newborn health problems and transferring when needed
4.f Providing family planning services
For details, I suggest you open the document.
