Failure or progress?: The current state of the professionalisation of midwifery in Europe
Joeri Vermeulen 1  
Ans Luyben 2, 3, 4
Patricia Gillen 6, 7
Ramon Escuriet 8, 9
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Department of Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium
Centre for Midwifery, Maternal and Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, United Kingdom
Department of Health Services Research, University of Liverpool, Liverpool, United Kingdom
Cantonal Hospital Graubünden, Chur, Switzerland
School of Nursing and Midwifery, University College Cork, Cork, Ireland
Southern Health and Social Care Trust, Northern Ireland, United Kingdom
Institute of Nursing and Health Research, Ulster University, Northern Ireland, United Kingdom
Catalan Health Service, Barcelona, Spain
National Commission of Midwives, Ministry of Health, Barcelona, Spain
School of Nursing and Allied Health, Liverpool John Moores University, Liverpool, United Kingdom
Joeri Vermeulen   

Department of Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium
Publication date: 2019-12-17
Submission date: 2019-11-22
Final revision date: 2019-12-01
Acceptance date: 2019-12-04
Eur J Midwifery 2019;3(December):22
Throughout Europe midwives called for increasing professionalisation of midwifery during the 1980s and 1990s. While the Bologna Declaration, in 1999, supported this development in education and research, it remains unclear how other fields, such as practice, have fared so far. This study therefore aimed to explore the current state of professionalisation of midwifery in Europe.

An exploratory inquiry was conducted with an on-line semistructured questionnaire. Its content was based on the Greenwood sociological criteria for a profession. Descriptive statistics and thematic content analysis were used to analyse the data. Participants were national delegates from member countries to the European Midwives Association.

Delegates from 29 European countries took part. In most countries, progress towards professionalisation of midwifery has been made through the move of education into higher education, coupled with opportunities for postgraduate education and research. Lack of progress was noted, in particular in regard to midwifery practice, regulation, and leadership in health care provision and education. Most countries had a code of ethics for midwives as well as a midwifery association. Based on organisational collaborations with other disciplines, the sustainability of a distinct professional culture was unclear. An increased focus on future development of midwifery practice was proposed.

Progress in midwifery education and research has taken place. However, midwives’ current roles in practice as well as leadership and their influence on healthcare culture and politics are matters of concern. Future efforts for advancing professionalisation in Europe should focus on the challenges in these areas.

The authors thank the European Midwives Association (EMA) for supporting and facilitating the study. In particular, we thank the delegates from all associations in the 29 European countries for participating in this study and providing us with all available information.
The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
There was no source of funding for this research.
Not commissioned; externally peer reviewed.
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