PURPOSE:
To present the development and impact of the Second Edition National Consensus Framework for Rural Maternity Services, co-created by a coalition of key national maternity stakeholders and Government to address the urgent need for equitable, culturally safe, and sustainable maternity care in rural and remote Australia.

DISCUSSION:
This framework responds to the ongoing closure of rural maternity services and the resulting health inequities faced by rural and remote communities. It was developed through a collaborative process involving midwives, doctors, policy makers, Aboriginal and Torres Strait Islander health leaders, and consumer representatives. The framework reflects a shared commitment to respectful maternity care, continuity of care, and culturally responsive, place-based service design. It challenges reductionist models of care and instead promotes holistic, community-led approaches that value local knowledge, cultural safety, and multidisciplinary collaboration. The co-creation process itself exemplifies a model of inclusive leadership and shared vision, offering a replicable approach for other regions globally.

EVIDENCE WHERE RELEVANT:
The framework is grounded in national and international evidence, including WHO recommendations on respectful maternity care and midwifery continuity of care. It references over 40 sources and integrates findings from the 2023 Australian National Rural Maternity Forum and stakeholder consultations. Evidence supports that midwifery continuity of care improves outcomes for women and babies and enhances workforce retention.

KEY MESSAGE:
Achieving "One Million More Midwives" requires not only increasing workforce numbers but also creating environments where midwives can thrive. Collaborative, culturally safe, and community-led frameworks are essential to restoring and sustaining rural maternity services. Midwives are central to this transformation, and their leadership in co-designing care models is vital. Policy - professionalism