BACKGROUND:
Midwives are crucial to improving maternal and neonatal outcomes, with midwifery-led care proven to reduce unnecessary interventions and empower women. Yet, across Europe, systemic and cultural challenges continue to hinder midwives’ full adherence to global standards like the International Confederation of Midwives (ICM) Essential Competencies. This study explores midwives’ perspectives on how the competencies are applied within diverse European health systems and regulatory contexts.

OBJECTIVES:
Specific objectives include conducting interviews in one country per region, analysing participants’ experiences of adherence and its impact on practice and autonomy, and performing thematic analysis to identify commonalities, and differences, barriers, and enablers.

METHODS:
In 2024, an explorative qualitative study gathered perspectives from 10 midwives in the UK, Germany, Belgium, Bulgaria, and Italy. Purposive sampling ensured diverse representation of midwives working within national regulatory frameworks and practising independently. Semi-structured interviews provided rich insights into competencies’ adherence, with thematic analysis revealing key trends. Participant confidentiality was ensured.

RESULTS:
The study identified universal challenges, including societal undervaluation, workforce strain, and restrictive legislations, alongside regional differences such governance barriers and unregulated out-of-hospital births. Benefits to adherence included enhanced autonomy and opportunities for international collaboration. Key themes encompassed two domains of internal dynamics, including relationship-centred care, theory-practice gap, professional collaboration and external dynamics like medicalisation, inequitable access to care, and power imbalances. Proposed strategies included strengthening legal frameworks, fostering academic and political support, enhancing professional standing within society and healthcare.

CONCLUSIONS:
This study highlights the pressing need to address cultural and structural barriers to aid ICM competencies adherence across Europe. Urgent collaboration among policymakers, educators, and midwives is essential to create enabling environments that promote professional growth, preserve autonomy, and improve maternal outcomes.

KEY MESSAGE:
ICM Essential Competencies are felt by midwives across Europe as a foundation to enable them to provide safe, autonomous care and improve professional standing, job satisfaction and growth. Poster session 3 (Group B)