BACKGROUND:
In the context of primary healthcare reform in Ukraine, the implementation of midwife-led models of care is becoming increasingly relevant. The success of such changes depends on the individual readiness of midwives to expand their scope of practice. Changes that are internally accepted at the individual level are significantly easier to implement — making this area of study crucial for sustainable health system transformation.

OBJECTIVES:
A quantitative survey was conducted among 202 midwives working in outpatient health care settings in Ukraine. The instrument included two validated scales — the Acceptance of Change Scale and the Resistance to Change Scale — along with open-ended questions. The analysis included descriptive statistics, bivariate correlations, and multivariate regression.

METHODS:
A quantitative survey was conducted among 202 midwives working in outpatient health care settings in Ukraine. The instrument included two validated scales — the Acceptance of Change Scale and the Resistance to Change Scale — along with open-ended questions. The analysis included descriptive statistics, bivariate correlations, and multivariate regression.

RESULTS:
Most respondents (74%) expressed readiness to provide autonomous care. Higher readiness was reported among those with prior experience or support from facility leadership. Identified barriers included: unclear legal framework, fear of mistakes, lack of patient referral protocols, and limited access to training. Qualitative analysis of responses emphasized the need for mentorship and interprofessional collaboration.

CONCLUSIONS:
Ukrainian midwives demonstrate strong potential for role expansion when supported appropriately. The findings may inform the development of educational programs, regulatory adjustments, and strategic policies in primary healthcare.

KEY MESSAGE:
Midwives in Ukraine are ready to expand their roles and provide autonomous care, but success requires systemic support — including clear protocols, ongoing training, and mentorship — to translate this readiness into practice. Midwife autonomy (including three-minute presentation competition)