PURPOSE:
To define the professional role of the midwife in supporting women with urogenital complaints in outpatient settings, based on Estonian legislation, international ICM recommendations, and scientific literature.

DISCUSSION:
Women with urogenital complaints—such as dyspareunia, vaginal dryness, urinary incontinence, urgency, or postcoital infections—often consult either gynaecologists or urologists, receiving fragmented, symptom-focused care within narrow specialities. However, these conditions require comprehensive assessment, counselling, and consistent follow-up that considers individual factors. Midwives in Estonia are authorised to provide care for such conditions within their professional scope. They can offer structured support focused on quality of life, behavioural counselling, and clinical evaluation. Their responsibilities include pelvic health assessment, interpretation of basic tests, and prescribing certain medications, including local antibiotics and antifungal agents. When necessary, they refer to other healthcare professionals. This integrative approach allows midwives to bridge gaps between specialities and support women with persistent or recurring urogenital symptoms.

EVIDENCE WHERE RELEVANT:
This theoretical analysis is based on Estonian legal and regulatory documents (e.g. Health Services Organisation Act, ministerial guidelines for midwifery services), national midwifery development strategies, and international frameworks including ICM Essential Competencies (2019). A literature review was conducted (PubMed, 2015–2025) using keywords such as: Midwifery, Urogynecology, Pelvic floor dysfunction, Dyspareunia, Urinary incontinence, Recurrent urinary tract infections, Primary health care, Midwife-led care.

KEY MESSAGE:
Midwives can play a key role in the primary assessment, support, and counselling of women with urogenital symptoms, particularly in cases where urgent medical intervention is not required. Expanding this role within the existing legal framework—combined with targeted training and interdisciplinary collaboration—can improve access to care, enhance women’s quality of life, and reduce the burden on the healthcare system. The development of dedicated guidelines for midwives and targeted educational programmes is recommended to better integrate urogynecological support into routine midwifery practice. Marginalized - refugees 2