PURPOSE:
Within the framework of free movement in the European Union, midwives benefit from the automatic recognition of their professional qualifications, allowing them to practise across all member states. While this mobility-facilitating system is based on minimum training requirements, it does not reflect the profound disparities that exist in terms of education, practice, and professional identity across Europe.

DISCUSSION:
The length of training varies considerably—from three to six years—and educational pathways are highly heterogeneous. In some countries, midwifery is a nursing specialisation; in others, it is an autonomous medical profession, like in France. The scope of practice also differs: some midwives provide comprehensive sexual and reproductive healthcare, including pre-, peri-, and postnatal care, gynaecology, contraception, and the performance of voluntary terminations of pregnancy. Others work within a more limited framework, often under medical prescription.These differences, shaped by national histories and the specific needs of each healthcare system, are creating increasing challenges. A growing number of midwives trained in one country are practising in another—often in response to demographic pressures—without necessarily having the expected level of autonomy or the relevant competencies. As some states expand midwifery training and responsibilities to address public health priorities, the qualification gap continues to widen.

EVIDENCE WHERE RELEVANT:
This fragmented landscape raises concerns about safety and quality of care, as well as professional equity. It is now essential to move beyond current minimum standards and work towards true European harmonisation.

KEY MESSAGE:
This must be built on a strong common professional identity, a reinforced core of clinical competencies, and recognition of the central and autonomous role of midwives in the continuity of sexual and reproductive healthcare French - professional identity