Leading for two: A narrative review on leadership education in obstetric care

Effective leadership is essential for ensuring patient safety, enhancing teamwork and delivering high-quality care in obstetrics. Despite its crucial role, leadership training in obstetric care remains poorly understood and inconsistently implemented. This review synthesizes current evidence on how leadership is defined, taught and evaluated in obstetric settings, and explores the impact of leadership education on clinical and educational outcomes.

A narrative review was conducted through searches in PubMed, Scopus, Web of Science and complemented by manual screening. Studies were eligible if they focused on leadership models, training interventions or outcomes within obstetric settings. Both qualitative and quantitative research were included. Data were synthesized inductively following integrative review principles.

Of 489 records screened, 27 studies met inclusion criteria. Inadequate leadership was linked to communication failures, poor team dynamics and preventable maternal or neonatal harm. Training programs vary widely in format, duration and content. Multidisciplinary training is uncommon, and leadership integration into curricula remains limited. Structured leadership training was frequently associated with improvements in self-reported leadership skills and with better team performance in simulation; objective evidence of sustained behavioural change or demonstrable patient-level benefits in real clinical settings is currently limited.

Leadership training should be formally integrated into medical and midwifery education. Leadership can be taught and shows promise for improving team function in simulation and educational evaluations, but evidence of real-world clinical impact is scarce. Future research should prioritise multidisciplinary, longitudinal programmes and measure objective process and patient outcomes.