Transitioning to midwifery models of care: An evidence-based imperative for sexual and reproductive health

Progress in reducing preventable maternal and newborn mortality, morbidity, and stillbirths has stalled globally, highlighting fundamental limitations in prevailing maternity care models. Despite substantial investment, many systems remain fragmented, overly medicalised, and insufficiently respectful, with widespread reports of mistreatment and unnecessary interventions that compromise quality of care and women's experiences. This Editorial argues that transitioning to midwifery models of care is an evidence-based imperative for advancing sexual and reproductive health and achieving Sustainable Development Goals 3.1 and 3.2. Midwifery models-particularly continuity of midwife care-prioritise person-centred, respectful, and relationship-based care, support physiological processes, and reserve interventions for clinical need. Robust evidence demonstrates that these models improve maternal and newborn outcomes, reduce obstetric interventions and mistreatment, enhance women's satisfaction, and are cost-effective. Global agencies have increasingly endorsed midwifery models as central to universal health coverage and health equity, yet implementation remains constrained by hierarchical systems, restrictive regulations, and underinvestment in the midwifery workforce. This Editorial calls for sustained political commitment, enabling policy and regulatory frameworks, strengthened midwifery leadership, and meaningful engagement with women and communities. Aligning maternity services with midwifery models of care is both an ethical obligation and a practical pathway to improving outcomes and experiences for women, newborns, and families worldwide.