"United in diversity?" A comparative study of initial midwifery education and practice in 30 European countries

To explore initial midwifery education and scope of professional practice across Europe.

Free movement of professionals is a core value of the European Union, enabling midwives to practice across European countries. The European Directives established minimum standards for midwifery education. However, various health care delivery crises may challenge professional competencies and legal responsibilities.

An exploratory research design was used to obtain overall insight into various issues not well understood about midwifery education and practice in European countries.

A semi-structured questionnaire allowed comparisons between countries to be made using descriptive statistics and descriptive qualitative analysis.

Thirty of 32 invited countries responded. Data showed variations in midwife density and an aging profile. Bachelor-level was the principle educational model, with programme length and ECTS varying considerably. Substantial heterogeneity was observed in curricula and in the balance between theory, skills, and clinical practice. Content frequently extended European Directives, particularly in public health, evidence-based practice, and reproductive health. Most countries considered competency targets achievable, 37% reported difficulties-especially in numbers of births and suturing. Shortfalls were addressed through simulation or clinical placement solutions.

European midwifery education has advanced considerably since the introduction of the European Directives. However professional regulation, clinical requirements, and workforce governance remains uneven across countries. Variations in educational models highlight gaps between educational development and practice realities. Developing a competency-based European framework that includes emerging areas of practice, alongside strengthened professional registers and leadership competencies, could support mobility, patient safety and workforce sustainability.