Advanced midwifery practice: Considerations for an emerging global career structure

BACKGROUND: Advanced midwifery practice is gaining momentum as a means to improve maternal-infant outcomes, increase timely access to maternity care and improve workforce sustainability in diverse settings across the world. PROBLEM: From an international perspective, there is no standardised way of practising at an advanced level in the midwifery profession, nor is there a universally recognised definition of advanced midwifery practice. AIM: To describe the approach to advanced midwifery practice by different nations across the globe and consider what requirements, if any, are needed to ensure that midwives who practice at an advanced level do so in a holistically safe and consistent way. DISCUSSION: This paper further demonstrates the worldwide inconsistencies seen in the way midwives practice at what might be considered an advanced level. Noticeably, in regard to how practice is regulated, preparatory education requirements, and how advanced practice roles are remunerated. This questions whether a more unified approach may be required to reduce dissonance and promote a coherent, universal approach to advanced midwifery practice. CONCLUSION: Internationally, an open conversation about advanced midwifery practice is needed. This paper invites discourse at a global level concerning the role that advanced midwifery practice will play, and how this should unfold - for now and into the future.