Is one midwife per birthing mother an achievable goal? Education and leadership pathways for midwifery models of care in the Middle East

Midwifery models of care (MoC), where midwives are the primary, continuous care providers across pregnancy, labor and the early postnatal period, are central to World Health Organization (WHO) guidance and are associated with fewer interventions and better maternal experiences compared to multi-professional teams. Yet in many Middle Eastern health systems, services remain obstetrician-led, midwifery education is uneven, and midwives' professional autonomy is constrained. This mini-review synthesizes recent global guidance and regional evidence to outline education and leadership styles for accelerating a transition to midwifery MoC, with a pragmatic case example from the United Arab Emirates (UAE). I clarify what "one-to-one midwifery care" means in practice, summarize outcome evidence for midwife-led continuity and continuous intrapartum support, highlight regional progress and gaps in education, regulation and leadership, and provide a transparent, scenario-based staffing calculation for achieving one-to-one intrapartum care in the UAE using births-per-midwife planning ratios widely applied in service design. I conclude with a concise leadership and education roadmap, curricular alignment with the International Confederation of Midwives/WHO standards, protected leadership roles in governance, regulatory modernization for autonomy, and significant workforce expansion, arguing that one-to-one midwifery care is achievable and cost-sensible if implemented via phased, education-led reform.