Preserving professional distinction: The risk of merging nurses and midwives and the imperative to strengthen both professions – A commentary

TY - JOUR

T1 - Preserving professional distinction

T2 - The risk of merging nurses and midwives and the imperative to strengthen both professions – A commentary

AU - Bogren, Malin

AU - McFadden, Alison

AU - Jha, Paridhi

AU - Erlandsson, Kerstin

N1 - Publisher Copyright: © 2025 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/

PY - 2025/11/13

Y1 - 2025/11/13

N2 - Nurses and midwives are foundational to resilient health systems and achieving Universal Health Coverage, yet global policies often fail to reflect their distinct competencies, regulatory frameworks, and contributions. As the International Standard Classification of Occupations (ISCO) undergoes revision, a proposed sub-category—“nurse-midwives” under Midwifery Professionals—risks conflating these two professions. This commentary argues that such a classification threatens the integrity of health workforce data, undermines midwifery-led models of care, and compromises efforts to meet global targets for sexual, reproductive, maternal, newborn, and adolescent health. Drawing on the latest State of the World’s Nursing and Midwifery reports, we demonstrate how misclassification inflates midwifery coverage estimates and obscures persistent shortages. Furthermore, merging professions risks diminishing the autonomy and unique philosophy of midwifery, promoting over-medicalised care and diverting critical resources. We call for the preservation of nursing and midwifery as distinct, equally essential professions—each deserving of separate investment, regulation, and recognition. Only through accurate classification can we ensure accountable workforce planning, protect midwifery’s unique contributions, and advance person-centered, gender-equitable health systems worldwide.

AB - Nurses and midwives are foundational to resilient health systems and achieving Universal Health Coverage, yet global policies often fail to reflect their distinct competencies, regulatory frameworks, and contributions. As the International Standard Classification of Occupations (ISCO) undergoes revision, a proposed sub-category—“nurse-midwives” under Midwifery Professionals—risks conflating these two professions. This commentary argues that such a classification threatens the integrity of health workforce data, undermines midwifery-led models of care, and compromises efforts to meet global targets for sexual, reproductive, maternal, newborn, and adolescent health. Drawing on the latest State of the World’s Nursing and Midwifery reports, we demonstrate how misclassification inflates midwifery coverage estimates and obscures persistent shortages. Furthermore, merging professions risks diminishing the autonomy and unique philosophy of midwifery, promoting over-medicalised care and diverting critical resources. We call for the preservation of nursing and midwifery as distinct, equally essential professions—each deserving of separate investment, regulation, and recognition. Only through accurate classification can we ensure accountable workforce planning, protect midwifery’s unique contributions, and advance person-centered, gender-equitable health systems worldwide.

KW - Midwifery

KW - Nursing

KW - Health Workforce

KW - Health policy

KW - Health Policy

UR - https://www.scopus.com/pages/publications/105024202847

U2 - 10.1016/j.srhc.2025.101167

DO - 10.1016/j.srhc.2025.101167

M3 - Comment/debate

C2 - 41248597

SN - 1877-5756

VL - 46

SP - 1

EP - 3

JO - Sexual and Reproductive Healthcare

JF - Sexual and Reproductive Healthcare

M1 - 101167

ER -