Sustaining the quality of midwifery practice in Belgium: Challenges and opportunities for advanced midwife practitioners

Abstract

Background: Midwifery practice is essential in achieving high-quality maternal and newborn care in all settings and countries. However, midwifery practice has become more complex over the past decades. Considerable demands are being placed on midwives to meet increasing epidemiological, socio-economic, and technological challenges. These require a well-trained midwifery workforce ready to shape the care in the near and long-term future.

Objective: To discuss advanced midwife practitioner role implementation in Belgium as a possible answer to healthcare-related challenges that impact midwifery practice. Furthermore, to stimulate a debate within the profession at all levels in Belgium and in countries considering advanced midwife practitioner roles.

Method: The framework by De Geest et al. (2008) served as a basis for discussing the drivers for advanced midwife practitioner role implementation: the legal, policy and economic context, workforce issues, education, practice patterns, and healthcare needs of the population.

Findings: A legal basis for advanced midwife practitioner role implementation is lacking in Belgium. Remuneration opportunities for the non-clinical part of these roles (e.g. leadership and innovation activities) are missing. It might be challenging for healthcare organisations to support the implementation of such roles, as immediate revenues of non-clinical activities are absent. However, sufficient potential resources are available to fill in future advanced midwife practitioner positions. Additionally, advanced midwife practitioner specific master programmes are being planned in the near future.

Conclusions: Although several barriers for the implementation of advanced midwife practitioner roles were identified, a discussion should be held on the opportunities of implementing these roles to facilitate the development of new models of care that meet current and future challenges in midwifery practice and healthcare. After initial discussions amongst midwives in academic, managerial, and policy positions, stakeholders such as obstetricians, general practitioners, associations representing healthcare organisations, and policy makers should be involved as a next step.

Keywords: Advanced midwifery practice; Midwifery; Role implementation.