gms | German Medical Science

Background: According to Klemmt, professionalization has various characteristics based on the “feature theory approach” (merkmalstheoretischer Ansatz). Some of these features are already implemented or on their way to be implemented in a total of 29 European countries, according to an analysis on the state of professionalization of midwifery. For example, in most countries, progress in professionalizing midwifery had been made by moving education of midwives into higher education, combined with opportunities for postgraduate study and research. Features that fall within the realm of midwifery regulation are currently less of a focus of the professionalization debate. Specifically, these are professional and thematic autonomy in the practice of the profession, exclusive authorization/licensing in the practice of the profession, mandatory professional norms in the form of codes of ethics, as well as collegial self-regulation and the formation and establishment of an autonomous regulatory body. The latter point will be the focus of this paper.

Aim/question: Which possibilities and forms of establishing autonomous regulatory bodies in midwifery exist internationally? Can best practice examples be found among them and how can these be transferred to Germany?

Methodology: Within the framework of a policy analysis by means of document analysis, the international context of professional self-regulation was first considered based on the global standard for the regulation of the midwifery profession of the International Confederation of Midwives (ICM). Autonomous regulatory bodies (professional chambers, councils, boards) of different countries were measured against the ICM standard and best practice examples were examined for their transferability to the German (health) policy system.

Results: The Midwifery Council in New Zealand, as an autonomous regulatory body, implements all points of the ICM standard. The type and scope of midwifery practice (e.g. professional regulations) are defined by the Council, as are the competencies and regulations for education and training; the Midwifery Council organizes the obligatory registration/licensing and is responsible for compliance with re-licensing and thus the maintenance and expansion of competence. It regulates continuing professional education and has established a complaints system that can also impose sanctions. A binding code of conduct/professional ethics exists. The aim of the regulation is to protect the service users, which is why they are represented on the board of the Midwifery Council. A transfer to the German system is largely possible and could serve to strengthen the professionalization of midwifery.

Relevance: Midwives in Germany are on the path to professionalization. In addition to the academization that has already taken place, the focus can now be placed on the area of self-regulation and -governance.

Recommendations/conclusion: The establishment of an autonomous regulatory body to strengthen regulation and self-governance based on international standards is the next necessary step on the way to professionalization of midwifery in Germany.

Ethics and conflicts of interest: A vote on ethics was not necessary. The research was financed by own resources. There are no conflicts of interest.

The PDF file of the poster submitted for the meeting is available in German as Attachment 1 [Attach. 1].