From tradition to transformation: The global journey of midwifery
May 22, 2025
Having a baby is the same everywhere around the globe, yet midwifery varies significantly around the world due to a complex interplay of cultural traditions, healthcare systems, economic resources, and government policies. In some countries, midwives are the cornerstone of maternal care, deeply respected and fully integrated into the health system. In others, they may have limited recognition, training, or support. These differences influence everything from the role midwives play in childbirth, to the level of autonomy they have, to the type of care women receive during pregnancy and birth. Understanding these variations offers valuable insight into global health disparities and the need for greater investment in maternal care worldwide.
This week, as we celebrate International Day of the Midwife, whilst the core role of midwives, to support women through pregnancy, childbirth, and the postnatal period, remains consistent, it’s interesting to explore how widely the delivery of this care is differs around the world:
Professional status and regulation
In some countries, midwifery is highly regulated, for example Australia, New Zealand and the UK. In these countries, midwifery is an autonomous, licensed profession and midwives are trained through degree programs, need to be registered, and are fully integrated into the health system.
In other less regulated or informal arrangements, on for example, parts of Africa, South Asia and Latin America, traditional birth attendants (TBAs) often play midwifery roles without any formal education or licensure. Some receive training from NGOs or ministries of health but are less likely to be officially recognised.
Models of Care
In a model of midwife-led care, prevalent in countries like New Zealand, Sweden and the Netherlands, midwives manage most low-risk pregnancies and births independently, often outside of hospitals, at home or in birth centres.
In physician-dominated systems, in for example the United States, South Korea and many Latin American countries, obstetricians oversee most births, with midwives often working only in certain settings like community clinics.
In the shared or dual model, the most common approach in Australia and Canada, women can choose between midwife-led or doctor-led care, with midwives increasingly integrated into hospitals and maternity units.
Cultural practices and levels of integration
In many indigenous and rural communities, especially in countries like Mexico, India and many places across Africa, traditional practices are most prevalent. Midwifery remains deeply tied to cultural rituals, herbal medicine, and spiritual beliefs. In countries like Guatemala and Peru, traditional midwives hold sacred status in many Indigenous cultures. Birth is seen as a spiritual transition, and midwives may use rituals involving herbs, massage, and prayer. Midwives are also honoured during Mother’s Day celebrations recognising their contribution to the community and motherhood specifically.
By contrast, in countries like Australia, a medicalised approach is the only approach, and birth is treated as a medical event. C-sections and hospital births are common, limiting midwives’ autonomy but maximising health outcomes for both mother and child.
Religion can also impact the role of a midwife. In many Islamic countries for example, female midwives are essential for maintaining cultural modesty during childbirth and the midwife’s role is often intertwined with religious rituals, such as reciting prayers or ensuring the baby hears the call to prayer after birth.
In some cultures, midwives are honoured through naming ceremonies, community feasts, or being given special status as “mothers to all.”
Birth Settings
Home and birth centre births are extremely common in some countries, notably the Netherlands and Japan, with many births occurring outside hospitals under midwife supervision, with strong systems for hospital transfer if required. Japanese midwifery places emphasis on a non-interventionist, holistic approach, often in birth centres or at home. Midwives (josan-shi) are recognised as licensed professionals with a strong focus on natural childbirth and emotional support.
In other places, notably, the US, South Korea, the UAE and Australia, most births occur in hospitals, and midwives often work with obstetricians or within hospital policies.
Despite the differences and nuances in the role of the midwife, there are some common and shared global themes, not least that midwives are deeply respected for their wisdom, trust, and nurturing presence. They are often recognised during birth ceremonies, community events, or public health days, or even through events like this week’s International Day of the Midwife, and there’s a growing global movement to blend traditional knowledge with clinical expertise, recognising both cultural value and health outcomes.
Image credit: WaterAid and Shahriar Rupam
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Not every bad week means you need a new job. But not every comfortable job is one you should stay in. Sometimes the signs are obvious. You've stopped enjoying the work, there's nowhere left to grow, or an opportunity comes along that's simply too good to ignore. More often, it's less clear. The job is fine. You like the people. You know what you're doing. You're comfortable. But somewhere in the back of your mind is the question: Is it time for something else? Instead of simply asking "Do I want to leave?" , it can be more useful to ask: "Is staying still the right decision for my career?" Here are five questions to help you decide. Am I still learning? Career progression doesn't always mean a promotion or a bigger title. You might be developing new capabilities, dealing with more complex challenges, working with people you can learn from or gaining experience that will open doors later. Ask yourself: What can I do now that I couldn't do 12 months ago? What am I learning in this role today? What will I be better at 12 months from now if I stay? There's nothing wrong with being good at your job. But being comfortable and continuing to grow aren't always the same thing. Is there genuinely somewhere for me to go? It's easy to stay because of what might happen. "There could be an opportunity next year." "My manager has said I'm next in line." "They're talking about creating another position." Sometimes those opportunities materialise. Sometimes another year passes, and you're having exactly the same conversation. If your reason for staying relies heavily on a future opportunity, find out how real it is. What needs to happen? What's the likely timeframe? What do you still need to demonstrate? There is a difference between potential and wishful thinking . What is staying costing me? When we're considering a move, we naturally think about the risks of leaving. What if I don't like the new organisation? What if the role isn't what I expected? What if I leave a great team? They're sensible questions. But what about the risk of staying? If you remain where you are for another two years, what might you not experience? Perhaps it's leading a larger team, gaining new expertise, working in a different environment or taking on greater responsibility. Every career decision has an opportunity cost. Don't only ask: “What might I lose if I leave?” Ask: "What might I miss if I stay?" Am I moving towards something or simply away from something? A frustrating job can make almost any alternative look attractive. Before making a move, separate what you're trying to get away from, and what you're trying to move towards . You may want to escape poor leadership, excessive workload or limited progression. But what do you actually want instead? More responsibility? Better leadership? Greater flexibility? A different clinical environment? More autonomy? A new challenge? Knowing what you're moving towards makes it much easier to assess whether another opportunity is genuinely better or simply different. What would need to change for me to stay? Before deciding the answer is another job, ask: What would need to change for me to happily stay here for another two years? Perhaps you need more responsibility, greater flexibility, better development opportunities or a clearer progression path. Then ask: Have I actually asked for it? We can spend months becoming increasingly dissatisfied with something we've never had a direct conversation about. Not every problem can be solved. But before leaving a good organisation, it's worth finding out whether what you're looking for elsewhere could exist where you already are. You don't need to resign to explore the market Talking to a recruiter doesn't mean you've decided to leave. Looking at opportunities doesn't mean you're disloyal. And going to an interview doesn't mean you have to accept the job. Sometimes exploring the market is simply good career management. What opportunities are available? What are employers looking for? How is your experience valued? What could your next step realistically look like? You may discover an opportunity that excites you. Or you may discover that staying exactly where you are is the right decision. Either way, you've made that decision with better information. There is no rule that says you should change jobs every two, three or five years. Sometimes staying is the best career move you can make. Sometimes leaving is. The important thing is that neither happens simply by default. So perhaps the question isn't: "Should I stay or should I go?" It's: "Which decision puts me in a better place two or three years from now?"
When people start thinking about their next job, they often begin with a list. Better salary. Bigger title. More flexibility. Shorter commute. Different organisation. All perfectly reasonable things to want. But there's another question worth asking before you start scrolling through job ads: What does my next job actually need to give me? Because a new job isn't necessarily a good career move. Start with what you need, not what's available It's easy to become reactive when you're looking for a new role. You see an interesting position. A recruiter calls. Someone in your network mentions an opportunity. Suddenly, you're assessing whether you want that particular job. Try doing the thinking before the opportunity appears. Ask yourself what you want your next role to give you that your current one doesn't. It might be: greater responsibility exposure to a new area better leadership more autonomy an opportunity to lead greater flexibility a different clinical environment better remuneration new skills or experience a clearer path to where you ultimately want to go Once you know what you're looking for, it becomes much easier to recognise the right opportunity, and say no to the wrong one. Think More, Less and New A simple way to get clearer is to divide a page into three columns: MORE — LESS — NEW What do you want more of in your next role? What do you want less of? And what do you want that is completely new ? Your answers don't need to sound impressive. You might want more challenging work but less travel. More responsibility but fewer direct reports. More patient contact. Less bureaucracy. More flexibility. A new speciality or environment. The point is to understand what matters to you before someone else starts selling you an opportunity. Separate your wants from your non-negotiables . Not everything on your list carries equal weight. There are things that would be nice to have, and there are things a role genuinely needs to provide for it to work. For example, flexibility may be a preference for one person and a non-negotiable for another. The same applies to salary, location, hours, travel, development opportunities and organisational culture. Try dividing your criteria into three categories: Must have: I wouldn't take the role without this. Important: This would strongly influence my decision. Nice to have: I'd value it, but I could compromise. This becomes particularly useful when you're comparing two opportunities and neither is perfect. Look beyond the job title A bigger title can feel like progression. It isn't always. Likewise, a sideways move can look like a lack of progression when it may actually give you experience that dramatically expands your future options. Look beyond what the job is called. What will you be responsible for? What problems will you get to solve? Who will you work with and learn from? What will you be exposed to? What will you be able to say you've done after two years that you can't say today? Sometimes the best career move doesn't look like a promotion on paper. Think one move beyond the next move This is one of the most useful questions you can ask about any opportunity: What could this role make possible afterwards? You don't need to have the next ten years mapped out. Careers rarely work that neatly. But your next role will shape your experience, network, reputation and future options. Imagine you take the job and stay for three years. What will you have learned? What will you have achieved? What sort of opportunities might you be considered for next? A role that looks attractive today isn't necessarily a great move if it takes you further away from where you ultimately want to go. Use the interview to assess them too Once you're clear about what you need from your next job, interviews change. You're no longer simply trying to convince the organisation to hire you. You're gathering evidence about whether you should choose them . If development matters, ask how people in the team have progressed. If leadership matters, ask your prospective manager how they lead and what they expect from their team. If autonomy matters, ask how decisions are made. If flexibility matters, find out what it looks like in practice rather than relying on what's written in the job advertisement. Good candidates don't just prepare answers. They prepare questions that help them make a good decision. Give your recruiter something to work with "I'm looking for my next challenge." "I'd like something more senior." "I'm open to opportunities." A recruiter can work with those statements, but they don't tell them very much. Compare that with: "I want my next role to give me broader leadership responsibility and exposure to service strategy. I'm happy to consider a lateral move if it gives me that experience, but flexibility is important to me." Now your recruiter has something meaningful to work with. The clearer you are about what you're looking for, the easier it is for them to bring you opportunities that actually fit. Don't just find another job It's tempting to judge an opportunity by comparing it with the role you have now. Is the salary better? Is the title better? Does the organisation sound more interesting? But your current job shouldn't be the only benchmark. Before you make your next move, ask: What do I need this job to give me? What will I be able to do, know or demonstrate because I've taken it? And what could it make possible next? The goal isn't simply to find a better job. It's to make a better career move.
Why Good Candidates Give Bad Interviews You can be exceptionally good at what you do and still be surprisingly bad at talking about it. It happens all the time in interviews. A highly capable candidate walks into the room with years of experience, strong technical expertise and a track record of delivering results. Yet they walk out having failed to convince the interview panel that they are the right person for the role. Meanwhile, another candidate with similar, or sometimes less, experience gives a stronger interview and gets the offer. It can feel unfair. But there is an important distinction candidates often overlook: Being good at your job and being good at communicating your value are two completely different skills. An interview isn't a test of whether you can do the job. It is a short window in which you need to give the interviewer enough evidence to confidently believe that you can. And that's a skill you can learn. Your experience doesn't speak for itself One of the biggest mistakes experienced candidates make is assuming the interviewer will recognise the significance of what they've done. We think: It's on my resume. They know my industry. Surely they understand what was involved. Don't make them join the dots. Your job in an interview is to make it easy for someone to understand three things: What did you do? Why did it matter? What changed because of it? Compare: "I was responsible for implementing a new rostering system across the service." with: "We were experiencing significant rostering issues that were affecting both staff and service delivery. I led the implementation of a new system, including engaging the clinical teams, addressing resistance and managing the transition. Within six months, we'd significantly reduced unfilled shifts and had much greater visibility of workforce requirements." The second answer gives us something the first doesn't: evidence . You don't need to turn every answer into a five-minute case study. You simply need to stop assuming that your job title or responsibilities demonstrate your capability. Stop telling them what "we" did Healthcare and medical environments depend on teamwork, so it's understandable that candidates frequently talk about what we achieved. "We introduced…" "We changed…" "We managed…" "We achieved…" There is nothing wrong with acknowledging the team. In fact, claiming sole credit for a genuinely collective achievement can work against you. But the interviewer is hiring you . They need to understand your contribution. Try: "The team achieved X. My responsibility within that was Y, and the part I specifically led was Z." That one change can make an enormous difference to the quality of an interview answer. Don't bury your answer Another common problem is giving far too much context. The interviewer asks: "Tell me about a time you had to manage a difficult stakeholder." Seven minutes later, the candidate is still explaining the organisational structure. Context matters. Too much context kills an answer. A useful rule is: Give me enough background to understand the problem, then get to what you did. If you find yourself explaining every person, meeting and event that led to the situation, you're probably giving too much detail. Try using the STAR methodology: Situation → Task → Action → Result Keep the situation and task short. They are merely there to provide context. Spend most of your time on the action and result . That's where the evidence of your capability lives. Build an evidence bank, not a list of interview answers One of the best ways to prepare for an interview is not to predict 30 questions and write 30 answers. Instead, build an evidence bank . Before the interview, identify six to eight strong examples from your career that demonstrate different aspects of your capability. For example: a difficult problem you solved a significant change you led or contributed to a time you influenced someone without having authority over them a challenging stakeholder or relationship you managed a mistake or setback and what you did next an improvement you initiated a situation where you had to make a difficult decision an example of measurable impact you delivered For each example, know the problem, your role, what you did, the result and what you learned . One strong example can often be adapted to answer several different interview questions. That means you're not memorising scripts. You're becoming familiar with your own evidence. And that tends to make you sound far more natural. Put some numbers around your experience Numbers make experience tangible. You don't need to have increased revenue by 300% or managed a multimillion-dollar transformation. Depending on your role, useful measures might include: team size patient or client numbers budgets caseloads geographical coverage timeframes reduction in vacancies improvements in retention waiting times efficiency improvements service growth compliance or quality measures Compare: "I managed a multidisciplinary team." with: "I managed a multidisciplinary team of 35 across three locations." Immediately, we understand more about the complexity of the role. Before your interview, go through your examples and ask: Where can I quantify this? How can I make my example more tangible? Learn to talk about yourself without feeling like you're boasting This is particularly difficult for candidates who are naturally modest. They worry that talking about achievements will make them sound arrogant, so they soften everything. "I was lucky enough to…" "I only played a small part…" "It wasn't really just me…" Humility is a strength. Making yourself invisible isn't. There is a difference between taking appropriate credit and taking all the credit . You can say: "I led the project, and its success depended heavily on the clinical teams who implemented the changes." Both things can be true. An interview is one of the few situations where someone is explicitly asking you to explain what you're good at. Let them hear it. Answer the question they actually asked When we're nervous, we're often listening for a keyword rather than listening to the whole question. We hear "conflict" and launch into our prepared conflict story. But perhaps the interviewer asked how you prevented a conflict from escalating rather than how you resolved one. Those are different questions. It's perfectly acceptable to pause before answering. You can even say: "Let me think about the best example for that." Three seconds of silence will feel much longer to you than it does to the interviewer. And if you're unsure whether you've answered the question, finish with: "Does that give you what you were looking for, or would you like me to go into more detail?" Put your answers to the test When you're preparing for your next interview, take each of your examples and ask yourself: Will the interviewer understand what I did, why it mattered and what changed as a result? If the answer isn't immediately obvious, keep working on the example. Better still, practise saying it aloud. What sounds clear in your head can sound very different when you actually have to articulate it. Ask better questions The interview doesn't suddenly stop being an interview when they ask: "Do you have any questions for us?" The questions you ask tell the panel a great deal about how you think. Instead of relying only on questions about process, consider questions such as: "What would you most like the person coming into this role to change or improve?" "What would success look like after 6-12 months?" "What's the biggest challenge the team is facing at the moment?" "What tends to distinguish the people who are really successful in this organisation?" "If I joined, what would you want me to understand quickly?" Their answers also give you something equally important: information to help you decide whether you want the job. Because an interview isn't only about being chosen. It's about making a good career decision yourself. Make it easy for them to choose you Great interviews aren't necessarily delivered by the most charismatic candidates. They're delivered by candidates who make it easy for the interviewer to understand what they can do, how they think and what they could bring to the role. Your experience matters. Your expertise matters. Your achievements matter. But in an interview, none of those things can be left to speak for themselves. Your interviewer shouldn't have to work hard to discover why you're a great candidate. Give them the evidence they need to see it.
