Professional independence of midwives: Analysis of determining factors

The professionalisation of the midwifery profession is a key process both from the perspective of the professional group itself and the quality of healthcare provided to women and their families. By definition, professionalisation is a collective strategy undertaken by a professional group to achieve recognised status and autonomy. The World Health Organisation (WHO) and the International Confederation of Midwives (ICM) emphasise the importance of education, legal regulations and strong professional organisations as pillars of this process. Despite global efforts, the pace of professionalisation is uneven – midwives in highly developed countries often function as independent specialists, while in many lower-income countries they lack access to formal education, licensing and systemic recognition. One of the most important indicators of professionalisation is professional autonomy, understood as the ability to make clinical decisions, provide continuous care and assume professional responsibility. The development of this autonomy is influenced by both systemic (legal, organisational) and psychosocial factors, including internal motivation, self-efficacy and the work environment. Generational differences also play an important role – younger generations of midwives (e.g. Generation Z) have higher expectations of autonomy and work-life balance, but also a higher risk of burnout and job insecurity. The aim of this article is to analyse the professional autonomy of midwives as a key factor in the professionalisation process, taking into account educational, psychological, generational and systemic conditions, with particular reference to the situation in Poland.