This study aimed to examine the normative and policy frameworks influencing midwifery care delivery in Italy, generating insights to inform strategies for strengthening the recognition, role, and capacity of midwifery within the Italian health system. An interpretative approach, guided by Walt and Gilson's Policy Analysis Triangle, including actors, context, process, and content, was used to analyse 141 European, national, and regional documents related to Italian midwifery. The analysis shows that despite formal recognition as a profession, Italian midwives operate in a context that remains only partially professionalized, shaped by historical, social, and institutional influences. Three interrelated characteristics of the Italian maternity care landscape were identified: a persistent biomedical and risk-oriented paradigm, a technocratic approach to childbirth, and a hierarchical professional structure prioritizing obstetric-led models of care. These factors collectively constrain the recognition of diverse care models, limit midwives’ autonomy and professional visibility, and shape the choices available to childbearing individuals. The study concludes that comprehensive, multilevel strategic interventions are essential to advance midwifery in Italy and ensure care provision aligns with international standards. By situating midwifery within the broader sociopolitical and regulatory ecosystem, the study offers insights into cultural and institutional determinants of care delivery and highlights areas for future research, advocacy, and professional development aimed at promoting high-quality, accessible, and person-centered midwifery services.
Barbieri et al. (Wed,) studied this question.
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