Elsevier

Midwifery

Volume 62, July 2018, Pages 104-106
Midwifery

Midwifery in Iceland: From vocational training to university education

https://doi.org/10.1016/j.midw.2018.03.021Get rights and content

Highlights

  • An effective curriculum and continuous review are fundamental for quality maternity care and evidence based midwifery practice.

  • A university-based education in Iceland seems to have had impact on rate of home birth and strengthened midwives' role in primary care.

  • Icelandic curriculum reform with emphasis on midwife-led continuity of care has had limited influence within the hospital.

  • Research is needed on how midwifery education has impact on midwives´ scope of practice, facilitation of normal childbirth and reproductive health.

Abstract

Midwifery education is a foundation for health professionals’ competence in providing quality healthcare for the benefit of women, their families and society. This paper describes midwifery and the development of midwifery education in Iceland. It examines policy and extensive reforms, from hospital-based vocational training in midwifery to an academic university education, and the impact on the scope of midwifery practice in Iceland. The university-based programme, with its emphasis on autonomy of the midwife, seems to have affected the context of home birth and strengthened midwives’ role in primary healthcare. Education reform with a focus on evidence-based practice and midwife-led continuity of care has had limited influence within the hospital system, where the structure of care is fragmented and childbirth is under threat of increasing interventions. Research is needed on the role of education in supporting evidence-based practice, normal childbirth and reproductive health in the Icelandic context.

Section snippets

Background

Globally, within an evidence-informed framework for quality maternal and new-born care (QMNC), midwifery has been identified as a pivotal part of health systems for all childbearing women and their families (Renfrew et al., 2014). In Iceland, this has been the case for more than 250 years. In 1761, an educated midwife, Margarethe Christine Magnussen, came to Iceland from Denmark to teach midwifery based on guidelines from the first Country Doctor (now Directorate of Health).

Iceland has a

Structure of midwifery education in iceland

In 1964, midwifery education in Iceland was a two-year direct-entry vocational training programme. A nursing licence became the admission requirement from 1982 onwards, with midwifery students thus requiring five or six years to complete their studies, depending on whether the nursing education was a three-year diploma or a four-year BSc. In 1996, a new two-year post-nursing midwifery education programme (120 ECTS, European Credit Transfer and Accumulation System) was established in the then

The ‘new’ Icelandic midwifery curriculum development

The basis for the development of the new midwifery curriculum was a need to enhance midwifery knowledge and quality of maternity care with an aim to facilitate normal childbirth. A secondary aim of the curriculum building was to make a statement of midwifery ideology and identify the theoretical underpinning of midwifery as an independent healthcare discipline and a profession.

The model was originally developed in the context of cultural and historical traditions of midwifery and childbirth (

Discussion

In the last 20 years, there have been innovations and drawbacks in midwifery services, which have affected midwifery education. Attempts to provide midwife-led continuity-of-care services at the National University Hospital have eventually resulted in closure and an integrated midwife-led birth centre for normal births named ‘The Nest’ closed due to a combination of economic reasons and re-structuring of care. Thus, the Icelandic system of maternity care, not based on evidence, is fragmented

Conclusions and future considerations

An effective midwifery curriculum and continuous review are fundamental for quality maternity care. Revision of our programme has been in progress for some years in the Department of Midwifery, suggesting changes in admission requirements and implementation of a five-year direct-entry Master's programme. This was not accepted by the Councils of the Faculty of Nursing. Instead, a decision was made to develop the post-nursing two-year programme towards a full master's degree and a licence to

Funding sources

None declared.

Clinical trial registry and registration number

Not applicable.

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