Bridging National and International Midwifery Regulations: A Thematic Analysis of Italian Key Documents, Desk Review, and Normative Mapping.

Abstract

This study investigates the Italian regulatory landscape shaping the delivery of midwifery care and the midwifery profession. The primary objective was to identify and map relevant national and regional regulatory documents. A secondary aim was to compare three core national documents-the Code of Ethics, the Professional Profile, and the Educational Curricula-with the Professional Framework for Midwifery developed by the International Confederation of Midwives (2021). The study is a qualitative, two-phase exploratory design combining deductive thematic analysis and structured policy document review. In Phase I, a deductive thematic analysis was conducted using the ICM framework to assess the thematic alignment between international and national midwifery standards. Phase II involved a structured desk review identifying 141 regulatory documents, which were analyzed and mapped based on scope, origin, and relevance to midwifery care. Phase I findings revealed both thematic convergence and significant gaps, particularly regarding competencies, professional autonomy, midwifery-led care, and the role of professional associations. Phase II results highlighted a fragmented and inconsistent regulatory framework across regions, with a lack of specificity in policies supporting midwifery-led models, especially in sexual and reproductive health. Additionally, linguistic ambiguity in how "midwifery" is framed in Italian legal texts limits the profession's visibility and distinctiveness. This study outlines current regulatory complexities and discrepancies, providing a foundation for future policy development that better integrates midwifery within Italy's healthcare system in alignment with international recommendations.