The current legislative framework hinders implementation of midwife-led models of care: South African context

Background: The midwife specialists’ training was introduced in South Africa in 1980. The healthcare landscape in South Africa presents a critical challenge in maximising the potential of highly trained midwife specialists. Despite significant investments in advanced midwifery education and training, existing practice regulations continue to create substantial barriers to midwife-led models of care that prevent these skilled professionals from fully utilizing their extensive knowledge and expertise in primary caregiving and autonomous practice. Objectives: The purpose of the study is to examine how the current legislative framework in South Africa is creating barriers that prevent midwife specialists from implementing midwife-led models of care. Methods: A qualitative, descriptive, and exploratory research design was followed. Sixteen purposefully sampled midwife specialists participated in the focus group discussions, which were held virtually via Microsoft Teams and recorded. The recordings were transcribed verbatim, and data were analysed using Collaizi’s descriptive method based on the emerging themes and categories. Results: Three themes emerged detailing how the current legislative framework hinders the implementation of midwife-led models of care. Theme one highlights the regulatory Constraints on Midwife Specialists’ Practice. Theme two elucidates the apparent disconnect between advanced training and regulatory Frameworks. Lastly, theme 3 highlighted the systemic implications of these legislative barriers for healthcare delivery and the professional identity of midwife specialists. Conclusions: The study focused on the disconnect between the advanced training provided to midwife specialists and the regulatory environment that limits their ability to practice to the full extent of their capabilities and training.