This petition raises urgent concerns about proposed changes to the regulation of midwifery in Greece that would significantly limit midwives’ ability to support normal, physiological birth.

This petition is addressed to the Greek Ministry of Health and relevant regulatory authorities responsible for midwifery and maternity care policy.

In a country already experiencing some of the highest rates of medical intervention in childbirth in Europe, these changes risk taking maternity care backwards—reducing women’s choices, weakening informed consent, and undermining safe, evidence-based care for families.

Add your name. Support evidence. Protect midwifery. Safeguard birth.

Maternity care in Greece is characterised by one of the highest levels of medicalisation in Europe, with caesarean section rates consistently exceeding international benchmarks and World Health Organization (WHO) recommendations (WHO, 2015). Despite strong international evidence supporting physiological birth and midwife-led models of care for low-risk pregnancies, such approaches remain marginalised within the Greek healthcare system.

Proposed revisions to the professional framework regulating midwifery in Greece would further restrict core midwifery competencies, including the independent conduct of physiological (normal) birth and prescribing authority. These competencies are internationally recognised as essential components of safe, effective midwifery practice (ICM, 2019).

This issue has significant implications for public health and clinical governance. Extensive evidence demonstrates that midwife-led continuity and autonomous midwifery care are associated with reduced rates of unnecessary obstetric interventions, including caesarean sections, without compromising maternal or neonatal outcomes (Sandall et al., 2016). Conversely, excessive medicalisation of childbirth in the absence of clinical indication is associated with increased maternal morbidity and reduced patient satisfaction.

Informed consent and shared decision-making are central ethical and legal principles of modern healthcare. However, reports from Greece indicate that these standards are not consistently met in maternity care, particularly in relation to interventions such as induction of labour, augmentation, continuous electronic fetal monitoring, episiotomy, and caesarean section. Such practices diverge from evidence-based guidelines issued by international and European bodies, including NICE and WHO (NICE, 2021; WHO, 2018).

Restricting midwifery autonomy in this context represents a regression rather than a solution. It reinforces a medically led, intervention-driven model of birth that conflicts with contemporary evidence-based maternity care frameworks implemented across the United Kingdom and the European Union.

At a policy level, this approach also contradicts Greece’s stated commitment to attracting and retaining highly trained healthcare professionals from abroad (“brain gain”). Midwives returning with international education and clinical experience face professional restrictions that limit their ability to practise in accordance with evidence-based standards, undermining workforce development and system improvement.

This petition calls for:

1. Legal protection of core midwifery competencies in Greece

2. Alignment of maternity care policy with WHO, ICM, and EU evidence-based standards

3. Recognition of midwifery as a regulated, autonomous profession essential to safe maternity care

4. Systematic safeguarding of informed consent, shared decision-making, and women’s reproductive rights

Ensuring high-quality maternity care is a matter of public health, human rights, and scientific integrity. Policies that undermine midwifery autonomy undermine all three.

References

• World Health Organization. (2015). WHO Statement on Caesarean Section Rates.

• World Health Organization. (2018). WHO recommendations: intrapartum care for a positive childbirth experience.

• International Confederation of Midwives. (2019). Global Standards for Midwifery Education and Essential Competencies for Midwifery Practice.

• Sandall, J., Soltani, H., Gates, S., Shennan, A., & Devane, D. (2016). Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews.

• National Institute for Health and Care Excellence (NICE). (2021). Intrapartum care for healthy women and babies.