Our Search Pack of the Month for March, commemorating International Women’s Day, brings together research exploring how gender dynamics shape maternity care.
Sunday 8 March marks International Women’s Day (IWD) 2026, an annual opportunity to celebrate women’s achievements globally, whilst reflecting on the work still needed to reach true gender equality. Research has consistently shown that patriarchal structures influence everything from who holds power in maternity services, to how policies are formed and how care is delivered. Despite the first IWD being held 115 years ago, problems persisting in maternity services offer a clear example of why the day remains vital.
Our Search Pack of the Month for March – M53: feminism and gender issues in midwifery and maternity care – contains a wealth of research on gender inequalities and bias, spanning every aspect of the sector.
Male domination in career progression within midwifery, gynaecology and obstetrics
For decades, studies have highlighted the gendered hierarchy within healthcare systems. A 1998 NHS survey found that men were more likely to progress to higher career grades in nursing and midwifery than women (RCM Midwives Journal). Meanwhile, an article that same year argued that maternity services have long been dominated by the male-led medical establishment, positioning midwives and childbearing women in historically “powerless” roles (British Journal of Midwifery). These patterns echo a wider theme: that although midwifery is a predominantly female profession, leadership and decision-making powers have often been held by men.
More recent research shows that despite improvements, this imbalance remains. A 2015 German study by Jasmine Neuhold and Frauke von Versen-Hoynck found that “systemic inequities persist” in academic and leadership roles within gynaecology and obstetrics (Archives of Gynecology and Obstetrics). Additionally, a study last year on obstetrics and gynaecology research leadership revealed that while women successfully lead around half of OBGYN US clinical trials, there is still a need for the professional ecosystem to support women’s academic careers (AJOG Global Reports). These issues are not only at leadership level. Last year, in the Journal of Midwifery & Women’s Health, researchers found that bias, including gender bias, is widespread in clinical midwifery placements, with significant effects on students’ experiences and wellbeing (Journal of Midwifery & Women’s Health).
Male-centric models still shape maternity care
Another area in which inequality shows its influences is in the foundations of practice. Historically, maternity and reproductive health research, policy, and clinical definitions have emerged from male-dominated medical systems. Postnatal mental health is a clear example: a 1993 feminist analysis by Christine Jebali argued that the understanding and treatment of postnatal depression remain largely controlled by the medical profession, where it is often viewed only as an individual illness rather than a social and structural issue. (Health Visitor).
The power of feminist approaches in strengthening midwifery
Many researchers argue that feminism is essential in midwifery. Janet Draper noted in 1997 that, as a predominantly female profession caring for women, midwifery is uniquely placed to conduct feminist-informed research (British Journal of Midwifery). In 2018, Davison and Geraghty wrote that while not all midwives identify as feminists, it can be argued that midwifery practice itself expresses core feminist values. They concluded that feminist education should be embedded within midwifery programmes (British Journal of Midwifery).
Feminism also extends to fundamental aspects of women’s health and autonomy. Eve Espey argued in 2015 that contraception is crucial for enabling women to achieve their full social, intellectual and economic potential (Obstetrics & Gynecology). Even the struggle for midwifery autonomy has been framed as a feminist issue, with Carol Bates’ 2004 analysis suggesting that midwifery’s ongoing fight to be recognised as a respected and autonomous profession stems from deeply rooted patriarchal attitudes in healthcare (Pregnancy birth and maternity care: feminist perspectives).
Gender inequality in maternity care is a global issue
International research shows that gendered barriers shape maternity care in diverse ways across different contexts. In Rwanda, a 2021 study found that women’s limited decision-making power, along with gendered provider-mother dynamics, continue to hinder access to reproductive, maternal and newborn health care (BMC Pregnancy and Childbirth).
Meanwhile, the previous year, an ethnographic study of Wixarika Indigenous communities in Mexico showed that colonial systems introduced gender inequalities that persist today, affecting women’s autonomy, wellbeing and childbirth decisions (Social Science and Medicine). These findings reinforce that gender inequity in maternity care is not local, cultural, or historical; it’s systemic.
Calling for structural reform
In 2021, the International Confederation of Midwives issued a position statement on gender and pay equity, emphasising that women’s work – including midwifery – is undervalued, invisible, and underpaid, and stated that achieving pay equity requires structural change, including new funding models, advocacy, capability building, and legal reform. In 2024 they released their strategic plan, with gender equality being mentioned as objectives in all four of their strategic priorities.
International Women’s Day still matters: research from the maternity care sector highlights that gender inequality continues to shape decision-making, and the treatment of both midwives and mothers. This month’s free Search Pack brings together research to support midwives, students, educators and policy-makers who want to understand, and challenge, the gendered structures that are systemic within maternity care. Access our free Search Pack for March, ‘M53: Feminism and Gender Issues in Midwifery’, containing all research aforementioned and much more, at the link below.
What are MIDIRS Search Packs?
Our Search Packs are pre-made literature searches on topics within maternity research. They contain a comprehensive bibliographic list of articles as well as article abstracts. MIDIRS subscribers can find all of our Search Packs on the MIC database by searching for the specific number of a Search Pack. You can find a list of all of our Search Packs (and their corresponding numbers) here. If you require a more specific search, our librarians are also on hand to provide bespoke literature searches. You can order a bespoke search on our Products and Services page.
Take a look back at articles discussing feminism and gender issues in midwifery that have featured in past editions of MIDIRS Midwifery Digest:
”Why midwives should be feminists.’ Denis Walsh, Monica Christianson, Mary Stewart (June 2015)
Gender inequality and oppression is a pervasive feature of human cultures and societies across the world and this is reflected in women’s reproductive health with unacceptably high maternal mortality rates in low-income countries and excessive rates of intervention in childbirth in high-income countries. Midwifery, a profession whose raison d’etre is to be ‘with women’ with an explicit focus on maximising their reproductive health, has been slow to engage with a gendered analysis of these effects. There has also been a reluctance to utilise a feminist lens in addressing midwifery policy, practice and research. In this paper, we argue for change so that feminist values and gender equality become central to all midwifery endeavours.
‘Challenging the status quo.’ M O’Brien (September 2003)
A feminist approach to the present provision of maternity services.
To read these papers in full, plus hundreds more midwifery-related articles, subscribe to MIDIRS and access our full MIC database, as well as our quarterly Digest.
