Bridging National and International Midwifery Regulations: A Thematic Analysis of Italian Key Documents, Desk Review, and Normative Mapping
Bibliographic record
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.070 | 0.090 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.019 | 0.027 |
| Science and technology studies | 0.008 | 0.009 |
| Scholarly communication | 0.008 | 0.004 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".