Solidarity, Justice, and the Future of Midwifery at the International Confederation of Midwives 34th Triennial Congress

The 34th International Confederation of Midwives (ICM) Congress wrapped on June 18, 2026. A March for Midwives along the banks of the Tagus River welcomed midwives to Lisbon. Representing more than 120 countries, midwives processing with their colorful flags marked the official opening of the congress. Hallway greetings and conversations with friends new and old bookended formal sessions. Imagine a week of celebration, connection, education, and protest, filled with sharing of ideas and strategic organizing to strengthen midwifery around the world. More than 250 US midwives, including approximately 40 midwives of color, represented the American College of Nurse‐Midwives (ACNM) and the National Association of Certified Professional Midwives (NACPM). As your eyes and ears on the proceedings at the ICM Congress, each author has shared a summary of their individual reflections.

The Congress theme was One Million More Midwives ¹ to increase autonomous midwifery practice worldwide by educating 1,000,000 more midwives to ICM standards. This goal also includes building on the strong record of research showing the positive impact of midwifery models of care, urged by the World Health Organization (WHO), in advancing the health of families and communities, preventing stillbirths, and using fiscal resources more effectively. ²

ICM is an organization of midwifery associations, representing more than 130 midwifery associations in 116 countries. ACNM and NACPM are the 2 US member associations. ICM promulgates formal statements and develops resources under the Professional Framework for Midwifery to support midwifery associations, regulation, and education. For example, in the United States, the ACNM Core Competencies for Basic Midwifery Practice are consistent with the ICM Competencies.³ ICM also provides resources for midwifery advocacy, education program development, and a commitment to gender equality, justice, equity, diversity, and inclusion.

As an ICM member association, ACNM appoints 2 voting delegates to attend a 3‐day preconference council meeting. The council is part of the ICM governing body and provides guidance on strategic priorities, debates key issues, and votes on motions and resolutions. The ACNM delegates were Jessica Brumley, Immediate Past President, and Pandora Hardtman, Vice President. A precouncil meeting vote had resulted in passing a motion to temporarily rescind the ICM Statement on Indigenous Midwifery. During the Americas region meeting, it became clear that this topic had not received sufficient opportunity for dialogue or debate. Many council delegates from the Americas region and beyond were prepared to support the Indigenous midwives in their protest of this ICM action. This moment of protest and solidarity was one of the most memorable and meaningful of this Triennial Congress.

So, let's return to the Congress! Attending the ICM congress represented a professional dream come true! As a first‐generation American (M.C.F.), I have always located myself not just within the United States but also within the much larger global community. For many of us, our calling to midwifery originates from the tapestries of ancient ancestral tradition, extending our vision of midwifery far beyond the modern, American professional context that is our daily reality. The plenary speakers included impressive midwifery leaders from every continent, and their messages each morning were consistent and compelling. As the convening began, I was struck by the urgent call to midwifery leadership and the powerful message of midwives as human rights defenders and guardians of justice in the midst of political, health care, and climate crises around the world.

We were exhorted to “midwife ourselves” as a global workforce so that our presence can be felt deeply in all the places midwives show up for people and communities. Speakers underscored how when midwives show up on the scene, health care systems and the provision of sexual and reproductive health care become more robust, sustainable, and impactful. Likely the most moving and resonant plenary session came on Thursday, when Navajo midwife Nicolle Arthun boldly exercised her leadership as an Indigenous midwife. She used her platform to represent a coalition of Indigenous midwives, calling on ICM to acknowledge the harmful history of colonialism, to use their power to advance justice for Indigenous peoples, and to “stand up in defense of midwifery that is inclusive to all.” It was a powerful display of collective organizing and Indigenous sovereignty. I was humbled to bear witness to such a potent demonstration of Indigenous unity and midwifery solidarity and to be among the multitudes of midwives who voiced alignment with this call for accountability. ⁴

Attending the ICM congress has been a midwifery bucket list item for me (M.E.), and I felt incredibly privileged to have the resources and space to attend. In these times marked by US isolationism, in which global alliances seem to be transactional, in which US foreign aid for sexual and reproductive health care is being withdrawn, and in which the professional status of nursing and midwifery is being challenged, attending ICM felt like a necessary balm for the soul and an opportunity for meaningful diplomacy. Finding solidarity among an international community of midwives was grounding and restorative.

As the coalition of Indigenous midwives reminded us, midwifery is so much more than a profession. It is foundational—rooted in Indigeneity. It is community and connection. It is survival and self‐determination. It is for the people we serve. This was evident in each session I attended. I was proud of my US midwife colleagues’ contributions to this global forum centering people in our care. US midwives led many workshops, podium presentations, and poster presentations covering topics including midwifery outcomes, capacity‐building, workforce growth and attrition, and grant writing. A focus on the impacts of racism and discrimination on health was resonant. Midwifery‐led faculty development and organizing for health equity were also well represented. Physiologic birth, suturing, abortion care, culturally appropriate and accessible postpartum care, plus safe community‐based birth transfer were discussed in clinically focused forums. ⁵ From the audience of several of these sessions, I witnessed how the sharing of big bold ideas and exemplary clinical care inspired midwife attendees.

Being in proximity with so many midwives highlighted the value of community and connection. My most meaningful points of connection took place outside the Congress Center: in the airport entry and exit system and customs lines, at cafes and restaurants, on a rooftop of a restored palace, and at the beach. These third spaces made it possible to appreciate the collective humanity of midwives, each with our own unique contexts. In these spaces, even bigger thinking happened as well as much needed levity and laughter.

In reflecting on the week in Lisbon, we (M.C.F. and M.E.) are left with urgent questions for our profession. How can we continue to speak truth to power and repair the harm done to the most marginalized communities? How do we create spaces of belonging that intentionally amplify voices that are still being excluded—lesbian, gay, bisexual, transgender, and queer midwives; Indigenous midwives; Black midwives; and midwives around the world who are being systemically oppressed? How can we find ways to lead in systems that do not align with midwifery values and create models of health care that are more human centered? How do we educate students to thrive in practice and understand how to infuse modern health care with midwifery knowledge and frameworks? ICM served as a platform for solutions‐driven discussion and brought us face‐to‐face with the challenges we must continue to confront and address.

Looking back, I (M.D.A.) count this ICM congress in Lisbon as my eighth. Presenting research and scholarship, soaking up new ideas, connecting with friends from around the world and across the United States, and forging new collegial relationships over 27 years remains thrilling and a privilege to be present. I am continually struck by the similarity of issues midwives face as we press onward in our work, regardless of differences across our countries of origin.

Alongside the 2025 WHO statement promoting midwifery models of care globally ² was a palpable rise in presentations highlighting respectful maternity care and issues of bias and racism worldwide, including the United States. Opening session speakers reminded us that we need more midwives and more midwife leaders, that every dollar invested in midwifery results in $9 in economic benefits, that midwives are the “beating heart of maternal and child health care”, and that midwives are “among the greatest architects of peace, health, and human progress.”

My particular ICM goal was to promote the Journal of Midwifery & Women's Health (JMWH) to global scholars and encourage their engagement. One highlight was meeting in person with a French midwife I have communicated with via email for more than a year as Editor‐in‐Chief. We are partnering with the College National des Sages‐Femmes de France (French National College of Midwives) to produce a special JMWH issue in English detailing their interprofessional project examining evidence related to the timing of hospital postpartum discharge. It was, again, truly amazing to join midwives from around the world to exchange ideas and learn together. Experiencing the joys of connection, hugs, laughter, and the shared commitment to our profession in the beautiful setting of Lisbon was indescribable.

Yes, one million more midwives. Let us commit to doing the hard work required to both build and sustain a robust midwifery workforce in the United States. Next up is the 35th ICM Triennial Congress in Abu Dhabi, United Arab Emirates, on June 4 to 7, 2029. Amid ongoing wins to celebrate and challenges to address, we invite all of you to help make the next convening robust, inclusive, and dynamic. Together, let's create a reality in which all of us are represented and contributing to our collective midwifery future.