Midwives as scholars and leaders: being an advocate when women choose care outside of guidance

There is an intricate interplay between clinical midwives as autonomous leaders and their scholarly attributes in the profession. This interplay should be considered in the context of advocating for women when receiving out-of-guidance care. Advocacy, scholarship and leadership are fundamental pillars of the Nursing and Midwifery Council's standards of proficiency for midwives, which all registrants must adhere to. Conflict between midwives’ scholarly knowledge and leadership perception affects their confidence to advocate for women seeking out-of-guidance care. Critically appraising the evidence base is rarely undertaken overtly in practice and midwives often adhere to recommended guidelines; however, increased knowledge can facilitate decision making. Analysing midwives as autonomous leaders reveals similar trends, where the dichotomy of being the lead care professional in a multiprofessional team and being risk averse, paired with the requirement to advocate, poses challenges. This article discusses research findings and future recommendations to drive maternity excellence.