Midwifery practice in perinatal palliative care: A scoping review and conceptual framework

Background Perinatal palliative care (PPC) is a multidisciplinary, family-centred approach aimed at improving the quality of life and comfort of newborns with life-limiting conditions, and their families. Midwives can play a crucial role in supporting these pathways. However, their specific contribution within PPC remains underexplored in the scientific literature. Aim To map the available evidence on the role and contributions of midwives in perinatal palliative care and to explore how midwifery practice is integrated into care strategies for pregnancies complicated by life-limiting fetal conditions or uncertain neonatal prognosis. Methods This scoping review was conducted in accordance with the Joanna Briggs Institute Manual for Evidence Synthesis and reported following the PRISMA-ScR guidelines. Comprehensive searches were performed across PubMed, CINAHL, PsycINFO, EMBASE, and Google Scholar (May-September 2025). All English-language primary studies were included, with no restrictions on publication year or country. Results Eleven studies met the inclusion criteria. Most focused on professional education and healthcare professionals’ experiences and clinical recommendations from professional organizations. Findings highlight several domains - communication, emotional support, birth planning, breastfeeding counselling, and bereavement care - where midwifery competencies align with the principles of PPC. Based on the synthesis of the included studies, a conceptual framework was developed to illustrate how core domains of midwifery practice align with key components of perinatal and neonatal palliative care across the antenatal, intrapartum, and postnatal continuum. Conclusion Midwives hold professional, relational, and educational competencies that position them ideally to contribute to perinatal palliative care. However, the lack of formal recognition and structured training in this area highlights the need for policy guidance and further research to clearly define, strengthen, and standardise their role.