Obzornik zdravstvene nege, 57(3), pp. 160–163.
https://doi.org/10.14528/snr.2023.57.3.3253
This year marks the 270th anniversary of formal 
midwifery education, and I therefore dedicate this 
editorial to the subject of knowledge. We midwives take 
great pride in the long-standing tradition of formal 
education within our profession in Slovenia. We often 
note that it was already Empress Maria Theresa who 
recognised the significance of midwifery in ensuring 
the safe delivery of healthy infants, who would grow 
up to become a healthy nation. Gerhard Van Swieten, 
the physician commissioned by Maria Theresa 
to improve the health situation in her monarchy, 
advocated for the advancement of midwifery through 
education. He proposed the establishment of training 
programmes for midwives, believing that knowledge 
would transform the practice and provide women and 
their families with better quality and more professional 
care. His assertion is supported by theories of 
professionalism. The competencies acquired through 
formal training enable midwives to enter the labour 
market. After many years of clinical practice, this basic 
knowledge may be taken for granted, yet it remains 
an essential part of the professionalisation of the field.
According to Freidson (2001, p. 17), a renowned 
theorist of professionalism, the defining feature 
of professions is high specialisation of work. This 
specialisation precludes standardisation and routinisation, 
necessitating the acquisition of specific skills through 
comprehensive training. In the course of such extensive 
training, members of the profession not only acquire 
knowledge and skills, but also internalise the values and 
norms espoused by their professional group. As argued 
by Pahor (2006), long-term training shapes attitudes 
and interconnections, fosters strong identification with 
one's work and colleagues, and promotes professional 
solidarity. This professional identity is shaped by the 
process of professional socialisation that begins during 
formal education and is facilitated by teachers and 
(in health professions where a significant portion of 
training takes place in the clinical setting) also of clinical 
mentors. It is therefore imperative that midwives be 
taught by midwives, nurses by nurses and doctors by 
doctors. As argued by Lay (2000) and Leap (2000), 
independent midwifery education with direct entry 
into the profession produces more dedicated midwives 
who are strongly committed to the philosophy of 
physiology. It is this intangible component of the 
profession – professional identity – that reflects one's 
degree of identification with the profession (Pavlin, 
2007, p. 91) and motivates members to remain loyal 
to their professional field throughout their lives and 
to adopt its values as part of their personal ideology. 
Consequently, the current trend of midwives leaving 
their profession to pursue other fields may be indicative 
of weak professional consciousness, despite midwives' 
declarations of feeling a strong commitment to their 
profession (Mivšek, 2012).
A student midwife is transformed into a midwife 
through years of rigorous training. Midwifery is 
not merely a skillset involving the protection of the 
perineum and knowledge of the stages of childbirth, 
but rather a way of life in which professional values 
become an integral part of one's personal identity. In 
the practice of midwifery, the individual is determined 
by a commitment to prioritising the needs and wishes 
of the woman at the centre of care, to continually 
improving midwifery practices in line with the latest 
credible evidence, and to deeply valuing the capabilities 
of the female body. This entails a belief in the physiology 
of pregnancy, childbirth, and the postpartum period. 
The mentors and teachers of midwifery students must 
therefore be highly conscientious midwives who are 
committed to this philosophy. Faculties serve as the 
institutions responsible for developing professionals. 
As mentioned earlier, they not only impart knowledge, 
but also provide students with a holistic introduction 
to the professional field. 
Editorial/Uvodnik
The Birthplace of Midwives
Kje se rojevajo babice? 
Ana Polona Mivšek1, *
1 University of Ljubljana, Faculty of Health Sciences, Department of Midwifery, Zdravstvena pot 5, 1000 Ljubljana, Slovenia
* Corresponding author/Korespondenčni avtor: polona.mivsek@zf.uni-lj.si
Received/Prejeto: 20. 7. 2023
Accepted/Sprejeto: 24. 8. 2023
Mivšek, A. P. (2023)/Obzornik zdravstvene nege, 57(3), pp. 160–163. 161
The work of professionals encompasses three phases: 
the ability to classify the problem (diagnosis), the 
ability to identify its cause (inference of aetiology), 
and the ability to treat the problem (intervention). 
The second phase, which requires specific judgement 
skills, is considered the professional phase (Abbott, 
1988, p. 40). These skills are inaccessible and therefore 
incomprehensible to laypersons (non-professionals), 
which further emphasises the importance of students 
being taught primarily by members of their profession. If 
midwifery students are taught primarily by doctors whose 
training and subsequent clinical approach focus on the 
identification and prevention of (potential) risk factors 
and complications, and the treatment of pathologies, 
then midwifery students may be indoctrinated with 
values that diverge from those of midwifery. While 
such midwifery graduates may become more closely 
aligned with obstetricians in the clinical setting, the 
essence of midwifery is lost. The health system needs 
a counterpoint to the so-called 'biomedical model' for 
the care of uncomplicated pregnancies, childbirths and 
physiologically progressing postpartum periods. Europe 
encourages the coexistence of both approaches (medical 
and midwifery) within the health system, as demonstrated 
by the recommendations of the Commissioners for 
Midwifery when Slovenia joined the EU (Skoberne, 
2003). Midwifery was recognised as a profession in its 
own right, requiring specific terminology, a profession-
specific code of ethics, independent training (with 
midwifery teachers), and independent research. This 
initiative led to the establishment of the Department of 
Midwifery at the Faculty of Medicine of the University 
of Ljubljana with an autonomous study programme, and 
later to the establishment of a corresponding chair to 
promote research in midwifery. 
The role of faculties extends beyond the transmission 
of knowledge to include the development of 
knowledge itself. Research activity within faculties, 
which forms the intellectual basis of the profession, 
indirectly ensures that the profession retains 
sovereignty over its field (Abbott, 1988, p. 196). 
Consequently, intellectual work is highly valued 
within the profession (Kanjuo Mrchela, 2002), as 
are academics who conduct research and generate 
knowledge in the field (Abbott, 1988). Pahor (2006) 
notes a subculture of anti-intellectualism within the 
health professions, where less-educated members who 
deny the importance of education and glorify practical 
skills outnumber more educated members and impede 
professionalisation to some extent. Conversely, raising 
the educational level of members of a professional 
group reinforces the recognition of the importance 
of theoretical knowledge (Pahor, 2006, p. 28). This 
was clearly demonstrated in a survey assessing the 
professionalism of midwives in Slovenia (Mivšek, 
2012), which revealed a clear difference between the 
views of midwives and midwives with a degree in 
midwifery regarding theoretical knowledge.
Despite our great pride in the long tradition of 
midwifery education, it must be acknowledged that 
a profession only truly becomes a profession when 
education begins at the university level. In this 
respect, it can be said that the profession of midwifery 
in Slovenia, despite being very young, has recently 
achieved a considerable degree of autonomy in 
the field of education. We are also aware of the fact 
that midwifery care for women and their families is 
becoming increasingly complex, which means that 
young graduates entering the midwifery profession 
need to assume additional responsibilities. An urgent 
response to this situation is to elevate the basic level of 
knowledge (Pehlke-Milde, Beier, zu Sayn-Wittgenstein, 
& Fleming, 2006). For this reason, faculties across 
Europe now offer numerous midwifery master's 
programmes. At the Department of Midwifery, there 
has long been motivation and awareness of the need 
for postgraduate studies, as well as interest among 
graduates to continue their studies (Mivšek, Škodič 
Zakšek, Petročnik, & Jug Došler, 2017). According 
to experts, professionalisation is a deliberate political 
strategy, and a renewed strong initiative for a master's 
degree programme in midwifery is clearly a logical 
next step for an educational institution in the process 
of professionalising midwifery.
Slovenian translation/Prevod v slovenščino
Letos obeležujemo 270 let formalnega babiškega 
izobraževanja, zato uvodnik posvečam znanju. 
Babice smo izjemno ponosne na dolgo tradicijo 
formalnega izobraževanja na Slovenskem. Večkrat 
rade poudarimo, da se je že Marija Terezija zavedala 
pomena babiške obravnave za nosečnice, da bodo 
te rojevale zdrave otroke, ki bodo odrasli v zdrav 
narod. Zdravnik, ki ga je pooblastila za izboljšanje 
zdravstvenega stanja v monarhiji, Gerhard Van 
Swieten, je menil, da bo ravno šolanje tisto, ki bo 
spremenilo babiško obravnavo na bolje in omogočilo 
ženskam ter njihovim družinam višjo raven kakovosti 
in strokovnosti. Njegova glavna iniciativa je bila namreč 
odpiranje izobraževalnih programov za babice. Verjel 
je, da znanje (informiranost) spreminja miselnost 
in izboljšuje klinično delo. Teorije profesionalizma 
kažejo, da je imel prav. Kompetence, pridobljene 
med študijem, nam omogočajo vstop na trg dela. Po 
dolgoletnem delu v kliničnem okolju začnemo svoje 
bazično znanje sicer dojemati kot samoumevno, 
vendar pa je prav znanje tisti element, ki ima v procesu 
profesionalizacije stroke največji pomen. 
Po mnenju Freidsona (2001, p. 17), uveljavljenega 
teoretika profesionalizma, je namreč poglavitna 
značilnost profesij visoka specializiranost dela, kar 
onemogoča njegovo standardizacijo in rutinizacijo ter 
zahteva posebna znanja in spretnosti, pridobljene skozi 
dolgotrajno izobraževanje. V procesu tega dolgoletnega 
Mivšek, A. P. (2023)/Obzornik zdravstvene nege, 57(3), pp. 160–163.162
izobraževanja pripadniki stroke ne pridobijo zgolj znanj 
in veščin, pač pa so jim posredovane tudi vrednote in 
norme, za katere se poklicna skupina zavzema. Kot 
pravi Pahor (2006), dolgotrajno izobraževanje oblikuje 
stališča in medsebojne povezave, razvija močno 
identifikacijo z delom in kolegi ter spodbuja poklicno 
solidarnost. Ta t. i. profesionalna identiteta se oblikuje 
v procesu strokovne socializacije že v času študija; 
zanjo so odgovorni učitelji in (v primeru zdravstvenih 
strok, kjer polovica ur izobraževanja poteka v 
kliničnih okoljih) tudi klinični mentorji. Zato je tako 
pomembno, da babice učijo babice, medicinske sestre 
medicinske sestre in zdravniki zdravnike. Kot trdita 
Lay (2000) in Leap (2000), samostojno izobraževanje 
v babištvu z neposrednim vstopom v stroko oblikuje 
bolj predane babice, ki so močno zavezane filozofiji 
fiziologije. Prav ta neoprijemljiva komponenta 
profesije – strokovna identiteta – je tista, ki izraža 
»stopnjo posameznikove istovetnosti s poklicem« 
(Pavlin, 2007, p. 91) in je razlog, da pripadniki tega 
poklica ne zapuščajo, pač pa mu ostajajo zavezani 
vse življenje in sprejmejo njegove vrednote kot del 
osebne ideologije. Zapuščanje poklica in zaposlovanje 
na drugih področjih dela, kar je trenuten trend v 
babištvu, je torej lahko deloma odraz šibke strokovne 
zavesti, kljub temu da babice na deklarativni ravni 
izražajo močno pripadnost stroki (Mivšek, 2012). 
Študentka oziroma študent babištva se skozi leta 
izobraževanja prerodi v babico oziroma babičarja. 
Babištvo ni le veščina varovanja presredka in 
poznavanje števila porodnih dob, pač pa je življenjski 
stil, saj profesionalne vrednote postanejo del 
posameznikove osebne identitete. V primeru babištva 
posameznico/posameznika opredeljuje zaveza k temu, 
da postavlja žensko (njene potrebe in želje) vedno v 
središče obravnave, da izboljšuje babiške prakse glede 
na najnovejše kredibilne dokaze ter da globoko ceni 
žensko telo in njegove sposobnosti in zato verjame 
v fiziologijo procesov med nosečnostjo, porodom 
in v puerperiju. Zato morajo biti mentorji in učitelji 
študentov babištva močno zavedne babice, ki so 
predane tej filozofiji. Fakultete so namreč ustanove, ki 
oblikujejo strokovnjake. Kot že rečeno, ne posredujejo 
le znanja, pač pa posameznika celostno vpeljejo v 
področje dela. 
Delo strokovnjakov sestoji iz sposobnosti treh 
faz: sposobnosti klasifikacije problema, sposobnosti 
opredelitve vzroka ter sposobnosti obravnave 
problema, ki se v strokovnem žargonu imenujejo 
diagnostika, sklepanje o etiologiji ter intervencija, pri 
čemer je druga faza tista, ki je profesionalna ter kot 
takšna zahteva posebna znanja za presojo (Abbott, 
1988, p. 40). Ta znanja so laikom (nepripadnikom 
stroke) nedostopna in torej nedoumljiva. To je dodaten 
argument za to, da študente vedno v kar največji meri 
poučujejo člani stroke. V kolikor so namreč glavni 
izobraževalci študentov babištva zdravniki, katerih 
izobraževalni sistem in pozneje klinični princip je 
stremeti k iskanju (potencialnih) dejavnikov tveganja 
in preprečevanju (morebitnih) zapletov ter zdravljenje 
patologije, so študenti babištva indoktrinirani v 
drugačne vrednote. Tovrstni diplomanti babištva so 
sicer kot sodelavci v kliničnem okolju bolj po meri 
ginekologov porodničarjev, vendar pa babištvo na 
ta način izgubi svojo esenco. Zdravstveni sistem 
potrebuje kontrapunkt t. i. »biomedicinskega modela« 
za obravnavo žensk brez zapletov v nosečnosti, med 
porodom in s fiziološko potekajočim poporodnim 
obdobjem. Evropa spodbuja obstoj obeh pristopov 
(medicinskega in babiškega) v zdravstvenem sistemu, 
kar so pokazala tudi priporočila komisark za babištvo 
ob vstopu Slovenije v EU (Skoberne, 2003). Babištvo so 
dojemale kot samostojno stroko, ki zahteva specifično 
terminologijo, stroki lasten kodeks etike, samostojno 
izobraževanje (z učiteljicami babicami) in neodvisno 
raziskovanje. Na to pobudo se je takrat na Zdravstveni 
fakulteti Univerze v Ljubljani oblikoval Oddelek 
za babištvo z avtonomnim študijskim programom, 
pozneje pa je bila ustanovljena še pripadajoča katedra 
za spodbujanje raziskovalnega dela na področju 
babištva. 
Naloga fakultet ni le podajanje znanja, pač pa sam 
razvoj znanja. Raziskovalna dejavnost na fakultetah, ki 
oblikuje intelektualno bazo profesije, posredno skrbi za 
ohranjanje jurisdikcije stroke nad področjem (Abbott, 
1988, p. 196). Zato je v primeru profesij intelektualno 
delo visoko cenjeno (Kanjuo Mrčela, 2002), prav tako 
pa tudi akademiki, ki stroko raziskujejo in znanje 
ustvarjajo (Abbott, 1988). Pahorjeva (2006) omenja 
subkulturo anti-intelektualizma v zdravstvenih 
poklicih, ko nizko izobraženi člani, ki zanikajo pomen 
izobrazbe in poveličujejo praktične veščine, številčno 
prevladajo nad izobraženimi člani in v določeni 
meri zavirajo profesionalizacijo. Višanje izobrazbe 
pripadnikov poklicne skupine torej krepi zavedanje o 
pomenu teoretičnih znanj (Pahor, 2006, p. 28). To se je 
jasno pokazalo tudi v raziskavi o oceni profesionalizma 
babištva v Sloveniji (Mivšek, 2012), kjer je bila med 
mnenji srednjih babic in diplomiranih babic opazna 
razlika med stališči v odnosu do teoretičnih znanj.
Kljub izjemnemu ponosu, ki ga občutimo ob 
dolgoletni tradiciji babiške šole, je potrebno priznati, 
da poklic preraste v profesijo, šele ko se izobraževanje 
prične na univerzitetni ravni. V tem pogledu je v 
Sloveniji stroka babištva še zelo mlada in lahko rečemo, 
da je na področju izobraževanja v kratkem dosegla 
relativno visoko stopnjo avtonomije. Zavedamo se 
tudi, da postaja babiška obravnava žensk in njihovih 
družin vse bolj kompleksna, to pa bo od mladih 
diplomantov, ki vstopajo na področje babiškega dela, 
zahtevalo tudi prevzemanje dodatnih odgovornosti. 
Nujen odgovor na okoliščine je dvig osnovnega nivoja 
znanja (Pehlke-Milde, Beier, zu Sayn-Wittgenstein, & 
Fleming, 2006), zato fakultete po Evropi že množično 
ponujajo magistrske programe babištva. Motivacija 
ter zavedanje o potrebi po podiplomskem študiju na 
Mivšek, A. P. (2023)/Obzornik zdravstvene nege, 57(3), pp. 160–163. 163
Oddelku za babištvo obstaja že dolgo, prav tako pa 
tudi interes diplomantov za nadaljnji študij (Mivšek, 
Škodič Zakšek, Petročnik, & Jug Došler, 2017). Po 
mnenju strokovnjakov je profesionalizacija načrtna 
politična strategija, pri čemer ponovna močna 
iniciativa za magistrski program babištva očitno 
predstavlja logičen naslednji korak izobraževalne 
institucije v procesu profesionalizacije babištva. 
Conflict of interest/Nasprotje interesov
The author confirms that there are no conflict of 
interest./Avtorica izjavlja, da ni nasprotja interestov.
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Cite as/Citirajte kot: 
Mivšek, A. P. (2022). The Birthplace of Midwives. Obzornik zdravstvene nege, 57(3), 160–163. https://doi.org/10.14528/snr.2023.57.3.3253