Gender-inclusive and comfort-centered childbirth care: Implications for midwifery education and labor assessment training

Dear Editor,

Chen et al. recently highlighted the importance of balancing safety and comfort during childbirth through invasive and noninvasive labor assessment approaches among frontline obstetric healthcare providers in Taiwan.¹ Their grounded theory emphasized rapport-building, responsiveness, and holistic maternal care as central components of childbirth practice. Beyond clinical implications, the study also raises important considerations for health professions education, particularly in preparing maternity care providers to deliver patient-centered and culturally sensitive care.

These findings contextualize earlier observations from a study conducted in Kalinga, Philippines, which examined the performance of male midwives in hospitals and clinics.² The study reported that male midwives demonstrated excellent performance in antenatal, intranatal, postnatal, immunization, and family planning services despite persistent gender stereotypes and professional bias.² The findings suggest that competency in maternal healthcare is shaped less by biological sex and more by clinical preparation, communication skills, patient rapport, and professional training.

While Chen et al. advocated reflective and noninvasive childbirth assessment practices,¹ their framework may further be extended by considering how gender-inclusive educational preparation influences patient comfort and provider effectiveness in maternal care settings. In many conservative or rural communities, cultural assumptions regarding gender continue to influence perceptions of caregiving roles, potentially affecting both learning opportunities and clinical practice among male midwives. Integrating communication training, culturally responsive care, and noninvasive assessment competencies into midwifery and obstetric curricula may therefore strengthen both patient trust and healthcare quality.^3–5

The findings underscore the need for health professions education programs to integrate gender-inclusive, patient-centered, and noninvasive labor assessment competencies into midwifery and obstetric training curricula. Such educational reforms may help prepare maternity care providers – regardless of gender – to deliver holistic, comfort-sensitive, and culturally responsive childbirth care.

Authorship

Isaiah G. Patong substantially contributed to the conceptualization of the manuscript, integration of midwifery-related literature, contextualization of maternal healthcare practices, development of the scholarly discussion, and initial manuscript preparation. Pinky Larcelle L. Gas-ib, PhD contributed to the educational framing, critical interpretation of literature, academic refinement, language editing, and final preparation of the manuscript for submission. Both authors approved the final version of the manuscript and agree to be accountable for the integrity, accuracy, and scholarly content of the work.

Ethics committee approval

Ethical considerations were observed in the conduct and reporting of the referenced studies involving healthcare providers and maternal healthcare settings. The manuscript is based on previously conducted and publicly available scholarly works and secondary academic analysis. Principles of academic integrity, confidentiality, cultural sensitivity, and responsible scholarly reporting were observed throughout manuscript preparation.

Informed consent

The manuscript is based on previously published and institutional research studies. Necessary informed consent procedures were undertaken by the original researchers during the conduct of the referenced studies involving participants and healthcare professionals.

Declaration of generative AI and AI-assisted technologies in the writing process

The authors used generative artificial intelligence tools (ChatGPT, OpenAI) exclusively for language refinement, grammar checking, organizational assistance, reference formatting, and enhancement of academic clarity. The conceptual analysis, scholarly reflections, interpretation of literature, and final arguments presented in this manuscript remain the original intellectual work and responsibility of the authors.

Funding

This manuscript did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Therefore, no external funding applies to this submission.

Conflict of interest

The authors declare that there are no financial, professional, institutional, or personal conflicts of interest that could have influenced the preparation, interpretation, or publication of this manuscript on gender-inclusive and comfort-centered childbirth care.

Acknowledgments

The authors acknowledge Kalinga State University for supporting scholarly initiatives related to maternal healthcare education, gender-inclusive midwifery practice, and patient-centered childbirth care. The authors likewise recognize the contributions of healthcare professionals and midwifery practitioners whose experiences and insights continue to inform discussions on culturally responsive and comfort-centered maternity care in underserved communities.