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This article identifies significant social, economic, and professional barriers that hinder the provision of quality midwifery care in low and middle-income countries (LMICs). Through a systematic review of 82 items from 34 countries, the research highlights how gender inequality, poor working conditions, and lack of professional support contribute to midwives’ burnout and moral distress, ultimately affecting the quality of care they provide. The study proposes an analytical framework to illustrate how these barriers overlap and reinforce each other, emphasizing the need for comprehensive strategies that address these systemic issues. By focusing on the midwifery provider perspective, the study underscores the importance of improving working conditions and professional support to enhance maternal and newborn health outcomes in LMICs.