Fact sheet: Scope of practice and capabilities of midwives

Professional Codes & Guidelines

Updated November 2023

Download a PDF copy of this Fact Sheet: Scope of practice and capabilities of midwives (573 KB,PDF)

Introduction

The Nursing and Midwifery Board of Australia (NMBA) regulates the practice of nursing and midwifery in Australia and one of its key roles is to protect the public. The NMBA does this by developing standards,codes and guidelines which together establish the requirements for the professional and safe practice of nurses and midwives in Australia. The NMBA undertakes its functions as set by the Health Practitioner Regulation National Law, as in force in each state and territory (the National Law).

Under the National Law, nursing and midwifery are recognised as two separate professions These titles are protected under the National Law with each having different education, knowledge, skills and standards for practice and different responsibilities and activities.

This guidance on the scope of practice and capabilities of midwives provides a high-level collective synopsis of the NMBAs registration standards, standards for practice, codes and guidelines. It has been developed as guidance for stakeholders such as employers, private and public health services, and other health practitioners, on the varying roles and scope of practice of midwives and endorsed midwives. Employers can use the information as a starting point, when determining which practitioner best suits the needs and requirements of their health service. It can also provide clarity and guidance to the public when receiving care from a midwife.

The information in the following tables clarifies the educational outcomes, provides examples of core activities and fundamental differences between a midwife and an endorsed midwife. While the tables provide examples of some core activities that midwives carry out in practice, throughout their careers midwives continue to develop their knowledge and skills and expand their scope of practice.

For information about the education pathways and core activities of enrolled nurses, registered nurses and nurse practitioners, please refer to the NMBA’s Fact sheet: Scope of practice and capabilities of nurses.

For information on Australian Qualifications Framework (AQF)¹ please refer to the AQF website.

¹_{Australian Qualifications Framework (AQF) is the national policy for regulated qualifications in Australian education and training}_.

Midwifery education pathways and outcomes

Qualifications

Under the National Law there are specific titles which are referred to as ‘protected titles’. Midwife and endorsed Midwife are protected titles. This means that only those midwives who are registered or endorsed with the NMBA can use these titles in Australia.

The following qualifications and outcomes are necessary for registration/endorsement with the NMBA.

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Midwife

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Qualification/program of study (NMBA approved)

Bachelor of midwifery (AQF 7)

Study duration: Three years full time

Master of midwifery (AQF 9)

Study duration: Two years or equivalent

Graduate diploma of midwifery

Post graduate pathway (AQF 8)¹ – for current RNs seeking midwifery registration.
Study duration: 12 months

Graduates commonly complete a supported transition to practice program, though this in not mandatory

Clinical placement hours/setting

Students complete a minimum of 10 continuity of care episodes (antenatal, labour and postnatal care) with women and their families.

Educational outcome

Midwives graduate with a woman-centred approach to practice and an integrated theoretical and practice-based knowledge of care across the childbearing continuum.

Midwives have an in-depth scientific knowledge that includes the administration, supply and quality use of medicine relevant to midwifery practice.

Midwives have foundational skills in communication, relationships and management.

Endorsed midwife

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Qualification/program of study (NMBA approved)

Holds registration as a midwife in Australia and has 5000 hours of clinical practice as a midwife

Plus, completion of an NMBA-approved program of post-graduate study leading to endorsement for scheduled medicines. (AQF 8)1

For example:

Graduate Certificate in Midwifery Diagnostics and Prescribing

Prescribing for Midwives

Study duration: 6-12 months

Scope of practice

The NMBA publishes a list of midwives who are registered to practise in Australia. The list is called the ‘Register of practitioners’. When a midwife’s name appears on the list, you know that they are registered. Sometimes a registered practitioner has a type of registration or conditions that limit what they can do. If a midwife has restrictions or conditions associated with their registration you will see these on the public register. Midwives with endorsement are also identified on the public register.

While the foundational education of midwives in Australia captures the full breadth of the scope of the profession at the graduate entry level, the scope of practice of individual practitioners is influenced by the settings in which they practise. This includes the health needs of people, the level of competence and confidence of the midwife and the policy requirements of the service provider.

As the midwife gains new skills and knowledge, their individual scope of practice changes.

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Midwife

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What do Midwives do?

Midwives work in partnership with women. Midwives supervise student midwives and other healthcare workers and delegate activities from a midwifery plan of care.

Examples of core midwife activities include:

antenatal care including abdominal palpation, performing clinical observations on mother and unborn baby,
reviewing and ordering diagnostic and/or screening tests, and risk assessments from a clinical, health, lifestyle and psychological perspective
intrapartum care including monitoring and support of women during labour, monitoring the foetus during labour and medication management
birthing the baby, identifying variances to normal birth and escalating as necessary to specialist staff
managing medication and IV therapy within the context of midwifery practice
managing the third stage of labour, perineal assessment and suturing, facilitating initial mother and baby interaction, including skin to skin and breastfeeding support
advising and supporting parents on the daily care of their newborn babies
identifying where there may be concerns about the health and wellbeing of the mother and the newborn baby
offering breastfeeding and nutritional support
supporting parents who experience miscarriage, termination, stillbirth and neonatal death
women’s health, reproductive and sexual health, and child and family health care.

Endorsed midwife

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What do Endorsed midwives do?

In addition to the core activities of a midwife, examples of core activities of Endorsed midwives include:

provision of screening that includes ordering and interpreting diagnostic tests (pathology and medical imaging) relevant to the care of women and babies during pregnancy, labour and newborn period
prescribing, administering and supplying scheduled pharmacological and non-pharmacological interventions
comprehensive antenatal, intrapartum and postnatal care including the ability to admit women into hospital and provide care on their own authority
referral to obstetricians and paediatricians
access to the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS)