Midwifery Regulation

 In 1999 a joint WHO/UNFPA/UNICEF/World Bank statement called on countries to ensure that all women and newborns have skilled care during pregnancy, childbirth and the immediate postnatal period. Skilled care can be provided by a skilled birth attendant, who is an accredited health professional. All skilled attendants must have the core midwifery skills. (Core midwifery skills have been defined by the ICM in a document entitled Essential Competencies for Basic Midwifery Practice, The additional skills required will vary from country to country to take account of local differences such as urban and rural settings.


The ECSACON (East, Central, and South African College of Nurses) represents fourteen countries in Africa. They designed a Professional Regulatory Framework (PRF). The elements in the PRF indicate the acceptable minimum parameters for professional practice, core competencies, core content and standards of education for nurses and midwives.

The PRF is an important guideline in the advancement of professional nursing and midwifery in the African continent in general and the ECSA region in particular. The documents will be invaluable sources of information and guidance to educators, practitioners, students and policy makers. With the PRF the ECSACON will motivate Member States to strengthen the regulation of nursing and midwifery standards.



In 2007 the American College of Nurse-Midwives (ACNM), approved the Core Competencies for Basic Midwifery Practice, which describes the fundamental knowledge, skills, and behaviors expected of a midwife. The concepts, skills, and midwifery management process identified in the document comprise the foundation upon which practice guidelines and educational curricula are built.

To practice midwifery in the USA, it depends on the state which diploma is required. Each state in the USA has its own laws and regulations that govern the practice of midwifery. For foreign-educated midwifes there will be a transition period in which they can gain the required credentials.


The Canadian Midwifery Regulators Consortium (CMRC) made a description of midwifery, including required competencies and working conditions. The profession of midwifery is not yet regulated in all provinces and territories. In all regulated provinces and territories, midwives are legally required to be registered with the provincial regulatory authority in order to legally call themselves a midwife and to practice their profession.

Foreign-educated midwives must take part in assessment processes in order to prove that they have the skills, knowledge, and abilities required.

Asia Pacific

At the Second Western Pacific and South East Asian Regulatory Meeting held in Brisbane in 1998, a suggestion was made to make a collection of Country Profiles of countries in the Western Pacific and South East Asian Region (WP/SEAR). The information in the Country Profiles varies considerably depending on the amount of information supplied or the quantity of it condensed into the information sheets. 


In 2004 the Australian Nursing and Midwifery Council developed a national competency standard for midwives. It describes the core competencies of a midwife. The national competency standards for the midwife can be used to assess midwifery performance and for developing midwifery curricula.

Each Australian state and territory has its own sets of rules governing midwifery practice administered by its own nursing and midwifery board. Foreign-educated midwives are required to obtain registration and maintain a current practicing license in order to work in Australia.

New Zealand

In May 2004 the Midwifery Council of New Zealand approved the ‘Competencies for Entry the Register of Midwives’. This document provides detail of the skills, knowledge, and attitudes expected of a midwife to work within the Midwifery Scope of Practice.

Midwives applying for registration from overseas will be assessed according to the Midwifery Council's policy.

On 1 May 1998, the Trans-Tasman Mutual Recognition Arrangement (TTMRA) came into effect. It is a non-treaty arrangement between the Commonwealth, State and Territory Governments of Australia and the Government of New Zealand. The TTMRA describes that a person registered to practise an occupation in Australia is entitled to practise an equivalent occupation in New Zealand, and vice versa, without the need for further testing or examination.


Please follow this link to obtain information about regulation in Japan.


In 2005 the European Parliament approved a directive on the recognition of professional qualifications, in which a training programme for midwives is described. The training programme for obtaining evidence of formal qualifications in midwifery consists of two parts, theoretical & technical instruction and practical & clinical training. A certain number of competencies must be reached before graduation. (Directive 2005/36/EC of the European Parliament and of the Council of 7 September 2005 on the recognition of professional qualifications (Text with EEA relevance)

The free movement of persons and services is a fundamental principle of the European Community. One of its advantages for Community nationals is the freedom to pursue an occupation, on a self-employed or employed basis, in a Member State other than the one in which they acquired their professional qualifications. In addition, a system has been put in place at European level facilitating the recognition of diplomas and professional qualifications by virtue of which individuals can pursue a specific occupation. The system applies if you’re a national of a Member State, you hold a diploma which entitles you to exercise one of the professions covered by the sectoral Directives and you wish to follow the same occupation in the host Member State. The profession of midwife is covered by the system of mandatory and automatic recognition of diplomas. When the training is obtained outside of the European Union, the Member states must check that the Community minimum training requirements have been met.

Project by Simone Evers and Hanneke van Meerten,Internship at ICM Headquarters, The Hague, 27-03-08

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