Midwifery Profession: Scope and Definition

The midwife is an autonomous and accountable health professional who works in partnership with women to provide care during pregnancy, labour, birth, and the postnatal period, and who cares for the newborn. The scope of midwifery practice defines what care the midwife is educated and authorized to provide independently and where care should be shared with or referred to other professionals.

Definition

Midwifery is the profession of providing skilled, autonomous, and woman-centred care across pregnancy, birth, and the postnatal and newborn period, within a defined scope of practice and in collaboration with other health professionals when complications arise.

Scope

This topic explains how the profession is defined, the breadth of midwifery competencies across the maternity continuum, the principle of autonomy within defined limits, and the distinction between normal physiological care and situations requiring referral. It is a reference description of the profession, not a clinical protocol.

Core questions

• Who is a midwife and what care falls within the profession's scope?
• How does midwifery distinguish autonomous practice from care that requires referral?
• How does the content and organization of midwifery care relate to maternal and newborn outcomes?

Key concepts

• Definition of the midwife
• Scope of practice and competencies
• Autonomy and accountability
• Continuity of care
• Normal physiological childbirth
• Referral and shared care
• Skilled care at birth

Mechanisms

Midwifery scope is operationalized through education, competency standards, and regulation that authorize the midwife to provide a defined range of preventive, supportive, and clinical care, to recognize complications, and to refer when needs exceed that scope. The evidence-informed quality framework of Renfrew and colleagues (2014) characterizes effective midwifery by what care is offered (education, assessment, support, and management) and how it is organized (continuity, respectful relationships, and integration with the wider system).

Clinical relevance

A clear definition and scope underpin how maternity systems allocate roles and ensure that women receive skilled care while complications are escalated appropriately. Skilled care around the time of birth is a core component of strategies to reduce preventable maternal and newborn deaths and stillbirths (Lawn et al., 2014; Chou et al., 2015). This entry describes the profession and does not provide individualized care direction.

Epidemiology

Global health analyses identify the period around birth as the time of highest mortality risk for mothers and newborns, and skilled midwifery care is positioned as central to reducing that burden (Lawn et al., 2014; Chou et al., 2015).

Evidence & guidelines

A Cochrane review reports that midwife-led continuity-of-care models are associated with several benefits and no identified adverse effects relative to other models (Sandall et al., 2016), and a Lancet framework links the scope and organization of midwifery to maternal and newborn quality of care (Renfrew et al., 2014).

Key figures

• Mary J. Renfrew
• Jane Sandall
• Joy E. Lawn

Seminal works

• renfrew-2014
• sandall-2016

Frequently asked questions

What is the difference between a midwife's autonomous scope and shared care?

Within scope, a midwife provides care independently for healthy pregnancy and birth; when risk factors or complications arise, care is shared with or referred to obstetric, neonatal, or other specialists.

Why is the scope of midwifery defined at all?

A defined scope clarifies the midwife's competencies and accountability, helps maternity systems organize roles safely, and sets the threshold at which other professionals should be involved.