For complications related to pregnancy and birth that are beyond the midwife's scope of practice, including surgical and instrumental deliveries, they refer their patients to physicians or surgeons.

Many developing countries are investing money and training for midwives, sometimes by retraining those people already practicing as traditional birth attendants.

According to the definition of the International Confederation of Midwives, which has also been adopted by the World Health Organization and the International Federation of Gynecology and Obstetrics:[1] A midwife is a person who has successfully completed a midwifery education programme that is recognised in the country where it is located and that is based on the ICM Essential Competencies for Basic Midwifery Practice[2] and the framework of the ICM Global Standards for Midwifery Education;[5] who has acquired the requisite qualifications to be registered or legally licensed to practice midwifery and use the title midwife; and who demonstrates competency in the practice of midwifery.The word derives from Middle English mid, "with", and wif, "woman", and thus originally meant "with-woman", that is, a woman who is with another woman and assists her in giving birth.

In English, the noun midwife is gendered, and in most countries, the corresponding noun and practice is historically used for women (sometimes banned for men), while in English, the verb midwifery is also applied to men (e.g. Havelock Ellis is said to have midwifed bigamist Howard Hinton's aka John Weldon's twins in 1883;[8] historically, assistance was done be relatives, even only husbands, while male midwifery, excluding relatives, being common in some cultures, dates back to the mid 1900's; for Semelai people women also practised it up to 1980, while by 1992 some areas had only male midwives, and later most areas had only male midwives[9]).

"[9] The midwife is recognized as a responsible and accountable professional who works in partnership with women to give necessary support during pregnancy, labor, and the postpartum period.

All midwives are expected to work within a defined scope of practice and conform to ongoing regulatory requirements that ensure they are safe and autonomous practitioners.

The Internationally Educated Midwives Bridging Program (IEMBP) runs between 8 and 10 months at the University of British Columbia.

At the Université du Québec à Trois-Rivières, French-speaking internationally trained midwives may earn the Certificat personnalisé en pratique sage-femme.

[citation needed] The legal recognition of midwifery has brought midwives into the mainstream of health care with universal funding for services, hospital privileges, rights to prescribe medications commonly needed during pregnancy, birth and postpartum, and rights to order blood work and ultrasounds for their own clients and full consultation access to physicians.

Any unregulated person who provides care with 'restricted acts' in regulated provinces or territories is practicing midwifery without a license and is subject to investigation and prosecution.

In 1996, the Health Professional Council released a draft of Bylaws for the College of Midwives of BC, which the Cabinet approved on 13 April 1997.

[25] In BC, midwives are primary care providers for women in all stages of pregnancy, from prenatal to six weeks postpartum.

If a complication arises in a pregnancy, labour, birth, or postpartum, a midwife consults with a specialist such as an obstetrician or paediatrician.

[31] Midwives (sage-femmes, literally meaning "wise-woman" or maïeuticien/maïeuticienne) are independent practitioners, specialists in birth and women's medicine.

[38] This figure fell to 23% delivered at home between 2007 and 2010 according to Midwifery in the Netherlands, a 2012 pamphlet by The Royal Dutch Organization for Midwives.

In all settings, midwives transfer care to an obstetrician in case of a complicated childbirth or need for emergency intervention.

[45] When a 16-year civil war ended in 1992, Mozambique's health care system was devastated and one in ten women were dying in childbirth.

As the figures now stand, Mozambique is one of the few countries on track to achieve the MDG of reducing the maternal death rate by 75% by 2015.

The midwifery profession has knowledge, skills and abilities to provide a primary complete maternity service to childbearing women on its own responsibility.

But, when complications arise, these women either die or develop debilitating conditions, such as obstetric fistula, or lose their babies."

Short course students, who are already registered adult nurses, have different funding arrangements, with a diminishing number being employed by the local NHS Trust via the Strategic Health Authority (SHA), and are paid salaries.

They must know when to refer complications to medical staff, act as the women's advocate, and ensure that mothers retain choice and control over childbirth.

Many states have birthing centers where a midwife may work individually or as a group,[78] which provides additional clinical opportunities for student midwives.

In the United Kingdom, even after the passing of the Sex Discrimination Act 1975, the Royal College of Midwives barred men from the profession until 1983.

[90] In the US, there remain a small, stable or minimally declining number of male midwives with full scope training (CNMs/CMs), comprising approximately 1% of the membership of the American College of Nurse-Midwives.

Pierrette de Bouvile the sworn midwife in the 1460s in the village of Arpajon south of Paris, she was married to a churchwarden.

[94] They consulted in investigations of rape cases and determination on a female's virginity because they were the society's top specialists in sexual medicine.

Although midwives dominated the field and had extensive experience in childbirth, they did not have equivalent participation on elite medical literature.

Male physicians even established a boundary between their learned pharmaceutical knowledge as opposite to the midwife's manual manipulations.

[105] They believed the midwife's existence was due to gender segregation, and it limited the male physician's role in childbirth.