Midwife vs Nurse: Key Differences in Training, Work and Which Career Suits You

“So you’re a nurse who delivers babies?” Every midwife has heard it. In many countries midwifery is a completely separate profession with its own degree, its own register and its own scope of practice. Whether you’re choosing a course or thinking about switching careers, here’s how the two really compare.

Imagine two friends who start university on the same day. One trains as a nurse and, ten years later, is running an intensive care unit, caring for people from teenagers to ninety-year-olds. The other trains as a midwife and has helped bring hundreds of babies into the world, supporting families from the first scan to the weeks after birth. Both chose healthcare. Their days could hardly be more different.

The core difference

• Nurses care for people of all ages with a huge range of health needs, in hospitals, communities, homes, schools and more.
• Midwives are specialists in pregnancy, labour, birth and the weeks after birth. They care for the woman or birthing person and the newborn baby, lead care in straightforward pregnancies, and refer to doctors when complications arise.

The World Health Organization and its partners estimate that fully educated and supported midwives could provide around 90% of essential sexual, reproductive, maternal and newborn healthcare, yet the world is short of hundreds of thousands of midwives.

How training works in different countries

• United Kingdom: midwifery is a separate three-year degree (direct entry). Registered nurses can take a shortened midwifery programme. Both professions register with the Nursing and Midwifery Council, on separate parts of the register.
• United States: most midwives in hospitals are Certified Nurse-Midwives (CNMs): registered nurses with a graduate degree in midwifery who pass a national exam. Certified Midwives (CMs) complete the same graduate education without being nurses, but can practise in fewer states. Certified Professional Midwives (CPMs) mainly attend births outside hospital. Labour and delivery nurses are RNs, not midwives.
• Australia: you can take a Bachelor of Midwifery, a double degree in nursing and midwifery, or a postgraduate midwifery course after nursing. Registration is with the Nursing and Midwifery Board of Australia.
• Canada: midwifery is a separate regulated profession, usually entered through a four-year university degree, and regulated province by province.
• Many other countries train “nurse-midwives,” who hold both qualifications and work across both roles.

Day-to-day work compared

• Patients: nurses see every age and condition; midwives focus on pregnancy, birth and newborns.
• Settings: nurses can work almost anywhere; midwives work in antenatal clinics, labour wards, birth centres, postnatal wards and families’ homes.
• Autonomy: midwives in many countries lead the care of straightforward pregnancies and births. Nurses’ autonomy grows with specialisation and advanced practice.
• Career flexibility: nursing offers more specialities to move between; midwifery offers depth in one field, with paths into research, education, leadership and specialist roles.

But which one should you choose?

Choose midwifery if pregnancy and birth genuinely fascinate you and you’re ready for the emotional highs and the hard days when things go wrong. Choose nursing if you want broad options and the freedom to change specialty over your career. Unsure? Nursing first, then midwifery later, is a common route in many countries, and some people train in both from the start. Before you decide, check how each qualification is recognised in any country you might want to work in, because direct-entry midwifery is not recognised everywhere.

Sources: World Health Organization, UNFPA and International Confederation of Midwives (State of the World’s Midwifery 2021), Nursing and Midwifery Council (UK), American College of Nurse-Midwives, Nursing and Midwifery Board of Australia, Canadian Association of Midwives. This article is for general information.