The evolution of registration standards for internationally qualified midwives in Australia.

Background: Registration as an internationally qualified midwife in Australia can be challenging, as the individual must meet rigorous education and professional competency assessment standards.

Aim: The purpose of this discussion is to present an overview of the evolution of registration standards for internationally qualified midwives in Australia from 2000 to 2020 and evaluate their effectiveness in promoting internationally qualified midwives' professional integration.

Results: Australian registration policies for internationally qualified midwives have undergone significant change over the last 20 years. In 2010, registration policy and governance moved from state or territory to national jurisdiction, then these standards were upgraded in 2014, and finally transitioned to an outcome-based assessment (OBA) program in 2020. Inconsistency and lack of transparency in established registration policies and their implementation were revealed, most notably when bridging programs for internationally qualified midwives from non-English speaking backgrounds were discontinued in Australia in 2015, despite reference in the NMBA policy as an available transition program from 2000 to 2020. The implementation of OBA in 2020, which occurred after a significant delay, complicated registration processes further with inclusion of two levels of assessment (MCQ examination and OSCE) and associated expenses.

Conclusion: Evidence-based strategies and regulatory adjustments are necessary to effectively register internationally qualified midwives in Australia, particularly those from non-English speaking backgrounds.