Misalignment in South African midwife specialists' education and practice legal frameworks

BACKGROUND:  The midwifery specialisation is one of sixteen clinical nursing specialisations in South Africa aimed at ensuring safe and comprehensive patient care. While specific training guidelines to ensure expanded knowledge and skills amongst the midwife specialists exist, there are no relevant regulations to legalise their specialists' knowledge. Current practice regulations are unsupportive of the midwife specialists' roles in clinical settings. OBJECTIVES:  This study aimed to explore and describe the legislative framework of midwife specialists' education and practice through the lens of midwife specialists in South Africa. METHOD:  Qualitative, explorative and descriptive research was followed. Sixteen midwife specialists identified through purposive sampling participated in virtual, semi-structured focus group interviews. Data were analysed using Collaizi's descriptive method. The context of the study is the public maternal health services of South Africa. RESULTS:  One central theme with seven subthemes emerged. Midwife specialists verbalised their views on the current education and training regulations (R.212; R.635 and competencies of midwife specialists). The midwife specialists also shared their views on practice regulations (R.2127, R.2488, R.767 and position statements on registered midwives' allocation and participation in surgical procedures). Additionally, midwife specialists highlighted the misalignments in these regulations. CONCLUSION:  Revision of the current legislation must align the midwife specialists' education and training competencies and outcomes. The alignment of these regulations will in turn legalise their specialists' practice.Contribution: This article advocates for the regulatory body's legal recognition of midwife specialists to enable autonomous and independent practice among midwife specialists.