Licensure rules are blocking midwives
A Scottish midwife was prevented from practicing in British Columbia because of regulatory hurdles, prompting her return home, and Nigerian threads report delays in certificates, calls for dedicated midwifery degrees, and low student stipends—spotlighting how bureaucratic and educational gaps worsen global midwifery shortages. These examples show that licensure friction and training-resource shortfalls can be as decisive as workforce numbers. (x.com) (x.com)
A 58-year-old Scottish midwife spent seven months delivering care in Victoria, British Columbia, then was told on March 24 to leave Canada after her work permit was rejected, even as the province said it needs more birth-care staff. The rejection was not about a misconduct finding or a failed clinical exam. Immigration, Refugees and Citizenship Canada said the University of British Columbia bridging program she completed was not an eligible program for a post-graduate work permit because part of the nine-month course was online. British Columbia’s own regulator requires internationally educated midwives to complete that exact University of British Columbia Internationally Educated Midwives Bridging Program before they can move toward licensure. The British Columbia College of Nurses and Midwives says those midwives cannot apply directly until they meet the college’s eligibility rules, and the bridging program is the gate they must pass through. That means one branch of the system told Heather Gilchrist to take a British Columbia-approved path, while another branch treated the same path as a reason to deny her status. Premier David Eby called the result absurd enough that he publicly asked Ottawa to revisit the case before her planned April 4 return to Scotland. This is what a workforce shortage looks like on paper instead of in a hospital hallway. The World Health Organization estimated in July 2025 that the world is short about 310,000 midwives by 2030, and a January 2026 analysis cited by the International Confederation of Midwives put the current gap even higher at 980,000 across 181 countries. The newer midwifery study says the problem is not just training more people. It says many midwives are already educated but are not employed, deployed, or enabled to practice fully, which turns bureaucracy into the same kind of bottleneck as a staffing shortage. Nigeria shows the same problem in a different form. Pulse Nigeria reported on April 6 that thousands of nursing and midwifery graduates who finished training and passed professional exams have been unable to work since 2023 because the Nursing and Midwifery Council of Nigeria has not issued their certificates. In Nigeria, the missing document is the lock on the door. The Nursing and Midwifery Council of Nigeria is the statutory body that regulates nursing and midwifery practice, so without its certificate, graduates can be trained on paper and still be unemployable in formal settings. The World Health Organization’s own plan for nursing and midwifery names four levers: education, jobs, leadership, and service delivery. The British Columbia case sits at the border between education and immigration, and the Nigeria complaints sit at the border between education and certification, but both end at the same place: fewer practicing midwives than the headline numbers suggest. That is why raw headcounts can mislead. A country can approve a bridging course, train a clinician, and still lose her to a visa rule, or it can graduate students, examine them, and still stall them with missing certificates, leaving pregnant patients to feel a shortage that was partly created by paperwork.
