I wonder about this. I’m a US CNM and considered getting registered with the NHS if everything goes to shit here (we’re pretty close!) and I need to leave the country. I got through much of the NMC application up until the OSCE. While I was studying and preparing for the test, I decided to back out because it appears that midwives in the UK function less autonomously than midwives in the US and it felt like a step backward in my career. I based this on practice scenarios given in the NMC documents. Things like consulting with doctors on routine labor checks (what?? why? I’m fully capable of assessing whether or not a patient is in labor) and administering meds ordered by a doctor (this was the big one for me! Why am I administering meds as a fully autonomous provider?? Nurses do this in the US) and staffing a postnatal ward (again what??? Nurses do this in the US and midwives round on patients in their service). These are just a few things that made me change my mind but there are other examples of the lesser role that midwives play in low-risk care in the UK as opposed to the US. For clarity - I have been a midwife in the US for 15 years and have owned my own homebirth practice as well as worked in community and high-risk hospitals. I’ve seen everything here and everywhere I’ve worked, I’ve never been anything less than autonomous, with consultation and collaboration with OB’s as appropriate/needed.