Objective: To describe medical responsibilities of midwives in maternity units and to compare these responsibilities between categories of maternity units.
Method: A mail survey was carried out in 1996 on a random sample of midwives. The analysis was based on 884 midwives providing antepartum, perpartum or postpartum care in public or private maternity units.
Results: For many procedures and decisions, medical responsibilities of midwives were more important in the public sector than in the private sector. Responsibilities were more extended in university hospitals than in other public hospitals. These differences were observed in the postnatal ward, in the antenatal ward, and for some specific tasks in the labor ward. In the private sector, responsibilities varied according to the status of the maternity unit: midwives performed fewer procedures in profit-based maternity units than in non-profit ones.
Conclusion: The roles of midwives vary from one type of maternity unit to another, but differences are also observed within the same categories of units. Consensus on what are the medical responsibilities of midwives does not exist in a variety of situations, even with regard to the management of normal pregnancies and deliveries.