Workforce issues, skill mix, maternity services and the Enrolled Nurse : a discussion

New South Wales (NSW) is experiencing a shortage of registered midwives. Currently midwives are being actively recruited for 125 metropolitan and 45 rural positions in area health services across the state. This shortage of registered midwives is occurring not only in NSW but also throughout Australia, and has also been reported internationally (McKenna & Hasson, 2002; Keeney et al. 2005). In an attempt to address the ongoing shortage of registered nurses and midwives the NSW Health Department has proposed that a skill mix of 80% registered nurses or midwives to 20% enrolled nurses be implemented within hospitals. This initiative will have significant consequences for women and their families receiving care within maternity units and for the midwives who currently deliver that care should this be implemented within Maternity units.