Midwifery Guide 2025

Midwifery Practice in
GCC Hospitals

RM licensing, normal labour, obstetric emergencies, neonatal care, APGAR calculator and GCC career pathways — all in one guide.

AED 18K
Senior midwife ceiling salary — UAE
+15–25%
Midwife premium over general nursing
4
Separate GCC licensing pathways for RM
RM+RN
Dual registration = wider scope & pay
Tab 1
Midwifery in the GCC — Overview

Midwives in the GCC hold separate RM registration — not simply an extension of RN practice. Understanding this distinction is essential before applying.

🏅
RM vs Obstetric Nurse — Key Distinction
A Registered Midwife (RM) holds an independent midwifery qualification and registration separate from RN. In GCC hospitals, midwives manage autonomous caseloads including normal labour, delivery and postnatal care.

An obstetric nurse (RN) supports within a medically directed team but cannot independently conduct deliveries or make autonomous midwifery decisions without midwifery licensure.
Dual Registration Advantage: Holding both RN and RM registration qualifies you for senior midwife and specialist roles, unlocking 15–25% higher salary and broader scope of practice.
💰
Midwife Salaries in GCC (2025)
LevelUAE (AED/mo)Qatar (QAR/mo)
Staff Midwife8,000–11,0009,000–12,500
Senior Midwife12,000–18,00013,000–19,000
Head of Midwifery20,000–28,00021,000–29,000
Saudi Arabia and Kuwait salaries typically 10–15% lower; Bahrain and Oman comparable to Saudi. All figures tax-free.
GCC Licensing Pathways for Midwives
AuthorityCountryMidwifery CategoryKey Points
DHADubai, UAESeparate RM categoryDedicated midwife classification; full autonomous scope in licensed facilities
DOHAbu Dhabi, UAEMidwife — separate trackRM credential assessed independently of RN; Prometric exam required
SCHS / NCBESaudi ArabiaLimited midwifery scopeMidwifery largely subsumed under obstetric nursing; limited RM-specific roles in public sector
QCHPQatarMidwifery classificationSidra Medicine and HMC hire RMs directly; dedicated midwifery department structures
MOH Kuwait / Bahrain / OmanKuwait, Bahrain, OmanRN with midwifery endorsementRM qualification recognised; often licensed under RN track with midwifery competency verification
Key Employers — Dedicated Midwifery Hospitals
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Sidra Medicine — Doha, Qatar
Qatar's flagship women's and children's hospital. Runs a UK-influenced midwifery model with midwife-led units, birth centres and dedicated RM workforce. Highly sought after for career development.
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Women's Hospital HMC — Doha, Qatar
Part of Hamad Medical Corporation. Largest volume maternity unit in Qatar; large midwifery workforce, excellent training infrastructure and structured competency frameworks.
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SKMC Women's Hospital — Abu Dhabi, UAE
Sheikh Khalifa Medical City Women's Hospital. Tertiary-level maternity and fetal medicine. Strong midwifery establishment with DOH licensing support and research opportunities.
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King Fahad Medical City — Riyadh, KSA
Women's and Children's Hospital within KFMC. Large maternity complex; obstetric nursing dominant but RM-qualified staff are placed in senior roles and specialist positions.
Tab 2
Normal Midwifery Practice

Core midwifery competencies across the antenatal, intrapartum and postnatal continuum.

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Antenatal Care
  • Booking visit: history, dating scan, blood panel (FBC, blood group, rubella, VDRL, HIV, HBsAg), urine culture, BMI
  • Ongoing surveillance: BP, urinalysis, fundal height, fetal lie/presentation, fetal heart
  • Fetal wellbeing: anomaly scan (18–20 wks), growth scans PRN, CTG from 34 wks if indicated
  • Education: nutrition, iron/folate, birth planning, infant feeding choice
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Labour Assessment & Admission
  • Confirm labour: regular contractions, cervical change on VE (dilatation, effacement, station)
  • Admission CTG ≥20 min — reactive pattern before midwife-led care
  • Partogram commenced at active labour (≥4 cm); alert/action lines used to detect progress failure
  • SBAR handover on admission; identify high-risk features triggering obstetric review
⏱️
Stages of Normal Labour
  • 1st stage: latent (0–4 cm) and active (4–10 cm). Support, hydration, mobility, 4-hourly VE
  • 2nd stage: passive descent then active pushing. Perineal support, controlled delivery of head
  • 3rd stage (AMTSL): oxytocin 10 units IM with delivery of anterior shoulder; controlled cord traction; uterine massage if atony
  • Inspect placenta for completeness; perineal inspection and repair if indicated
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Pain Relief Options
  • Entonox (50% N₂O/O₂): self-administered, minimal fetal effect, popular in UAE
  • IM pethidine 100mg or diamorphine 5mg: midwife-administered; monitor for maternal sedation and neonatal respiratory depression
  • Epidural: anaesthetist-placed; midwife manages top-ups, monitors BP, motor block, maternal temperature
  • Water birth: growing popularity in UAE private hospitals; maintain water temp 36–37.5°C
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Immediate Newborn Care
  • Delayed cord clamping: minimum 1–3 min (NICE/WHO recommendation)
  • Skin-to-skin: immediate, minimum 1 hour if stable
  • APGAR: scored at 1 and 5 minutes (see calculator in Tab 5)
  • Vitamin K: 1mg IM within 1 hour of birth
  • Identification bands × 2; weight, head circumference, temperature
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Postnatal — BUBBLEHE Framework
Breasts · Uterus · Bladder · Bowels · Lochia · Episiotomy/perineum · Homans sign (DVT) · Emotional wellbeing

Breastfeeding: assess latch (LATCH score), positioning (cradle, football, laid-back), engorgement management, mastitis — advise continue feeding, warm compress, analgesia; if abscess refer.
Tab 3
Obstetric Emergencies — Midwifery Response

Recognise, call for help, initiate — the midwife's role in time-critical obstetric emergencies.

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PPH — Postpartum Haemorrhage
Primary PPH: blood loss ≥500 ml (vaginal) or ≥1000 ml (LSCS) within 24 h. Uterine atony = 80% of cases.
HAEMOSTASIS
H
Help — call team; two large-bore IVs, bloods, O₂
A
Assess/resuscitate — ABC, IV crystalloid, cross-match
E
Establish cause — 4 Ts: Tone, Trauma, Tissue, Thrombin
M
Massage uterus — bimanual compression if atony
O
Oxytocics — oxytocin 10u IM → ergometrine → carboprost 250 mcg IM → misoprostol 800 mcg PR
S→S
Shift to theatre if medical management fails; massive transfusion protocol at ≥4 units pRBC
⚡
Eclampsia
Tonic-clonic seizure in pre-eclamptic patient (or de novo).
1
Protect airway — position lateral, do not restrain, suction if needed, O₂ 15L NRB
2
MgSO₄ loading: 4g IV over 20 min (dilute in 100ml NaCl), then 1g/hr maintenance infusion
3
BP control: labetalol 20mg IV (titrate) or hydralazine 5mg IV for BP ≥160/110
4
Monitor patellar reflex, urine output ≥25ml/hr, resp rate ≥14 — signs of Mg toxicity. Antidote: calcium gluconate 1g IV
5
Expedite delivery — mode dependent on cervix and gestation
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Shoulder Dystocia
Failure of shoulder delivery after head. Call for help immediately.
HELPERR
H
Help — call obstetrician, senior midwife, paediatric team, anaesthetist
E
Evaluate for episiotomy (creates space for manoeuvres)
L
Legs — McRoberts manoeuvre (hyperflex thighs onto abdomen)
P
Pressure — suprapubic, downward and lateral (Rubin I)
E
Enter — rotational manoeuvres (Woods screw, Rubin II)
R
Remove posterior arm — sweep across chest
R
Roll to all-fours (Gaskin manoeuvre)
Document time of head delivery, manoeuvres performed in order, time of delivery. Debrief parents.
🔗
Cord Prolapse
  • Cord below presenting part after membrane rupture — fetal emergency
  • Manual elevation of presenting part per vaginum to relieve cord compression
  • Position: knee-chest or Trendelenburg; keep cord warm and moist (saline-soaked gauze)
  • Do NOT replace cord into uterus
  • Continuous CTG; call crash team; emergency LSCS within 30 min
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Uterine Rupture
  • Sudden severe abdominal pain, cessation of contractions, fetal bradycardia/loss of FHR
  • Maternal haemodynamic collapse, haematuria, palpable fetal parts outside uterus
  • Immediate: IV access × 2, fluids, O₂, cross-match, crash team
  • Emergency laparotomy — uterine repair or hysterectomy; neonatal resuscitation team on standby
  • Risk factors: prior LSCS, grandmultiparity, oxytocin hyperstimulation
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Amniotic Fluid Embolism (AFE)
  • Sudden cardiovascular collapse + DIC during or after labour — rare but catastrophic
  • Phase 1: pulmonary vasospasm → hypoxia, right heart failure
  • Phase 2: left heart failure, haemorrhage from coagulopathy
  • Initiate CPR; call anaesthetics, intensivists; massive transfusion protocol
  • Peri-mortem caesarean at 4 minutes of maternal cardiac arrest if ≥20 wks
Neonatal Resuscitation (NRP): Dry and stimulate → assess tone, breathing, heart rate → if HR <100 or apnoeic: open airway, 5 inflation breaths (30 cmH₂O) → 15 chest compressions : 2 breaths if HR <60 → adrenaline 10–30 mcg/kg IV if HR remains <60. Call paediatric team immediately. Use interactive APGAR calculator in Tab 5.
Tab 4
High-Risk Obstetrics

Conditions requiring escalation, specialist review, and heightened midwifery vigilance across the GCC.

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Pre-eclampsia & HELLP
Diagnosis: BP ≥140/90 mmHg on 2 occasions + proteinuria ≥300mg/24h (or PCR ≥30 mg/mmol) after 20 weeks.

Severe features: BP ≥160/110, oliguria (<500ml/24h), severe headache, visual disturbance, epigastric pain, pulmonary oedema, thrombocytopaenia.

HELLP: Haemolysis, Elevated Liver enzymes, Low Platelets — life-threatening; deliver regardless of gestation.

Midwife role: 4-hourly BP, daily urinalysis, fluid balance, fetal surveillance, prepare for MgSO₄ and antihypertensives.
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Gestational Diabetes (GDM)
GCC context: among the world's highest rates — routine screening essential.

OGTT: 75g at 24–28 weeks; diagnosis: fasting ≥5.1, 1h ≥10.0, 2h ≥8.5 mmol/L.

Intrapartum: hourly capillary glucose; target 4–7 mmol/L; insulin infusion if not controlled with diet.

Neonate: feed within 1 hour of birth; capillary BGL at 2h; monitor for hypoglycaemia (BGL <2.6 = treat).
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Placenta Praevia
  • Low-lying placenta covering or near internal os
  • Presents as painless bright red antepartum haemorrhage (APH)
  • NO vaginal examination — risk of catastrophic bleed
  • Admit for APH; IV access, CTG, obstetric review
  • Major praevia: elective LSCS at ≥37 weeks; blood products on standby
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Placental Abruption
  • Painful APH with uterine tenderness and hypertonicity
  • May be concealed (no visible bleeding) — suspect if haemodynamic compromise
  • Risk: fetal distress, DIC, maternal collapse
  • Two large-bore IVs, FBC/clotting/crossmatch, continuous CTG
  • Delivery decision based on maternal/fetal condition; DIC management with FFP, cryoprecipitate, platelets
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IUGR — Intrauterine Growth Restriction
  • EFW <10th centile; assess with serial growth scans every 2–4 weeks
  • Umbilical artery Doppler: absent or reversed end-diastolic flow = deliver promptly
  • Biophysical profile if Doppler compromised
  • Timing of delivery: balance prematurity vs in-utero deterioration
  • NICU team briefed; neonatal resuscitation equipment ready
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Preterm Labour
  • Regular contractions with cervical change <37 weeks
  • Tocolysis: nifedipine 20mg oral (first-line) or atosiban IV — 48h window for steroids
  • Betamethasone: 12mg IM × 2 doses, 24h apart — if <34 weeks; reduces RDS, IVH, NEC
  • MgSO₄ neuroprotection: if <32 weeks — 4g loading, 1g/hr maintenance until delivery
  • Transfer in utero to facility with appropriate NICU level
Tab 5
Neonatal Midwifery Care

Newborn assessment, screening, common conditions and the interactive APGAR calculator.

APGAR Score Calculator — Interactive

Select the best description for each parameter at the chosen time point.

A — Appearance (Colour)
P — Pulse (Heart Rate)
G — Grimace (Reflex Irritability)
A — Activity (Muscle Tone)
R — Respiration (Breathing)
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Vitamin K & Newborn Screening
  • Vitamin K: 1mg IM at birth (preferred) — prevents VKDB; oral schedule available but less reliable
  • Metabolic screen: PKU, hypothyroidism, CF, organic acidaemias — heel prick at 48–72h
  • NBHS: Newborn Hearing Screening — OAE before discharge; AABR if refer
  • Hip: Barlow (dislocate) and Ortolani (relocate) tests in first 72h; refer if positive
🌞
Neonatal Jaundice
Physiological: day 2–3, resolves by day 10–14. Bilirubin <250 μmol/L at term = usually safe.

Pathological: day 1 onset, prolonged (>14 days term / >21 days preterm), rapidly rising, conjugated — investigate cause (haemolytic, metabolic, infection).

Phototherapy nursing: eye patches, expose maximum skin, 4-hourly temperature, extra fluid intake (breastfeed +), turn every 2–4h; pause for feeds.
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Infant Feeding
  • WHO recommendation: initiate breastfeeding within 1 hour of birth; exclusive BF for 6 months
  • Colostrum high in IgA, protein, growth factors — essential for neonatal gut colonisation
  • Formula supplementation indicated for: maternal contraindication (HIV, active TB, certain medications), neonatal metabolic disease, documented insufficient milk with weight loss >10%
  • BFHI (Baby-Friendly Hospital Initiative) — all GCC tertiary hospitals work towards this standard
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SIDS Prevention — Safe Sleep
  • Back to sleep — supine position for every sleep
  • Firm, flat, waterproof mattress in cot
  • No co-sleeping — especially if parent smokes, uses alcohol, is very tired, or infant is preterm
  • Smoke-free environment — pre- and postnatal
  • Room temperature 16–20°C; avoid overheating
  • Pacifier at sleep onset once BF established (may be protective)
Tab 6
GCC Context & Career Development

The unique clinical and cultural landscape for midwives practising across the Gulf.

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GCC Maternity Landscape
  • High birth rates: GCC populations are young with above-average fertility — large maternity hospitals in every country
  • Female-only birth teams: cultural and religious preference means male midwives and male nurses do not practise in GCC maternity settings — this is a firm expectation, not preference
  • CS rates: among world's highest in GCC private hospitals — patient or obstetrician preference; VBAC support growing, especially in public sector
  • GDM epidemic: GCC has some of the world's highest rates of T2DM and GDM — screening and insulin management are core daily midwifery skills
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Cultural Practices in Midwifery Care
  • Postpartum foods: specific traditional foods believed to aid recovery and milk production — dates, fenugreek, ghee — support rather than discourage
  • Family presence: large family involvement in labour and postnatal care — communicate respectfully; involve family in education
  • Modesty: female-to-female care preference; knock, explain, cover; male staff always ask permission before entering
  • Hajj complications: pregnant pilgrims present to Makkah hospitals — emergency obstetric care in resource-variable settings
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Career Ladder
1
Staff Midwife — 1–4 years; caseload management, competency consolidation
2
Senior Midwife — 4–8 years; shift coordinator, preceptor for new staff
3
Head of Midwifery / Ward Manager — 8+ years; department governance, staffing, quality
4
Consultant Midwife / Clinical Specialist — advanced practice; research, policy, complex care
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Qualifications & Courses
  • RM registration bodies: UK NMC, Irish Nursing & Midwifery Board, Australian AHPRA — all highly regarded by GCC regulators
  • ALSO: Advanced Life Support in Obstetrics — highly valued by GCC employers; covers all obstetric emergencies
  • NRP: Neonatal Resuscitation Program — mandatory in most GCC maternity hospitals
  • CTG interpretation: STAN, K2MS, or equivalent — expected competency at hire
  • Postgraduate: MSc Midwifery, PgDip High-Risk Obstetrics, Fetal Medicine modules
Registering BodyCountry of IssueGCC RecognitionNotes
UK NMC (RM)United KingdomGold standardRecognised by all GCC authorities; direct pathway in DHA and QCHP
Irish NMBI (RM)IrelandWidely acceptedEquivalent to NMC; document verification via Dataflow
AHPRA (RM)AustraliaAcceptedStrong reputation; some additional competency assessment may apply
SANC (Midwife)South AfricaCase by case4-year midwifery diploma accepted; additional assessment common
PRC (RM)PhilippinesLimited scopeFilipino midwifery scope differs; often re-assessed; RN + RM both needed