The authors - social scientists and midwifery practitioners - reflect on regional differences in the emerging profession, providing a systematic account of its historical, local, and international roots, its evolving regulatory status, and the degree to which it has been integrated into several mainstream provincial health care systems. They also examine the nature of midwifery training, accessibility, and effectiveness across diverse ethnic and socio-economic groups, highlighting the key issues facing the profession before, during, and in the immediate post-integration era in each province.