BACKGROUND: The use of complementary and alternative medicine during pregnancy has become increasingly popular over the past decade in Australia. AIM: The purpose of this discussion paper to make recommendations and foster a constructive debate regarding the appropriate response by the midwifery profession. DISCUSSION: Midwives should receive basic education regarding the use of complementary and alternative medicine. All women should be routinely question women about their use and this should be documented. While a few therapies could be safely integrated, in most situations interested women should be referred to a qualified practitioner. Referral frameworks and flexible clinical guidelines should be investigated. CONCLUSION: With the appropriate education and support, midwives are in an excellent position to engage women in open dialogue and raise awareness of the benefits and risks of CAM practices. The way forwards for midwifery profession is to focus on self-governance, education and flexible clinical guidelines.