BACKGROUND: Midwives commonly endorse the use of complementary medicine. However many work in hospitals where there can be significant opposition to use of these therapies. This paper describes how one group of midwives negotiated the conflicting perspectives. METHOD: Grounded theory was employed. Twenty five participants were recruited from metropolitan hospitals in Australia. Data was collected from interviews and observations. RESULTS: Midwives' behaviour was influenced by the meaning they constructed around their professional role and authority. Some emphasised ideological congruence, historical ties, and the ability of certain complementary therapies to reduce medical interventions, in order to legitimise their use. However, many were aware of biomedical opposition and undertook various strategies to protect themselves from conflict. CONCLUSIONS: Conflict regarding the use of complementary and alternative medicine is context specific. In some situations midwives can successfully negotiate the competing perspectives and expectations, while at other times they struggle to reconcile the disparities.