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The transition from student midwife to autonomous practitioner within an institution such as the National Health Service (NHS) can be a turbulent period, which requires the collaboration and commitment of the universities and NHS Trusts to adequately support and nurture this essential professional phase (Kitson-Reynolds et al 2015). Lecturers frequently remind student midwives of their impending autonomous status, yet failures exist to adequately and accurately reflect the‘concept and realities'of autonomy in professional practice (Baird 2007). The universities and hospitals alike appear to regard autonomy as a panacea for the next generation of midwives. The attributes of independence, self-governance and self-determination (Pairman et al 2015), are no doubt attractive definitions to add to any ‘person specification' when seeking to employ staff who appear to have the skill set to address the failings that perpetually persist within the maternity setting. The NHS remains a hierarchal, antiquated institution and is arguably completely incompatible with the rhetoric of autonomy. The NHS was prophetically described in 1997 by Nigel Lawson, a Tory Chancellor of the Exchequer, as‘the closest thing to a religion in England'(The Economist 2000). Similar to religion it is frequently inflexible and interpreted to suit the needs of misguided individuals, often holding positions of power they are no longer suitable to hold in the 21st century.