Sarah Watts delivered her first baby before she became a midwife.

While working as a nurse in a general ward at a hospital in rural England, Ms Watts tended to an unwell pregnant woman.

"I just happened to come into the room and quickly pressed the buzzer because the woman thought the baby had come out," Ms Watts says.

"She was right, the baby had started to crown. Between me and a registered nurse, who had never done any obstetrics at all, we delivered the baby."

That moment went on to inform her ensuing midwifery training and her 20-year career, in which the safety of women and babies takes precedence.

Her warm and even voice, likely from years of calming labouring women, belies a passion for ensuring midwives are heard in the health hierarchy.

"If you don't think something's right, then you need to speak up, and keep speaking up until someone listens," Ms Watts says.

Now a consultant midwife for Victoria's Loddon Mallee perinatal support program, Ms Watts has been nominated for healthcare industry super fund HESTA's midwife of the year award.

NSW midwife Melanie Briggs, who founded the first Aboriginal-led maternity model of care, and Queensland's Teresa Walsh, who manages one of the first private midwifery practices in Australia, are also nominated.

In her busy role, Ms Watts works across 58,961 square kilometres from the Macedon Ranges, an hour from Melbourne, to Mildura, in the far west of the state.

Distance is the biggest challenge of a career in regional and rural settings, but the close-knit bonds of country life give deep meaning to her work.

She has delivered every child in some local families.

"One woman works in the shopping centre and I see her all the time,'' Ms Watts said.

"She tells everybody, 'This was my midwife.'

"Her children are grown up, and nearly ready to leave home.

"You have to be very mindful that you're going to make an impact on that person's life forevermore."

This month, the International Day of the Midwives highlighted the need for accessible and consistent birthing care.

One of Ms Watts's proudest achievements is working with others to develop a pregnancy road map, given to families to keep up with required screenings and understand every stage in the lead-up to birth.

It's a simple tool that supports the diverse population of regional Victoria and aims to ensure no one falls through the cracks.

Ms Watts takes seriously the origins of the word midwife, "woman who is with".

"As a birthing person you're totally reliant on somebody else that isn't your partner, or your loved ones,'' she said.

"You've got to put all your trust and faith in that person."