Electronic Fetal Heart Monitoring (EFM) is a critical component of perinatal care, necessitating a nuanced understanding of midwives' knowledge and skills in its application. This study introduces a comprehensive examination of midwives' proficiency in EFM, addressing a gap in current literature. The novelty lies in its multi-faceted approach, encompassing theoretical understanding, practical skills, and contextual challenges. The aim is to identify strengths, areas for improvement, and effective interventions to enhance midwives' competence. Methodologically, a series of studies spanning from 1993 to 2023 employ cross-sectional analyses, simulation-based evaluations, longitudinal assessments, qualitative exploration, and a comparative analysis of educational interventions. Preliminary findings underscore variations in midwives' theoretical knowledge, the importance of simulation-based training, ongoing skill progression, and contextual challenges. The conclusion emphasizes the need for tailored educational interventions, addressing contextual challenges, and fostering a collaborative approach.