Childbearing women’s concerns are evaluated by midwives during telephone triage to determine a need for advice or further assessment. Individual maternity services rather than general call centres manage these calls from women. This important practice contributes to the provision of timely and appropriate healthcare, further evidenced during the Covid-19 pandemic. Little is known about midwives’ telephone triage practises. The aim of this study was to explore practising midwives’ views, experiences, and practices of telephone triage. A two-phased sequential mixed method design was used encompassing an online survey and one-on-one interviews. Survey data underwent descriptive statistical analyses using SPSS V24. Transcribed verbatim interviews were analysed thematically. Survey respondents totalled ( n =230) and interview participants ( n =14). Integrated findings suggest telephone triage is an unacknowledged practice that increases midwives’ workloads. Midwives reported they manage thousands of calls each year with competing workload interests, environmental distractions, and inconsistent workplace processes. The need for experience and time to develop specific skills to safeguard ‘getting it right’ and ‘meeting expectations’ was identified. Considerable time is needed to respond to calls and provide quality care to women. Workplace environments can impede information collected and decision-making. Telephone triage was perceived as ‘risky business’ with intrinsic clinical, legal and professional risk that for some may evoke anxiety. This study emphasises variations in service provision, midwives’ practice, and management of telephone triage. Empathy, high-level interpersonal and communication skills are needed. Recommendations from midwives included training and support to develop skills in telephone triage. With evolving technologies and communication platforms, these findings establish a basis for midwives and health services when providing care from a distance. Providing quality, effective, and safe care to women during telephone triage, midwives need clear governance, support to develop skills, time to triage, and suitable work environments.