With the registration of nurses and midwives being undertaken by the various State Government Registration Boards, in 1924 the ATNA evolved into a professional organisation and trade union. The State Branches of ATNA and the RVTNA came together to form the branches of Australian Nursing Federation.
In 1937, ANF gained membership to the International Council of Nurses. The ANF went into recess in 1939 due to the outbreak of World War II, before recommencing operations in 1943.
Royal assent was granted in 1955 during a visit from Queen Elizabeth II, and the name changed to the Royal Australian Nursing Federation (RANF). The Royal was dropped in 1988.
Throughout the twentieth century groups of midwives in each State met regularly to discuss all issues related to, or affecting midwifery. Initially these groups had met as sub groups under the ATNA’s various State Nurses Associations, and then moved to become Special Interest Groups of the State Branches of the Australian Nursing Federation. The origins of the Australian College of Midwives is in these Midwifery Special Interest Groups.
In 2013 the ANF changed its name to the Australian Nursing & Midwifery Federation (ANMF) to recognise the specialist skills and knowledge of midwife members. Today, the ANMF is the largest national union in Australia, with an autonomous branch in each State and Territory. It is the peak professional, industrial and OH&S organisation for midwives and nurses, and their primary focus is still on improving the pay and working conditions for all members.