California College of Midwives

Jan 2003

Principles of Mother-Friendly Childbearing Services

 Part Four ~ Generally Accepted Practices for Community-based Midwifery Practice

Code of Ethics ~ Adapted from the practice guidelines of the College of Midwives,
British Columbia, Canada

These principles direct the conduct of midwives in their relationships with individuals, institutions and the community as a whole. They provide a framework to enhance the midwife's capacity for effective ethical decision making and reflection.

Midwives are professionals who recognize their accountability to their clients, the public and their profession. Midwives should always act in a manner that enhances the reputation of, and inspires public confidence in the profession.

1. A midwife's primary responsibility is to safeguard the well-being of the women and newborns in her care. Midwives use their knowledge and expertise to provide a high standard of care to women and their families .

1.1. Midwives shall practice midwifery in accordance with the Licensed Midwifery Practice Act of 1993 and the Generally Accepted Practices for community-based midwifery.
1.2. Midwives shall promote the normal process of birth within the context of safe practice.
1.3. Midwives shall accept full responsibility for the care they provide to women and their newborn infants.

2. Midwives recognize the importance of continuing education and participation in the education of students and other midwives. Midwives are expected to share midwifery knowledge through a variety of processes such as peer review and research.

2.1. Midwives shall maintain current competency in their midwifery practice.
2.2. Midwives shall only engage in research that is consistent with the Standards of Practice.

3. Midwives provide care that is responsive to the needs and values of women and respect the dignity of their clients. Midwives work with women and support the woman's right to participate fully in decisions about her care. Midwives provide the best possible care in all circumstances. When a midwife is unable to provide care she should make a reasonable attempt to assist the woman to find appropriate alternate care. Midwives do not let their personal beliefs deprive their clients of essential health care services.

3.1. Midwives shall provide midwifery care without discriminating on the basis of race, color, ancestry, place of origin, political beliefs, religion, marital status, family status, age, sexual orientation, physical or mental disability.
3.2. Midwives shall respect a woman's right of informed choice and consent.
3.3. Midwives shall inform their clients of the scope and limitations of midwifery practice.
3.4. Midwives shall inform their clients of the legal limitations of confidentiality.
3.5. Midwives shall ensure that no act or omission places the woman or her newborn at risk.
3.6. Midwives shall not compromise care for reasons of personal or institutional
3.7. Midwives shall not abandon care of a client in labor.
3.8. Midwives shall never practice midwifery while their ability to do so is impaired.

4. Midwives recognize the human interdependence within their field of practice and seek to resolve inherent conflicts. The midwife recognizes the contribution and expertise of colleagues from other health care disciplines. Midwives also acknowledge and respect the role of community groups who provide care and support for childbearing women.

4.1. Midwives shall interact respectfully and honestly with the people with whom they work and practice.
4.2. Midwives shall collaborate with other health care professionals, consulting and referring as necessary when the woman's need for care exceeds the midwife's professional expertise.

5. Midwives act as effective role models by maintaining a standard of practice that is both professional and ethical. Midwives should not engage in any professional activity that would adversely affect the honor, dignity, or credibility of the profession.

5.1. Midwives shall adhere to the professional standards in making known the availability of their services.
5.2. Midwives shall not accept any gift, favor or hospitality which might be construed as either professional endorsement of a commercial product or as seeking to obtain preferential consideration from a client.

6. Midwives work with policy and funding agencies to determine women's need for health services and to promote the fair allocation of health care resources.

6.1. Midwives shall actively promote equal access to health care that meets the needs of childbearing women.

The California licensed midwives looks forward to a time when we are regulated by a Midwifery Board made up of six elected midwife members and three appointed public members that meets quarterly. Public attendance at board meetings should be encouraged.  Committees of the Board should meet regularly.

Adapted from the practice guidelines of the College of Midwives,
British Columbia, Canada

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