Midwives provide women and their families with educational, emotional and social support and resources during pregnancy. Like most professions, midwifery is guided by ethical principles. According to Illysa R. Foster and Jon Lasser, authors of "Professional Ethics in Midwifery Practice," these guidelines help practitioners make decisions that support the dignity of the client and the midwife and protect the integrity of the profession as a whole.
Midwifery ethics serves several purposes. It raises the standard of practice for all midwives and allows the profession to self-regulate. Midwifery ethics helps identify the responsibilities of midwives with regard to professional relationships, maintaining education and skills, communicating with clients and colleagues and decision making. Professions that adopt a code of ethics establish public trust.
Systems of applied ethics are often developed over time and formed out of the collective experiences and shared beliefs of the practitioners in a profession. The professional identity of midwives is strengthened by the development of an applied system of professional ethics. Ethical codes help practitioners respond appropriately to common problems, and they help practitioners determine an appropriate course of action when unusual issues arise.
Midwifery ethics is influenced by biomedical ethics, particularly the four principles identified by Beauchamp and Childress. These principles include: beneficence, justice, respect for autonomy and doing no harm. Midwifery ethics is also profoundly influenced by the Midwives Model of Care (MMOC). According to Foster and Lasser, MMOC recognises that midwives develop much more personal relationships with their clients than most other health care professionals and that the development of this personal connection is essential to a midwife’s ability to provide a high standard of care, make appropriate decisions and advocate for the mother.
The field of midwifery is composed of direct entry practitioners and nurse midwives. The perspective of these two groups differs at times, and several codes of midwifery ethics have been developed over the years. The American College of Nurse Midwives (ACNM) and the International Confederation of Midwives (ICM) put forth ethical codes, and the editors of "Midwifery Law and Ethics" present one as well. The codes address similar issues and encourage midwives to provide the best possible care to women and infants, respect the autonomy of their clients, honour their profession, maintain their education and training, protect the confidentiality of their patients, avoid financial conflicts of interest, exercise sound judgment and make referrals when appropriate.
Midwifery ethics and the codes of ethics for midwives are continually evolving. As the profession becomes more unified and gains more acceptance, midwifery ethics will continue to be refined. Technological advances and increased cultural diversity encourage the midwifery profession to continue the discussion and development of its ethical guidelines.
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