• Offers her experience, care, respect, counsel and support to each woman she serves
• Freely shares her midwifery philosophy, professional standards, personal scope of practice and expertise, as well as any limitations imposed upon her practice by local regulatory agencies and state law
• Recognizes that each woman she cares for is responsible for her own health and well-being
• Accepts the right of each woman to make decisions about her general health care and her pregnancy and birthing experience
• Negotiates her role as caregiver with the woman and clearly identifies mutual and individual responsibilities, as well as fees for her services
• Communicates openly and interactively with each woman she serves
• Provides for the social, psychological, physical, emotional, spiritual and cultural needs of each woman
• Does not impose her value system on the woman
• Solicits and respects the woman's input regarding her own state of health
• Respects the importance of others in the woman's life.
Standard Two: Midwifery actions are prioritized to optimize well-being and minimize risk, with attention to the individual needs of each woman and baby.
The NACPM member:
• Supports the natural process of pregnancy and childbirth
• Provides continuous care, when possible, to protect the integrity of the woman's experience and the birth and to bring a broad range of skills and services into each woman's care
• Bases her choices of interventions on empirical and/or research evidence, verifying that the probable benefits outweigh the risks
• Strives to minimize technological interventions
• Demonstrates competency in emergencies and gives priority to potentially life-threatening situations
• Refers the woman or baby to appropriate professionals when either needs care outside her scope of practice or expertise
• Works collaboratively with other health professionals
• Continues to provide supportive care when care is transferred to another provider, if possible, unless the mother declines
• Maintains her own health and well-being to optimize her ability to provide care.
Standard Three: The midwife supports each woman's right to plan her care according to her needs and desires. The NACPM member:
• Shares all relevant information in language that is understandable to the woman
• Supports the woman in seeking information from a variety of sources to facilitate informed decision-making
• Reviews options with the woman and addresses her questions and concerns
• Respects the woman's right to decline treatments or procedures and properly documents her choices
• Develops and documents a plan for midwifery care together with the woman
• Clearly states and documents when her professional judgment is in conflict with the decision or plans of the woman
• Clearly states and documents when a woman's choices fall outside the NACPM member's legal scope of practice or expertise
• Helps the woman access the type of care she has chosen
• May refuse to provide or continue care and refers the woman to other professionals if she deems the situation or the care requested to be unsafe or unacceptable
• Has the right and responsibility to transfer care in critical situations that she deems to be unsafe. She refers the woman to other professionals and remains with the woman until the transfer is complete.
Standard Four: The midwife concludes the caregiving partnership with each woman responsibly. The NACPM member:
• Continues her partnership with the woman until that partnership is ended at the final postnatal visit or until she or the woman ends the partnership and the midwife documents same
• Ensures that the woman is educated to care for herself and her baby prior to discharge from midwifery care
• Ensures that the woman has had an opportunity to reflect on and discuss her childbirth experience
• Informs the woman and her family of available community support networks and refers appropriately.
Standard Five: The NACPM member collects and records the woman's and baby's health data, problems, decisions and plans comprehensively throughout the caregiving partnership. The NACPM member:
• Keeps legible records for each woman, beginning at the first formal contact and continuing throughout the caregiving relationship
• Does not share the woman's medical and midwifery records without her permission, except as legally required
• Reviews and updates records at each professional contact with the woman
• Includes the individual nature of each woman's pregnancy in her assessments and documentation
• Uses her assessments as the basis for on-going midwifery care
• Clearly documents her objective findings, decisions and professional actions
• Documents the woman's decisions regarding choices for care, including informed consent or refusal of care
• Makes records and other relevant information accessible and available at all times to the woman and other appropriate persons with the woman's knowledge and consent
• Files legal documents appropriately.
Standard Six: The midwife continuously evaluates and improves her knowledge, skills and practice in her endeavor to provide the best possible care. The NACPM member:
• Continuously involves the women for whom she provides care in the evaluation of her practice
• Uses feedback from the women she serves to improve her practice
• Collects her practice statistics and uses the data to improve her practice
• Informs each woman she serves of mechanisms for complaints and review, including the NARM peer review and grievance process
• Participates in continuing midwifery education and peer review
• May identify areas for research and may conduct and/or collaborate in research
• Shares research findings and incorporates these into midwifery practice as appropriate
• Knows and understands the history of midwifery in the United States
• Acknowledges that social policies can influence the health of mothers, babies and families; therefore, she acts to influence such policies, as appropriate.
V. Endorsement of Supportive Statements
NACPM members endorse the Midwives Model of Care ({ 1996-2004 Midwifery Task Force), the Mother Friendly Childbirth Initiative ({ 1996 Coalition for Improving Maternity Services) and the Rights of Childbearing Women ({ 1999 Maternity Center Association, Revised 2004). For the full text of each of these statements, please refer to the following web pages.
Copyright © 2004 National Association of Certified Professional Midwives, All Rights Reserved
