24 Del. Admin. Code § 1795-2.0

Current through Register Vol. 28, No. 5, November 1, 2024

Section 1795-2.0 - Ethical Standards for Midwives

2.1 The midwife shall refuse to provide or continue care and refer the woman to other professionals if the life or health of either the mother or baby is at risk as defined by these regulations.

2.2 The midwife works in partnership with each woman she serves. The midwife:

2.2.1 Offers her experience, care, respect, counsel and support to each woman she serves;

2.2.2 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;

2.2.3 Recognizes that each woman she cares for is responsible for her own health and well-being;

2.2.4 Accepts the right of each woman to make decisions about her general health care and her pregnancy and birthing experience;

2.2.5 Negotiates her role as caregiver with the woman and clearly identifies mutual and individual responsibilities, as well as fees for her services;

2.2.6 Communicates openly and interactively with each woman she serves;

2.2.7 Provides for the social, psychological, physical, emotional, spiritual and cultural needs of each woman;

2.2.8 Does not impose her value system on the woman;

2.2.9 Solicits and respects the woman's input regarding her own state of health;

2.2.10 Respects the importance of others in the woman's life.

2.3 Midwifery actions are prioritized to optimize well-being and minimize risk, with attention to the individual needs of each woman and baby. The midwife:

2.3.1 Supports the natural process of pregnancy and childbirth;

2.3.2 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;

2.3.3 Bases her choices of interventions on empirical and/or research evidence, verifying that the probable benefits outweigh the risks;

2.3.4 Strives to minimize technological interventions;

2.3.5 Demonstrates competency in emergencies and gives priority to potentially life-threatening situations;

2.3.6 Refers the woman or baby to appropriate professionals when either needs care outside her scope of practice or expertise;

2.3.7 Works collaboratively with other health professionals;

2.3.8 Continues to provide supportive care when care is transferred to another provider, if possible;

2.3.9 Maintains her own health and well-being to optimize her ability to provide care.

2.4 The midwife supports each woman's right to plan her care according to her needs and desires. The midwife:

2.4.1 Shares all relevant information in language that is understandable to the woman;

2.4.2 Supports the woman in seeking information from a variety of sources to facilitate informed decision-making;

2.4.3 Reviews options with the woman and addresses her questions and concerns;

2.4.4 Respects the woman's right to decline treatments or procedures and properly documents her choices;

2.4.5 Develops and documents a plan for midwifery care together with the woman;

2.4.6 Clearly states and documents when her professional judgment is in conflict with the decision or plans of the woman;

2.4.7 Helps the woman access the type of care she has chosen;

2.4.8 Shall refuse to provide or continue care and refer the woman to other professionals if she deems the situation or the care requested to be unsafe or unacceptable;

2.4.9 Has the right and responsibility to transfer care in critical situations that she deems to be unsafe;

2.4.10 She refers the woman to other professionals and remains with the woman until the transfer is complete.

2.5 The midwife concludes the caregiving partnership with each woman responsibly. The midwife:

2.5.1 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;

2.5.2 Ensures that the woman is educated to care for herself and her baby prior to discharge from midwifery care;

2.5.3 Ensures that the woman has had an opportunity to reflect on and discuss her childbirth experience;

2.5.4 Informs the woman and her family of available community support networks and refers appropriately.

2.6 The midwife collects and records the woman's and baby's health data, problems, decisions and plans comprehensively throughout the caregiving partnership. The midwife:

2.6.1 Keeps legible records for each woman, beginning at the first formal contact and continuing throughout the caregiving relationship;

2.6.2 Does not share the woman's medical and midwifery records without her permission, except as legally required;

2.6.3 Reviews and updates records at each professional contact with the woman;

2.6.4 Includes the individual nature of each woman's pregnancy in her assessments and documentation;

2.6.5 Uses her assessments as the basis for on-going midwifery care;

2.6.6 Documents the woman's decisions regarding choices for care, including informed consent or refusal of care;

2.6.7 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;

2.6.8 Files birth and death certificates or records as required by law.

2.7 The midwife continuously evaluates and improves her knowledge, skills and practice in her endeavor to provide the best possible care. The midwife:

2.7.1 Continuously involves the women for whom she provides care in the evaluation of her practice;

2.7.2 Uses feedback from the women she serves to improve her practice;

2.7.3 Collects her practice statistics and uses the data to improve her practice;

2.7.4 Informs each woman she serves of mechanisms for complaints and review;

2.7.5 Participates in continuing midwifery education and peer review;

2.7.6 May identify areas for research and may conduct and/or collaborate in research;

2.7.7 Shares research findings and incorporates these into midwifery practice as appropriate.

24 Del. Admin. Code § 1795-2.0

20 DE Reg. 62 (7/1/2016) (Final)