Informed decision making and the midwife's role

Date of this document October 2006

The Australian College of Midwives recognises and respects every woman’s right to make decisions for herself. Midwives have a responsibility to inform and advise women in their care of relevant evidence, guidelines, and clinical experience which may be helpful to the woman’s decision making

Rationale:

Midwives are accountable for the dissemination of unbiased, current information to promote informed choice by women. Midwives encourage and support women in their right to participate actively in decisions about their care, encouraging women to speak for themselves on issues affecting their health and welfare, and that of their families.

Guidelines:

• Midwives encourage women to ask questions and raise any concerns
• Obtain the woman’s consent before conducting an examination or commencing any care, intervention or treatment.

• Obtain informed consent a midwife will provide the woman with all the relevant information that will assist her with the decision making; including benefits and risks, the availability of any alternative choices, and any time frames within which her choice is to be made. Seek confirmation of the woman’s understanding.
• Provide current, objective, accurate, unbiased and appropriate information.
• Provide clear and precise written or other audiovisual information regarding the care, intervention or treatment, whenever possible, as an adjunct to verbal communication to assist in the decision making process.
• Offer the use of a qualified health interpreter, either in person or by telephone, when the woman’s first language is not English.
• Offer women a second opinion for any aspect of care, should they request it.

• Make clear and contemporaneous notes of the information given to the woman, including specific risks that have been discussed, whether any written or oral information was given, and the woman’s response to the information.

References:

ACM Code of Ethics 2002

ACM Philosophy Statement, April 2004

RANZCOG College Statement – Guidelines for consent and the provision of information regarding proposed treatment. March 2006

This College statement is intended to provide midwives, women and maternity services with the profession’s position on given situations.
Statements are designed to educate and support best practice and should never be relied on as a substitute for full assessment with respect to an individual woman or her baby. It is the responsibility of each provider to be fully aware of the individual circumstances of each case with regard to the application of this statement.
Whilst the College endeavours to ensure that statements are accurate and current at the time of their preparation, each provider must have regard to relevant information, research or literature which may have been published or become available subsequently.