Part 5 ~ Generally Accepted Practices for Community-based Midwifery Practice

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Informed Choice Policy ~ Adapted from the practice guidelines of the College of Midwives,
British Columbia, Canada

Informed choice is a fundamental principle of midwifery care. Women have the right to receive information and be involved in the decision-making process throughout their midwifery care. In the Philosophy of Care document, the childbearing woman is recognized as the primary decision-maker. The interactive process of informed choice involves the promotion of shared responsibility between the midwife and her client. Midwives encourage and give guidance to clients wishing to seek out resources to assist them in the decision-making process. It is the responsibility of the midwife to facilitate the ongoing exchange of current knowledge in a non-authoritarian and co-operative manner, including sharing what is known and unknown about procedures, tests and medications.

California licensed midwives provide each client with the following information at the onset of their care and followed up in discussion:

education and experience in midwifery of the midwives in the practice;
services provided, including:
scope of practice
philosophy of care
choice of birth setting
contact information, including how the client can reach a midwife known to her 24 hours a day
(1), change of appointment procedure, off-call coverage arrangements, back-up arrangements;  second attendant arrangements, if applicable;
standards of practice and protocols, including:
continuity of care
consultation and transfer of care
supportive care
role and responsibilities of the client;
confidentiality and access to client records;
any student and/or supervised practice arrangements.

California licensed midwives provide each client with the following information throughout the course of care:

potential benefits and risks of, and alternatives to, procedures, tests and medications;  
relevant research evidence; 
community standards and practices

(1) Where a midwife is in solo practice and cannot make arrangements for on-call coverage by
another midwife, she must inform her client of how to access an alternate primary caregiver when she
is off-call. Ideally that alternate care provider would also be known to the woman.

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

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