discuss how the Codes and Guidelines for Practice for Midwives protect and improve outcomes for childbearing women and families.

Midwifery – providing safe and competent care through standards and guidelines for practice

The prime role of the Midwifery Board of Australia is to protect the public through ensuring all practitioners provide safe and competent care. One way is to set standards and guidelines for practice. The following 3 apply to midwifery practice and are all interrelated. http://www.nursingmidwiferyboard.gov.au/
•Code of Professional Conduct for Midwives
•Code of Ethics for Midwives
•Professional Boundaries for Midwives (guideline).

Task: Using the following example from a health tribunal case which demonstrates unsatisfactory professional conduct by a midwife, discuss how the Codes and Guidelines for Practice for Midwives protect and improve outcomes for childbearing women and families. Use the following headings as a guide:
•Introduction (10%)
•The relationship between professionalism and health outcomes (10%)
•How midwives ensure safety of women and babies (20%)
•Role of midwifery codes and guidelines in promoting optimal outcomes (20%)
•Breaches of the codes/guidelines by the midwife (in the scenario) and rationale (30%)
•Conclusion (10%)

Scenario

A primipara who was adamant that she wanted a homebirth was booked for a homebirth with the midwife. Antenatal care was uneventful with the exception that the midwife incorrectly calculated the estimated date of birth to be 42 weeks gestation at the onset of labour when in fact the woman was 44 weeks gestation. Over the course of the intrapartum care, the midwife inappropriately failed to take and/or record maternal and fetal observations.

8th February: At 0930 hours the woman called the midwife to report that contractions had commenced. The midwife did not attend but rang the woman at 1530 hours and attended at 2230 hours to provide early labour care overnight and the next day.

9th February: At 2030 hours the cervix was 3cm dilated and contractions were irregular. At 2130 hours the midwife left for the night and instructed the woman’s partner on checking the fetal heart rate with the Doppler.

10th February: The woman continued to labour having strong contractions 2:10 and was attended by the midwife for some of the day. The midwife then left to work a night shift at the local hospital.

11th February: The midwife attended the woman at 0830 hours after her night shift. The cervix was 5cm dilated with moulding present. The midwife then went to sleep at the woman’s house. She was woken approximately six hours later at 1430 hours. Care resumed and the woman was fully dilated and pushing at 1830 hours. The fetal heart rate was auscultated at numerous times throughout the labour however at 1905 the fetal heart was unable to be auscultated. The woman was transferred to hospital where she gave birth to a stillborn baby.

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