for Midwives Practicing in Newfoundland and Labrador

Ethics is the study of moral values and moral reasoning. Ethical 
codes are formal statements that guide members of a profession in their 
obligations to clients, colleagues, the larger society and global health. 
A code of ethics is the consequence of the right to self-regulate that 
society grants to a gtiven profession in return for the proper exercise of 
its professional responsibilities.

The Code of Ethics of the College of Midwives of Newfoundland and Labrador 
(CMNL) is the set of principles used by College members to govern their 
decision-making in choosing between right and wrong. A midwife may incur 
penalties and/or sanctions resulting from violation of this Code. It is 
used to assure the public that registered midwives are acting in a 
professional and ethical manner.

This Code of Ethics is a useful guide in helping midwives to identify, 
work through, and put into words ethical issues in light of their 
responsibilities as articulated in the Code's principles and standards, 
and to decide on an ethically responsible course of action. While the Code 
acts as a guide, the midwife must also use professional judgement in her 
moral decision-making. It is important to realize that some challenges or 
moral dilemmas are perceived to be primarily ethical in nature when, in 
fact, they arise less from comflicting principles than from poor 
communication, lack of information, or failure to follow established 

The principles of 'beneficence', 'justice/fairness', 'autonomy', 
'accountability', 'integrity' and 'confidentiality' direct the conduct of 
registered midwives and student midwives in their relationships with 
individuals, institutions, their profession, and the community as a whole.

As an autonomous practitioner each registered midwife is accountable to 
her [includes masculine gender] practice to the woman/baby/family, the 
public and to her profession, and in the exercise of professional accountability, shall:


1. Always act to promote and safeguard the well-being of clients by 
advocating for their rights.

2. Avoid any abuse of the client-midwife relationship that allows 
privileged access to the person, property, residence, or personal 
practices, or customs of the client.

3. Promote, protect and support breastfeeding in communities and 

4. Practice so as to optimize safety with no action or omission placing 
the client or baby at risk.


1. Provide care which is based on fairness and respects individuals' 
needs, values, beliefs and dignity, and does not discriminate on the basis 
of language, culture, age, ecominic status, health status, sexual 
orientation, marital status, gender, geographic location, 
institutionalization, ability, race or reglion.

2. Take any necessary and practicable steps to understand the social and 
economic status of clients and the impact of this on childbirth.

3. Negotiate and integrate, where possible, the coient's cultural norms 
and expectations governing birth.

4. Support the right of clients ro actively participate in decisions 
regarding their care and empower them to speak for themselves on issues 
affecting women and families in their culture/society.


1. Clearly inform and educate clients and the public as to the role, 
function, standards and philosophy of midwifery practice.

2. Respect and uphold the client's right to informed choice and consent, 
including choice of caregiver and place of birth, and the right to decline 
treatment and intervention.

3. Actively involve and promote informed choice on the part of a client's 
substitute decision-maker, when the client lacks the capacity for informed 

4. Respect the importance of others in the client's life including other 
professional or lay caregivers chosen by a woman to support her during 
pregnancy, labour, birth, and then postpartum period.


1. Adhere to any Newfoundland Labrador laws or regulations that govern the 
practice of a midwife including, but not confined to, the Health 
Professions Act (2010) and the Newfoundland and Labrador Council of Health 
Professionals (NLCHP), midwifery regulations, the Personal Health 
Information Act (2011), the by-laws, standards and code of ethics of the 

2.Practice within the bounds of the midwife's competence, scope of 
practice, personal and/or professional limitations.

3. Support the work of the Association of Midwives of Newfoundland and 
Labrador and the CMNL to promote materna;/child health and professional 

4. Prescribe only drugs listed on the Midwifery Formulary and administer 
only drugs and/or other substances consistent with the midwife's scope of 

5. Provide the best possible care under any circumstance, ensuring that no 
woman is denied care.

6. Ensure clients find appropriate alternative care if for any reason the 
midwife is unable to provide care.

7. Facilitate research in midwifery practice by keeping accurate records 
and providing statistics.

8. Take every reasonable opportunity to maintain and increase professional 
knowledge and competence, including taking part in peer review and meeting 
continuing education requirements.

9. Assume responsibility for reporting poor practice or professional 
misconduct to the Registrar of the NLCHP and to the CMNL when the action 
of a professional might endanger the safety of clients.

10. Inform the NLCHP and the CMNL in the event of becoming unable to 
practice safely and competently.

11. Participate in the professional development of midwifery students, 
registered midwives and other health care practitioneers by acting as 
preceptors, mentors and educators.


1. Openly disclose to clients and health care practitioners any 
conscientious objection or conflict of interest, which may affect 
professional practice or the client's right to informed choice.

2. Collaborate with colleagues in a coopeerative, constructive, and 
respectful manner.

3. Avoid the use of professional qualifications in the promotion of 
commercial products or services in order to maintain the independence of 
professional judgement on which clients rely.

4. Refuse to accept any gift, favour or hospitality, which might be 
interpreted as either endorsement of a commercial product, or providing 
preferential consideration to a client on the basis of financial or other 

5. Support and sustain midwifery colleagues in their professional roles 
and actively nurture her own and others' welf-worth.


1. Refrain from disclosing confidential information obtained in the course 
of professional practice without the consent of the client or a person 
entitled to act on her behalf, except where disclosure is required by law 
or by the order of a court.

2. Understand and respect the potential of compromising confridentiality 
when connecting with clients through social media networks or other 
electronic media.


Association of Midwives of Newfoundland Labrador. (2010). 'Code of 

Canadian Dental Hygienists Association. (2012). 'Code of ethics'.

College of Midwives of Ontario. (1994). 'Code of ethics'.

College of Midwives of British Columbia. (1996). 'Code of ethics'. 

International Confederation of Midwives. (2008). 'Core documents. 
International code of ethics for midwives'.


Informed choice is a fundamental principle of midwifery care. It is based 
on a collaborative exchange of information between midwife and her client 
that supports and respects the client in decision-making. Information 
exchange includes options, benefits, risks, and possible side effects of 
care or intervention. This includes consideration of any test results or 
procedures as well as research evidence. On the basis of this information 
the client can choose to accept or decline aspects of care or intervention 
and accepts responsibility for the outcomes of her choices.



Beneficence involves acting to promote the good of another. Midwives use 
their knowledge and skills to assist clients achive and maintain optimal 
health and overall well-being.


Justice is linked to fairness, entitlement and equality in health. The 
midwife works to ensure that she does not wrongly exclude from, or wrongly 
include in midwifery care, any group or individuals (e.g., based on race, 
class, gender, etc.). She promotes the right of individuals to fair, 
reasonable and equal access to quality reproductive health services that 
are an integral part of the health care system.


Autonomy refers to the right to make one's own choices. By communicating 
relevant information openly and truthfully, midwives assist clients to 
make informed choices and to participate actively in achieving optimal 
reproductive health.


Accountability pertain to take responsibility for one's own actions and 
omissions in light of relevant principles, standards, laws, and 
regulations. It includes the potential to self-evaluate and to be 
evaluated. It involves practising competently and accepting responsibility 
for behaviours and decisions in the professional context.


Integrity relates to consistency of actions, values, methods, outcomes and 
expectations. It conveys a sense of wholeness and strength, and doing what 
is right with honesty and truthfulness.


Confidentiality is the duty to hold secret any information acquired in the 
professional relationship. Midwives respect a client's privacy and hold in 
confidence infromation disclosed to them except in certain narrowly 
defined circumstances.

		(December 2000 revised September 2010 and March 2015)