Missouri Midwives Association
Ethics Council




Ethics Council


Peer Review










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The Ethics Council Governs the MMA Regulatory Structure according to the MMA Code of Ethics and national midwifery standards. The Ethics Council is made up of the Accountability, Peer Review, Education, and Grievance Boards.

The ethical practice of midwifery includes accountability to clients and others in the profession. The Accountability Review Board includes the elected Chair and two appointed members who oversee the Missouri Midwives Association Accountability Program.

Certified Professional Midwives, Certified Nurse Midwives and Certified Midwives who are in compliance with the MMA Code of Ethics and participate in the Accountability Review Program may seek Ethics Council Certification. Ethics Council Certification is the Missouri Midwives Association standard of accountability which exceeds NARM requirements. Please visit the Accountability page for more information.

The Education Review Board provides educational opportunities for midwives across the state of Missouri and supports local midwifery study groups. Please visit the Education page for more information.

Peer Review
The Peer Review Board supports and educates midwives through open peer review and private peer review. Please visit the Peer Review page for more information.

The Grievance Review Board investigates complaints against Missouri Midwives. Please visit the Grievance page for more information.

Code of Ethics

The MMA code of ethics statement is intended to promote quality care for childbearing families and provide guidance for professional conduct in the practice of midwifery. Our code of ethics affirms and promotes:

  1. the intrinsic right of women to give birth as they choose.
  2. practices that enhance the health of the woman and her infant.
  3. childbirth as a normal and significant life event.
  4. the intrinsic right of parents to choose the location and attendants for the births of their children.
  5. cooperation between midwives and other professional and non-professional groups concerned with maternal and infant health.
  6. competence in midwifery practice.
  7. the discovery, encouragement, and training of midwives.
  8. continuing educational opportunities that upgrade midwifery skills.
  9. safe birth practices in all environments and cultures.

We affirm that the professional practice of midwifery includes the following ethical behaviors:

  1. Midwives should at all times maintain standards of personal conduct which reflect credit upon the profession.
  2. Midwives are accountable for their decisions and actions related to their practice of midwifery.
  3. Midwives implement quality standards of practice through peer review, accountability, grievance and continuing education.
  4. Midwives maintain a core of professional knowledge by examination of current practices and initiation of new research.
  5. Midwives participate in the education of midwifery students and the continuing education of other midwives.
  6. Midwives respect and maintain client confidentiality and protect the client's right to privacy.
  7. Midwives use professional judgment when sharing information necessary to achieve health care goals.
  8. Midwives consult and refer as necessary with other professionals, when the woman's need for care exceeds the competencies of the midwife.
  9. Midwives clarify the expectation of mutual responsibility with the client when choosing a course of action and the resulting outcome, including transfer of care.
  10. Midwives practice autonomously and affirm the value of accountability.

We believe that:

  1. competence requires responsibility in our personal and professional lives.
  2. midwifery is a unique profession, distinct from all others and determines the knowledge, skills, and behaviors to be maintained by a midwife.
  3. the practice of midwifery requires adaptation and integration of knowledge and skills into behaviors necessary to a particular context.
  4. the practice of midwifery is dynamic, not static. Rapid changes in the knowledge and skills of midwifery and related disciplines, changes in society, and changes in available health-care resources all force the definition of competence to evolve.
  5. by being competent, midwives assure their ability to contribute to the good of others and to prevent harm while also preserving their own integrity and that of the midwifery profession.

Rights and Responsibilities

The Midwife's Rights and Responsibilities:

  1. The midwife has the right to clearly state her expectations of the client's responsibility concerning her prenatal care, in labor and postpartum.
  2. The midwife has the right to decline to participate in activities she is morally opposed to.
  3. The midwife has the right to refuse, transfer or discontinue care and to determine and define the conditions appropriate for doing so.
  4. The midwife has the right and responsibility to gather information regarding client conditions and concerns for which a midwife may need to consult, refer or transfer the client to another health care professional.
  5. The midwife has the responsibility to clearly state and document when a woman’s choices fall outside the midwife’s practice guidelines.
  6. The midwife has the right to honest financial information and appropriate compensation.
  7. The midwife has the responsibility to assist the client in activities that promote the woman’s well being.
  8. The midwife respects the client’s right to decline treatments or procedures.
  9. The midwife has the right to a client signature on refusal of recommendation documents.
  10. The midwife has the responsibility to document the client’s refusal of the midwife’s recommendations in writing and to retain the documents in the client’s records.
The Client's Rights and Responsibilities:
  1. The midwife recognizes, informs and supports the woman’s right as primary decision maker regarding her health care and that of her infant.
  2. The client has the responsibility to educate herself as primary decision maker regarding her health care and that of her infant.
  3. The client has the responsibility of participating in her education concerning the potential benefits and risk of treatments and procedures.
  4. The client has the right to informed consent prior to any procedure and/or prescribed medication to be given to her and her newborn, including risks, benefits, options and alternatives.
  5. The client has the right to accept or refuse the midwife's recommended care.
  6. The client accepts the responsibility for outcomes of refusing recommended care.
  7. The client has the responsibility to truthfully and fully inform the midwife of all matters concerning her own health care history.
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