Midwifery Nursing

This paper discusses the philosophy, competency standards, ethical responsibilities, and legal responsibilities in midwifery nursing. It explores the concept of woman-centered care and the role of midwives in providing safe and responsive care. The case study of Ivy, a 22-year-old multigravida, is used to illustrate these concepts.

Running head: MIDWIFERY NURSING
Midwifery nursing
Name of the Student:
Name of the University:
Author Note:

Introduction:
Childbirth is a natural process but a painful and exhausting process for a mother along
with the carer. The process has a psychological, physical and emotional effect on the mother
along with the family members of the mother. Midwives are responsible for accurate care and
support to the mother. The case study represents a health condition of Ivy who is 22-year old
multigravida, G3P1, whose pregnancy was confirmed at 8 weeks gestation and seeks the support
of midwives. This paper will illustrate a theoretical model of midwifery related to woman-
centered care, National Competency Standards for the Midwife, Code of Conduct and Code of
Ethics, ethical dilemma and responsibility along with legal responsibility.
Discussion:
Identifies and discusses the philosophy underpinning midwifery practice:
The case study represents the health condition of Ivy who was 22-year old multigravida,
G3P1, whose pregnancy was confirmed at 8 weeks gestation. According to the International
Confederation of midwives, childbearing is a normal physiological process which has a
significant meaning to the woman, her family, and the community. Midwives provide the most
appropriate care providers to attend the childbearing (internationalmidwives.org., 2019). These
philosophies are related to women-centered care because midwifery care supports, promotes and
protects women’s sexual, reproductive health, rights, race, and ethnicity (Lawton et al., 2016).
Moreover, midwifery care is holistic in nature which undertakes the social, cultural, emotional
experience of women while providing care and improves the health as the social status of the
childbearing mother. In the current context, midwifery-led continuity models of care can be
applied. WHO highlighted that the model provides a continuity of care, monitoring

psychological and physical wellbeing of women, provide support throughout the delivery, and
provide counseling and education. Hence, it would be appropriate for Ivy (Ross et al., 2016).
National Competency Standards for the Midwife, Code of Conduct and Ethics:
The case study highlighted that Ivy had a stillborn death at 23 weeks gestation and she
started putting some weight and they are anxious about the childbirth. According to National
competency standards for the midwife , a midwife should have a competency of
communication about the information to facilitate the decision making by women ( competency
3), a competency of promoting safe and effective midwife care (competency 4), a competency
of assessment, plan and evaluation for the woman and baby with complex need (6), a
competency of ethical decision making ( competency 11) (Hopkinson et al., 2018). Therefore to
provide care to Ivy, the midwife should possesses few competencies to promote safe and
responsive woman-centered care. According to the International Confederation of midwives, the
midwife should support the rights of Ivy and tony to actively participate in the care of Ivy (code
of ethics I). Since Ivy was anxious and already diagnosed with postnatal depression because of
the lost child, a midwife should response to psychological, physical, spiritual needs of Ivy to
promote safe care ( code of ethics II) (Leinweber et al., 2017). Since Ivy was interested some
complementary and alternative therapies to assist with her pregnancy, protecting confidentiality
at the same time take the ethical decision which is accurate for her (code of ethics III). The
midwife should respect and adhere to the legal obligations ( code of conduct 1), the midwife
should provide safe, women-centered and evidence-based practice for health and wellbeing of
the Ivy ( code of conduct 2), the midwife should conduct culturally safe practice and built a
respectful relationship with ivy and tony ( code of conduct 3) (Mcdonald et al., 2016).

Ethical responsibilities and an ethical dilemma:
The case study represents the health conditions of Ivy who is a 22-year-old multigravida,
G3P1 and anxious about the pregnancy. She was overweight and diagnosed with postnatal
depression, requires clinical assessments. In the current context, the ethical responsibility of the
nurse is to provide support to Ivy during her pregnancy. The first responsibility would be
providing education regarding the pregnancy so that she feels empowered and comfortable about
the pregnancy. The second ethical responsibility would be to arrange a referral counselor to
manage her postnatal depression where her husband would be incorporated in the counseling
(Beaumont et al., 2016). The third ethical responsibility would be the reduction of her drinking
habit of wine and amendment of food habits along with exercise to reduce the weight (Beck,
LoGiudice & Gable, 2015). In this case, the ethical dilemma is autonomy of the patient since
she had a habit of drinking wine per week, restriction of the drinking may breach the autonomy
of the patient. To promote beneficence autonomy can be breached which is another ethical
dilemma.
Legal responsibility of the midwife:
In the current context, the first legal responsibility of the midwife would be ensuring Ivy
would receive safe and responsive care with a thorough assessment of her current health status.
The second legal responsibility is ensuring that confidentiality of the ivy should be protected
throughout the process of recovery and while seeking the assistance of the support counselor
(Cust & Carter, 2018). The third responsibility is developing advocacy for limited medical
services they are getting and along with the amendment of policies so that every woman get
woman-centered, culturally safe and responsive care (Toohill et al., 2017). The third
responsibility also includes the arrangement of transportation for women who requires
specialized care for health.

Conclusion:
Thus, it can be concluded that in safe childbirth the contribution of midwifery is
revolutionary. The case study represents the health condition of Ivy who is anxious about her
pregnancy and diagnosed with postnatal depression after the death of her child born. In the
current context, the function of the midwife is to provide care by undertaking the midwife
philosophies such as childbearing is a normal physiological process and incorporation of the led
continuity models of care. The midwife should have competencies of National competency
standards for the midwife discussed before and few ethical responsibilities were identified
before. The ethical dilemma such as the autonomy of Ivy along with the legal responsibility of
midwives has been identified in this case study.

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