Wisconsin Administrative Code › Department of Safety and Professional Services › SPS 1-299 - Professional Services › SPS 180-189 - Midwives › Chapter SPS 183 - Grounds For Discipline › Appendix I - ESSENTIAL DOCUMENTS OF THE NATIONAL ASSOCIATION OF CERTIFIED PROFESSIONAL MIDWIVES

Current through June 24, 2024
Gender references: To date, most NACPM members are women.
					 For simplicity, this document uses female pronouns to refer to the NACPM
					 member, with the understanding that men may also be NACPM members.
I.
Introduction
The Essential Documents of the NACPM consist of the NACPM
					 Philosophy, the NACPM Scope of Practice, and the Standards for NACPM Practice.
					 They are written for Certified Professional Midwives (CPMs) who are members of
					 the National Association of Certified Professional Midwives.
* They outline the understandings that NACPM members hold
					 about midwifery.
* They identify the nature of responsible midwifery
					 practice.
II.
Philosophy and Principles of Practice
NACPM members respect the mystery, sanctity and potential
					 for growth inherent in the experience of pregnancy and birth. NACPM members
					 understand birth to be a pivotal life event for mother, baby, and family. It is
					 the goal of midwifery care to support and empower the mother and to protect the
					 natural process of birth. NACPM members respect the biological integrity of the
					 processes of pregnancy and birth as aspects of a woman's sexuality.
NACPM members recognize the inseparable and interdependent
					 nature of the mother-baby pair.
NACPM members believe that responsible and ethical
					 midwifery care respects the life of the baby by nurturing and respecting the
					 mother, and, when necessary, counseling and educating her in ways to improve
					 fetal/infant well-being.
NACPM members work as autonomous practitioners, recognizing
					 that this autonomy makes possible a true partnership with the women they serve,
					 and enables them to bring a broad range of skills to the partnership.
NACPM members recognize that decision-making involves a
					 synthesis of knowledge, skills, intuition and clinical judgment.
NACPM members know that the best research demonstrates that
					 out-of-hospital birth is a safe and rational choice for healthy women, and that
					 the out-of-hospital setting provides optimal opportunity for the empowerment of
					 the mother and the support and protection of the normal process of
					 birth.
NACPM members recognize that the mother or baby may on
					 occasion require medical consultation or collaboration.
NACPM members recognize that optimal care of women and
					 babies during pregnancy and birth takes place within a network of relationships
					 with other care providers who can provide service outside the scope of
					 midwifery practice when needed.
III.
Scope of Practice for the National Association
					 of Certified Professional Midwives
The NACPM Scope of Practice is founded on the NACPM
					 Philosophy. NACPM members offer expert care, education, counseling and support
					 to women and their families throughout the caregiving partnership, including
					 pregnancy, birth and the postpartum period. NACPM members work with women and
					 families to identify their unique physical, social and emotional needs. They
					 inform, educate and support women in making choices about their care through
					 informed consent. NACPM members provide on-going care throughout pregnancy and
					 continuous, hands-on care during labor, birth and the immediate postpartum
					 period. NACPM members are trained to recognize abnormal or dangerous conditions
					 needing expert help outside their scope. NACPM members each have a plan for
					 consultation and referral when these conditions arise. When needed, they
					 provide emergency care and support for mothers and babies until additional
					 assistance is available. NACPM members may practice and serve women in all
					 settings and have particular expertise in out-of-hospital settings.
IV.
The Standards of Practice for NACPM
					 Members
The NACPM member is accountable to the women she serves, to
					 herself, and to the midwifery profession. The NACPM Philosophy and the NACPM
					 Scope of Practice are the foundation for the midwifery practice of the NACPM
					 member. The NACPM Standards of Practice provide a tool for measuring actual
					 practice and appropriate usage of the body of knowledge of midwifery.
Standard One
: The NACPM member
					 works in partnership with each woman she serves. The NACPM member:
* Offers her experience, care, respect, counsel and support
					 to each woman she serves
* Freely shares her midwifery philosophy, professional
					 standards, personal scope of practice and expertise, as well as any limitations
					 imposed upon her practice by local regulatory agencies and state law
* Recognizes that each woman she cares for is responsible
					 for her own health and well-being
* Accepts the right of each woman to make decisions about
					 her general health care and her pregnancy and birthing experience
* Negotiates her role as caregiver with the woman and
					 clearly identifies mutual and individual responsibilities, as well as fees for
					 her services
* Communicates openly and interactively with each woman she
					 serves
* Provides for the social, psychological, physical,
					 emotional, spiritual and cultural needs of each woman
* Does not impose her value system on the woman
* Solicits and respects the woman's input regarding her own
					 state of health
* Respects the importance of others in the woman's
					 life.
Standard Two
: Midwifery actions
					 are prioritized to optimize well-being and minimize risk, with attention to the
					 individual needs of each woman and baby.
The NACPM member:
* Supports the natural process of pregnancy and
					 childbirth
* Provides continuous care, when possible, to protect the
					 integrity of the woman's experience and the birth and to bring a broad range of
					 skills and services into each woman's care
* Bases her choices of interventions on empirical and/or
					 research evidence, verifying that the probable benefits outweigh the
					 risks
* Strives to minimize technological interventions
* Demonstrates competency in emergencies and gives priority
					 to potentially life-threatening situations
* Refers the woman or baby to appropriate professionals
					 when either needs care outside her scope of practice or expertise
* Works collaboratively with other health
					 professionals
* Continues to provide supportive care when care is
					 transferred to another provider, if possible, unless the mother declines
* Maintains her own health and well-being to optimize her
					 ability to provide care.
Standard Three
: The midwife
					 supports each woman's right to plan her care according to her needs and
					 desires. The NACPM member:
* Shares all relevant information in language that is
					 understandable to the woman
* Supports the woman in seeking information from a variety
					 of sources to facilitate informed decision-making
* Reviews options with the woman and addresses her
					 questions and concerns
* Respects the woman's right to decline treatments or
					 procedures and properly documents her choices
* Develops and documents a plan for midwifery care together
					 with the woman
* Clearly states and documents when her professional
					 judgment is in conflict with the decision or plans of the woman
* Clearly states and documents when a woman's choices fall
					 outside the NACPM member's legal scope of practice or expertise
* Helps the woman access the type of care she has
					 chosen
* May refuse to provide or continue care and refers the
					 woman to other professionals if she deems the situation or the care requested
					 to be unsafe or unacceptable
* Has the right and responsibility to transfer care in
					 critical situations that she deems to be unsafe. She refers the woman to other
					 professionals and remains with the woman until the transfer is complete.
Standard Four
: The midwife
					 concludes the caregiving partnership with each woman responsibly. The NACPM
					 member:
* Continues her partnership with the woman until that
					 partnership is ended at the final postnatal visit or until she or the woman
					 ends the partnership and the midwife documents same
* Ensures that the woman is educated to care for herself
					 and her baby prior to discharge from midwifery care
* Ensures that the woman has had an opportunity to reflect
					 on and discuss her childbirth experience
* Informs the woman and her family of available community
					 support networks and refers appropriately.
Standard Five: The NACPM member collects and records the
					 woman's and baby's health data, problems, decisions and plans comprehensively
					 throughout the caregiving partnership. The NACPM member:
* Keeps legible records for each woman, beginning at the
					 first formal contact and continuing throughout the caregiving
					 relationship
* Does not share the woman's medical and midwifery records
					 without her permission, except as legally required
* Reviews and updates records at each professional contact
					 with the woman
* Includes the individual nature of each woman's pregnancy
					 in her assessments and documentation
* Uses her assessments as the basis for on-going midwifery
					 care
* Clearly documents her objective findings, decisions and
					 professional actions
* Documents the woman's decisions regarding choices for
					 care, including informed consent or refusal of care
* Makes records and other relevant information accessible
					 and available at all times to the woman and other appropriate persons with the
					 woman's knowledge and consent
* Files legal documents appropriately.
Standard Six
: The midwife
					 continuously evaluates and improves her knowledge, skills and practice in her
					 endeavor to provide the best possible care. The NACPM member:
* Continuously involves the women for whom she provides
					 care in the evaluation of her practice
* Uses feedback from the women she serves to improve her
					 practice
* Collects her practice statistics and uses the data to
					 improve her practice
* Informs each woman she serves of mechanisms for
					 complaints and review, including the NARM peer review and grievance
					 process
* Participates in continuing midwifery education and peer
					 review
* May identify areas for research and may conduct and/or
					 collaborate in research
* Shares research findings and incorporates these into
					 midwifery practice as appropriate
* Knows and understands the history of midwifery in the
					 United States
* Acknowledges that social policies can influence the
					 health of mothers, babies and families; therefore, she acts to influence such
					 policies, as appropriate.
V.
Endorsement of Supportive Statements
NACPM members endorse the Midwives Model of Care ({
					 1996-2004 Midwifery Task Force), the Mother Friendly Childbirth Initiative ({
					 1996 Coalition for Improving Maternity Services) and the Rights of Childbearing
					 Women ({ 1999 Maternity Center Association, Revised 2004). For the full text of
					 each of these statements, please refer to the following web pages.
Midwives Model of Care (MMOC)-
http://www.cfmidwifery.org/Citizens/mmoc/define.aspx
Mother Friendly Childbirth Initiative (MFIC) -
http://www.motherfriendly.org/MFCI/
Rights of Childbearing Women -
http://www.maternitywise.org/mw/rights.html