Abstract
Aim
Midwives are expected to identify and help resolve ethics problems that arise in practice,
skills that are presumed to be taught in midwifery educational programs. In this study,
we explore how midwives recognize ethical dilemmas in clinical practice and examine
the sources of their ethics education.
Methods
We conducted semi-structured, individual interviews with midwives from throughout
the United States (U.S.) (n = 15). Transcripts of the interviews were analysed using an iterative process to identify
themes and subthemes.
Findings
Midwives described a range of professional ethical dilemmas, including challenges
related to negotiating strained interprofessional relationships and protecting or
promoting autonomy for women. Ethical dilemmas were identified by the theme of unease, a sense of distress that was expressed in three subthemes: uncertainty of action, compromise in action, and reflecting on action. Learning about ethics and ethical dilemmas occurred, for the most part, outside of
the classroom, with the majority of participants reporting that their midwifery program
did not confer the skills to identify and resolve ethical challenges.
Conclusion
Midwives in this study reported a range of ethical challenges and minimal classroom
education related to ethics. Midwifery educators should consider the purposeful and
explicit inclusion of midwifery-specific ethics content in their curricula and in
interprofessional ethics education. Reflection and self-awareness of bias were identified
as key components of understanding ethical frameworks. As clinical preceptors were
identified as a key source of ethics learning, midwifery educators should consider
ways to support preceptors in building their skills as role models and ethics educators.
Keywords
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Article info
Publication history
Published online: January 27, 2020
Accepted:
December 23,
2019
Received in revised form:
December 23,
2019
Received:
August 7,
2019
Identification
Copyright
© 2019 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
