Week 3: Informed choice and continuity of care

Question 1

4 tenets of midwifery care are?

Answer 1

1 informed choice
2 continuity of care
3 choice of birthplace
4 appropriate use of technology

Question 2

What are some considerations of Informed choice?

Answer 2

Finding out clients values

Using clinical information

Seeking and evaluating evidence

Talking it through

Reflecting on outcomes, feelings, and consequences

Question 3

What is an ICD

Answer 3

An Informed Choice Discussion (ICD) is a
semi-structured conversation that
midwives have with clients related to
specific topics

systematic way of presenting
information to clients.

Question 4

Examples of ICDs?

Answer 4

Choice of birthplace, pain management in
labour, infant feeding options, lab and
ultrasound screening/testing

Question 5

What is included in an ICD?

Answer 5

-relevant info
-community standards
-research evidence
-recommendations
-bias (if significant)
- consequences of no treatment

Question 6

What are the two forms of consent?

Answer 6

express and implied

Question 7

What are the two forms of express consent?

Answer 7

-oral or written
-unequivocal, direct and clear

Question 8

What does implied consent mean?

Answer 8

Inferred from actions or behaviors

Question 9

Discuss failure to obtain consent

Answer 9

Misconduct under the colleges Professional Misconduct Regulation and Midwifery Act, Liable through civil proceedings

Question 10

How can you anticipate consent in an emergency situation?

Answer 10

• ANTICIPATED – DISCUSSED IN
  ADVANCE
• INVOLVE CLIENT IN DECISION
  MAKING
• KEEP CLIENT INFORMED
• DISCUSSION FOLLOWING EVENT
• NO CONSENT (INCAPABLE PERSON)
  IF EMERGENCY AND DELAY WILL
  PROLONG SUFFERING OR PUT
  CLIENT AT RISK OF SUSTAINING
  SERIOUS BODILY HARM

Question 11

What are some examples of exceptional situation in consent?

Answer 11

• Language barrier
• Disability
• Reasonable steps taken
• Increases suffering
• No reason to believe client does not want treatment

Question 12

Why do positive outcomes occur as a result of continuity of care?

Answer 12

• midwife-client relationship
  -shared philosophy of midwives who practice CoC
  -Consistency of advice given

Question 13

What are the benefits of CoC for midwives?

Answer 13

• Sense of fulfillment
• Higher levels of professional identity
• Greater autonomy
• Greater flexibility
• Better work-life balance
• Protection against burnout