Professional Midwifery Practice
Professional Midwifery Practice
This domain tests autonomous, evidence-based practice within scope: assessment, monitoring, escalation, documentation, collaboration and emergency readiness. Questions often present a clinical situation and ask what the midwife should do next, or what should be recorded.
Core rules and concepts
- Midwives practise autonomously within their legal and professional scope and consult or refer when the woman's needs exceed that scope.
- Care should support normal physiology and avoid unnecessary intervention, while using effective interventions for clear indications.
- Informed consent requires explanation of benefits, risks and alternatives, and documentation of the woman's decision, including refusal.
- Monitoring includes maternal observations, fetal heart assessment and the partograph; deviations require action, not reassurance.
- Documentation must be contemporaneous, accurate, attributable and legible; record advice given, decisions, escalation and response.
- Emergency readiness includes drills, referral pathways, transport arrangements and clear communication with the receiving team.
- Infection prevention, medication safety, professional boundaries and maintenance of competence apply in every setting.
Worked example
A midwife in a stand-alone birth centre auscultates a fetal heart rate of 180 bpm that persists for 10 minutes at 6 cm dilation. Persistent fetal tachycardia is a deviation from normal. The midwife should reposition the woman, give oxygen and intravenous fluids according to protocol, arrange urgent transfer, communicate with the obstetric unit, document observations and times, continue monitoring and accompany the woman. The trap is repeating auscultation without escalation, or assuming the monitor is faulty because the woman appears well.
Traps that cost marks
Working outside scope; delaying referral to 'wait and see'; documenting retrospectively; failing to record advice declined; using interventions routinely without indication; omitting the time of escalation and the response.