Midwifery partnership and woman-centred care: informed choice, consent and cultural safety
This domain tests how you share power, give information and obtain valid consent in real scenarios. The exam rewards specific communication behaviours, not general statements about being respectful.
Partnership
- The New Zealand partnership model (Guilliland and Pairman) is a relationship of trust, shared responsibility, reciprocity and empowerment.
- Continuity of care builds trust and improves outcomes.
- The woman is the decision-maker; the midwife provides information, support and advocacy.
Informed choice and consent
- HDC Code Right 6: information in a form the woman can understand.
- Right 7: informed consent; competence is presumed; if not competent, consider advance directives and a welfare guardian.
- Discuss benefits, risks, alternatives, consequences of declining and uncertainty.
- Informed choice is a process, not a signature.
- Document the discussion, not just the decision.
- Obtain consent separately for vaginal examination, CTG, transfer and procedures.
Cultural safety
- Reflect on your own power and bias; avoid stereotypes; involve whānau with consent; use interpreters.
Worked example
A woman declines vitamin K for her baby. Explore her reasons, give balanced information, offer time, document the discussion and continue midwifery care. Refusal does not justify withdrawing care.
Traps
Obtaining "consent" by telling rather than discussing; using a family member as interpreter without consent; assuming refusal means incompetence.