DEFINITION (1)
The Association of Texas Midwives (ATM) endorses and accepts the International Definition of Midwifery and the sphere of practice described therein:

"The Midwife is a person who, having been regularly admitted to a midwifery education program fully recognized in the country in which it is located, has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery."

The sphere of practice:

"The Midwife must be able to give the necessary supervision, care and advice to women during pregnancy, labor and postpartum periods; to conduct deliveries on her own responsibility; and to care for the newborn and the infant. This care includes preventative measures, the detection of abnormal conditions in mother and child, the procurement of medical assistance, and the execution of emergency measures in the absence of medical help."

"The Midwife has an important task in counseling and education--not only for patients/clients but within the family and community. The work should involve antenatal education and preparation for parenthood and extends to certain areas of gynecology, family planning and child care."

"The Midwife may practice in hospitals, clinics, health units, domiciliary conditions, and any other service."
STANDARDS (2)

1. The midwife recognizes that childbearing is a family experience and encourages the active involvement of family members in care, including adequate preparation for the birthing and parenting experience.
2. Necessary skills of a practicing midwife include the ability to: provide continuity of care to the woman and her family during the maternity cycle, continuing interconceptionally throughout the childbearing years; assess and manage normal antepartal, postpartal and neonatal periods; identify and assess deviations from normal; maintain proficiency in life-saving measures by regular review and practice; manage emergency situations appropriately. It is affirmed that judgment and intuition play a role in the assessment and response to specific situations.
3. All midwives should be equipped to assess maternal, fetal and newborn well being; to maintain a clean and/or aseptic technique; to treat maternal hemorrhage; and to resuscitate mother and infant.
4. All midwives will keep accurate records of care provided for each client such as are acceptable in current midwifery practice. Other records should be maintained as deemed necessary by law.
5. All midwives recognize that there are certain conditions when medical consultations are advisable. The midwife shall make a reasonable attempt to insure that her client has access to consultation and/or referral to a medical care system when indicated.
6. Midwifery practice upholds the right to self-determination of consumers within the boundaries of safe care. Midwives will use risk factor assessments for initial and continuing eligibility for midwifery services. Women will be informed of their risk status. It is the right and responsibility of the midwife to refuse or discontinue her services, and to make appropriate referrals when indicated, for the protection of the mother, baby, and/or midwife.
7. Each midwife will present to each potential client accurate information about herself and her services, including the information specified in the Informed Choice Agreement utilized by the Association.
8. Midwives shall update their knowledge and skills pertinent to midwifery care through an on-gong in program of continuing education, both formal and informal.
9. Midwifery practice includes an on-going process of evaluation. Case review with peers on a regular basis is recommended.
10. Each midwife will develop protocols for her services that are in agreement with the basic philosophy of ATM and reflective of currently accepted midwifery practice in her area. The ATM GUIDE TO MIDWIFERY PRACTICE should be used as a guideline in developing such protocols. Protocols should be written and maintained on file by the midwife.
11. Midwives will maintain high ethical standards in their work, as evidenced by adherence to ATM's CODE FOR ETHICAL MIDWIFERY PRACTICE .
12. Midwives will comply with public health requirements of the jurisdiction in which midwifery practice will occur.

(1) International Confederation of Midwives (ICM) and Joint Study Group on Midwifery Care, rec. 1972.
(2) Based on Midwives' Alliance of North America (MANA) "Standards/Qualifications for the Art and Practice of Midwifery, " March 1985.

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