Informed Consent in Midwifery Care: A Shared Responsibility

One of the most foundational values in midwifery care is informed consent—but what does that actually mean in practice? At its core, informed consent is not just a form you sign. It’s an ongoing, collaborative process that centers your autonomy, your values, and your right to make decisions about your body and your baby.

In midwifery, this process is especially meaningful because care is built on relationship, trust, and open communication.

What Is Informed Consent?

Informed consent means that you are given:

• Clear, evidence-based information

• An explanation of benefits and risks

• Reasonable alternatives (including doing nothing)

• Space to ask questions and process information

This is often framed as the BRAIN model:

• Benefits

• Risks

• Alternatives

• Intuition

• Nothing (what happens if we wait or do nothing?)

  
  

Rather than being told what to do, you are supported in making decisions that align with your goals and comfort level.

The Midwife’s Responsibility

Your midwife has both a clinical and ethical responsibility to guide your care. This includes:

1. Providing accurate, up-to-date information - Midwives stay current with research and clinical guidelines so they can clearly explain your options in a way that is understandable—not overwhelming.

2. Assessing safety and clinical appropriateness - While midwifery honors physiologic birth, midwives are also trained to recognize when something moves outside of normal and when additional support or transfer of care is needed.

3. Offering recommendations (not directives) - A midwife may say, “Based on what I’m seeing, I recommend…”—but the final decision remains yours whenever possible.

4. Creating space for true choice - This means no coercion, no fear-based pressure, and respect for your decisions—even when they differ from the provider’s preference.

5. Documenting discussions and decisions - Clear documentation ensures transparency, continuity of care, and safety.

The Patient’s Responsibility

In a model that prioritizes autonomy, patients also carry meaningful responsibility in their care.

1. Engaging in the decision-making processThis means asking questions, expressing concerns, and taking time to understand your options.

2. Sharing honest and complete informationYour midwife relies on accurate health history, symptoms, and changes to provide safe care.

3. Considering recommendations thoughtfullyYou are always allowed to say yes or no—but informed refusal requires understanding the potential outcomes of that choice.

4. Following through with agreed-upon plansIf you and your midwife create a care plan together, consistency helps maintain safety for both you and your baby.

5. Understanding the scope of careMidwifery care is designed for low-risk pregnancies. If risk factors arise, part of informed consent includes being open to collaboration or transfer when appropriate.

Where Responsibility Meets Partnership

It can be helpful to think of informed consent not as a division of responsibility, but as a shared commitment:

• Your midwife brings clinical knowledge, training, and experience

• You bring your values, intuition, and lived experience in your body

  
  

Neither is more important than the other. The goal is not for you to become your own provider, nor for your provider to make decisions for you. The goal is informed, supported decision-making—together.

What About Emergencies?

In urgent situations, there may be less time for in-depth discussion. Even then, your midwife will:

• Communicate clearly and quickly

• Explain what is happening and why

• Act in the best interest of safety

  
  

Whenever possible, consent is still sought—even in fast-moving situations.

Why This Matters

Informed consent is deeply tied to birth satisfaction, emotional well-being, and trust in the care you receive.

When patients feel heard, respected, and included:

• Anxiety decreases

• Confidence increases

• Outcomes—both physical and emotional—improve

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Midwifery care is not about handing over control—it’s about sharing it responsibly.

You deserve to be informed.You deserve to be respected.And you deserve to be an active participant in your care. Because this isn’t just your birth—it’s your experience, your body, and your story.