Woman-centred ethical grid for midwifery education: A content analysis

Midwives across the world are required to practice in accordance with an internationally agreed set of ethical principles. Midwifery education for many students includes ethics theory content, but this does not necessarily provide them with the skills toward ethical competence in practice.

To understand students' perception of ethical issues and to use these findings as foundational information with which to create an ethical deliberation tool for practice.

Qualitative Content Analysis was used for this study. Purposive sampling provided twenty-one ethics-focused reflective assignments from one Western Australian university.

Institutional review board approval was obtained.

Three themes were created which captured midwifery students experience of ethics on clinical placement: 'Bearing witness and feeling moral distress'; 'Relationship with the woman fostered ethical awareness' and 'Learning to advocate'. These findings were then integrated with ethical theory to create a new Woman-Centred Ethical Grid to help students deliberate ethical issues.

Midwifery students identified ethical issues during practical placement related to consent, interventions, insensitive practice, and overuse of technology, but felt powerless to act, which caused subsequent moral distress.

Midwifery students require practical and supported education to better navigate the complex ethical issues that exist in maternity care. The Grid provides a comprehensive framework for ethical deliberation in midwifery practice to enhance midwifery advocacy.