Midwifery ethics in care, practice, and education: A scoping review

Midwifery ethics is central to high quality, respectful and relational maternity care. To inform the update of the International Confederation of Midwives, International Code of Ethics for Midwives, this scoping review systematically maps how ethics in midwifery care, practice and education is characterized.

Joanna Briggs Institute (JBI) methods for a scoping review were used to guide the literature review process. The Population/Concept/Context (PCC) framework provided the boundaries for the review. Population: midwives, midwifery educators, midwifery researchers, midwifery students and women mainly receiving midwifery care. Concept: midwifery ethics. Content: midwifery care, practice and education. Searches of qualitative and quantitative literature, and discussion papers, spanning 2002-2025, were made using MEDLINE, CINAHL, PsycINFO, MIDIRS, Emcare, Google and citation chaining. Data were extracted using an iterative content analysis approach extracting key ethical characteristics. The protocol for this review was prospectively registered with the Open Science Framework.

The search yielded 363 screened records, with 101 full texts assessed against inclusion criteria. Fifty articles were included in the review. Data was grouped to four interconnecting ethical concepts: Relational ethics emphasizes the importance of relationship, trust and emotional safety; the Practice of Ethics highlights care ethics attributes and accountability; the Ethical use of knowledge underscores evidenced based practice, reflexivity and sharing knowledge to equalize power; and Ethical leadership extends midwifery philosophical commitment to advocacy and reproductive justice.

This review provides a contemporary map of midwifery ethics and foundational evidence to support the update to the global International Confederation of Midwives, International Code of Ethics for Midwives.