PROFESSIONAL

GROWTH AND
DEVELOPMENT
E T H I C S O F M I D W I F E RY
P R A C T I C E

E M E L E N E A . H I P O L , R N
 INTRODUCTIO
N
HISTORY
ORGANIZATIONS
INTERNATIONAL CONFEDERATIONS
OF MIDWIVES’ CORE COMPETENCIES
 01 EGYPT
ANCIENT • EBBERS PAPYRUS (1550 BC) -
HISTORY midwifery was recognized as
FEMALE occupation
⚬ Obstetrics and Gynecology
⚬ Process of giving birth
⚬ Birth prognosis of the newborn
• WESTCOR PAPYRUS (1770 BCE) -
introduced instructions:
⚬ EDC Calculation
⚬ Different styles of birth chairs
 02 GRECO-ROMAN
ANCIENT • SORANUS OF EPHESUS - a good midwife:

HISTORY
⚬ literate
⚬ possessed a good memory
⚬ loving work
⚬ respectable
⚬ not unduly handicapped as regards to
her senses
⚬ robust
⚬ endowed with long slim fingers and
short nails
⚬ sympathetic disposition
⚬ keeps her hands soft for the comfort of
both mother and child
 02 GRECO-ROMAN
ANCIENT • PLINY - 3 grades of midwife’s present:
⚬ FIRST: technically proficient

HISTORY ⚬ SECOND: may have read some of the texts on

OB-Gyne
⚬ THIRD: highly trained and reasonably
considered a medical specialist with a
concentration on midwifery
• ROMAN WEST - 2 hypotheses:
⚬ FIRST: Midwifery was not a profession to
which freeborn women of families that had
enjoyed free status for several generations
were attracted (servile origin)
⚬ SECOND: Midwives were generally valued
enough, and earned enough income, to be able
to gain their freedom
 • 18th CENTURY - conflict between

MODERN surgeons and midwives

• UNITED STATES AND CANADA -
HISTORY Midwifery became outlawed or heavily
regulated
• NORTHERN AND RUSSIA -
establishment of a midwifery school for
women at the University of Dorpat
(1811) by Professor Christian Friedrich
Deutsch
• GUNNER HEINSOHN AND OTTO
STEIGER - theorize that midwifery
became a target of persecution and
repression by public authorities
 • LATE 20th CENTURY- Midwives were

CONTEMPORAR already recognized as highly trained

and specialized professionals in
Y obstetrics
• Midwives were trained to view birth as
a normal and healthy process
• SWEDISH MIDWIVES - Administer
80% of prenatal care and more than
80% of FP services
• SWEDEN - Midwives attend to all
normal birth in public hospitals
 PHILIPPINE
S
DECEMBER 4, 1901
The ratified Public Act No. 310 formed the
Medical Board of Examiners
⚬ Function: Regulatory Board for both
medicine and midwifery (Board of
Midwifery, 2013)
Establishment of Midwifery and Midwifery
Education (1901 - 1940)
• NOVEMBER 9, 1920 - Maternity
House then Maternity and
Children’s Hospital and presently
known as Dr. Jose Fabella Memorial
Hospital
• 1922 - School of Midwifery in
Manila
• 1965 - Nurse-Midwifery Course
Regulation for Midwifery Practice (1941 -
1980)

Republic Act No. 2382

(Medical Act of 1959)
• Regulation of midwifery was
separated from medicine
Regulation for Midwifery Practice (1941 -
1980)
June 18, 1960

Republic Act No. 2644

“An Act Regulating Midwifery
Training and Practice”
• creation of the Board of
Examiners for Midwives
Regulation for Midwifery Practice (1941 -
1980)
1992

Republic Act No. 7392

Philippine Midwifery Act
• established the functions of the
Board of Midwifery for the
profession
• promoted the academic preparation
and expanded role of the midwife
Midwifery Associations
• 1947 - PHILMIDAS (Philippine
Midwifery Association)
⚬ First midwifery association in the
Philippines
• 1961 - First National Convention of
Midwives
• 1961 - NFFM (National Federation of
Filipino Midwives)
• 1976 - IMAP (Integrated Midwives
Association of the Philippines)
Presidential Proclamation No. 1275

“Declaring the period from October

22-26, 1974, and the THIRD WEEK
OF OCTOBER EVERY YEAR
THEREAFTER AS MIDWIFERY
WEEK”
Development of Midwifery Education in
the Philippines
• 6 months, then increased to 1 year (focus on MCH)
• 1996 - CMO No. 24 s. 1992
⚬ competencies of the midwife in PHC
• 2000 - CMO 36 s. 2000
⚬ expanded role of the midwife (IE, IVF in cases of
emergency, perineal suturing for first- and second-
degree lacerations
• 2007 - CHED CMO 33
⚬ ladderized Bachelor of Science in Midwifery
THE PROFESSIONAL
ORGANIZATIONS
INTERNATIONAL CONFEDERATION OF
MIDWIVES
• Supports, represents, and works to strengthen
professional associations of midwives throughout the
world

VISION
• Every childbearing woman has access to a midwife’s
care for herself and her newborn

MISSION
• To strengthen Midwives' Associations and to advance
the profession of midwifery globally
THE PROFESSIONAL
ORGANIZATIONS
PHILIPPINE LEAGUE OF GOVERNMENT AND
PRIVATE MIDWIVES, INC. (PLGPMI)

• Registered in the Securities and Exchange Commission

in August 18, 1999
• It is an accredited Continuing Professional Education
(CPE) provider for midwives
THE PROFESSIONAL
ORGANIZATIONS
MIDWIFE FOUNDATION OF THE
PHILIPPINES, INC. (MFPI)

• Working for the welfare of the midwives

⚬ Quality Continuing Education
⚬ Scholarship Grants
• Focus efforts on highly quality services
through unparalleled highest standard of
midwifery practice
THE PROFESSIONAL
ORGANIZATIONS
PHILIPPINE SOCIETY OF PRIVATE CLINIC
MANAGERS AND OWNERS INC. (PSPCMO)

• Association of midwives who have private

practice or birthing clinics
• Upgrading the standards of the private birthing
clinics and quality or maternal and newborn
care
THE PROFESSIONAL
ORGANIZATIONS
THE ASSOCIATION OF PHILIPPINE SCHOOLS
OF MIDWIFERY, INC. (APSOM)
• MAIN PURPOSE:
⚬ to help in the attainment of the national health goal
• AIMS:
⚬ Elevate the standard of midwifery education
⚬ Promote professional advancement of midwifery
education administration
⚬ Foster closer relationships, fellowship, unity and
cooperation among midwifery schools
⚬ Participate in legislation affecting midwifery
education and practice
⚬ Make representations with national agencies and
other non-government entities
THE PROFESSIONAL
ORGANIZATIONS
INTEGRATED MIDWIVES ASSOCIATION OF
THE PHILIPPINES (IMAP)
• Envision to:
⚬ promote highest standards of Midwifery practice
⚬ enhance the competence of members
⚬ reduce maternal and infant mortality
⚬ sustain collaboration and partnership with related
agencies
• CORE VALUES
⚬ I - Integrity
⚬ M - Motivation
⚬ A - Accountability
⚬ P - Professionalism
 THE PROFESSIONAL
REGULATORY BOARD
OF MIDWIFERY
CHAIRMA
N

MEMBER MEMBER MEMBER MEMBER

Type 01
 Health science and health profession that
deals with pregnancy, childbirth, and the
01 MIDWIFERY
DEFINITIO
postpartum period (including newborn)

N OF 02
A person who has successfully completed

TERMS MIDWIFE a midwifery education program that is

duly recognized in the country

MIDWIFERY It focuses on maximizing the health and

03 MODEL OF
wellness of a woman and her baby, early
identification of medical problems, and
CARE holistic approach to pregnancy and birth

Women cared under this model were

MIDWIFE-LED
04 more likely to have spontaneous vaginal
CONTINUITY birth, slightly longer labors and less
MODEL CARE likely to use any pain relief
International Confederation of Midwives’
Model of Midwifery Care
• Promote and protect women’s and newborn’s health and rights
• Respect and have confidence in women and in the capabilities in childbirth
• Promote and advocate for non-intervention in normal childbirth
• Provide women with appropriate and advice that promotes participation and
enhances informed decision-making
• Offer respectful, anticipatory, and flexible care
• Empower women to assume responsibility for their health and their family’s
health
• Practice collaboration and consultation with other health professionals
• Maintain competence and ensure evidence-based practice
• Use technology appropriately and effect referral in timely manner
• Individually and collectively responsible for the development of mdwifery care
as well as education of new midwives
 CORE
COMPETENCIES
OF MIDWIVES
• Developed in 2002
• 2010 and 2013 - Updated
• 2014 - 2017 - ICM commissioned a team from
British Columbia University and a special
working group
• January 2019 - update competencies and
conceptual framework that reflects ICM’s
Philosophy and Model of Midwifery Care
FRAMEWORK
STRUCTURE
Category 1
General Competencies
COMPETENCIES:
• Midwife’s accountabilities as a health professional
• Relationships with women and other care
providers
• Care activities that apply to all aspects of
midwifery practice
Category 2
Pre-Pregnancy and Antenatal
COMPETENCIES:
• Health assessment of the woman and fetus
• Promotion of health and well-being
• Detection of complications during pregnancy
• Care of women with an unexpected pregnancy
Category 3
Care During Labor and Birth
COMPETENCIES:
• Assessment and care of women during labor that
facilitates physiological processes and a safe birth
• Immediate care of the newborn infant
• Detection of complications in mother or infant
Category 4
Ongoing Care of Women and Newborns
COMPETENCIES:
• Continuing health assessment of mother and infant
• Health education
• Support for breastfeeding
• Detection of complications
• Provision of family planning services
TECHNICAL STANDARDS
OF MIDWIFERY
PRACTICE
Guided by RA 7392 (The Midwifery Act of 1992) through
the Professional Regulatory Board of Midwifery,
Professional Regulation Commission (PRC)
Qualifications
• Graduate of BSM from an accredited institution
or a licensed nurse who passed Midwifery
Licensure Examination
• Licensed Registered Midwife (PRC)
• Shows evidence of professional competence
• Member of good standing of the Accredited
Professional Organization
Professionalism
• Exercise her responsibilities consistent with protocols,
midwifery law, and other legislations, professional
principles, organizational policies and procedures
• Contributes to the advancement of the profession and the
enhancement of professional image
• Competence, integrity, and professional attitude
• Keeps abreast with new trends and development of health
care system and the midwifery profession
Knowledge and
its Application
• Knows where to find relevant information
• Explains the rationale for midwifery procedures/
interventions
• Provides preventive and promotive care as may be deemed
necessary
• Support decisions with evidence-based reasons
Regulation of
Own Practice
• Maintains current registration with the PRC
• Enhance knowledge and skills required for safe midwifery
practice
• Practices within own level of competence and seeks help.
advice and guidance if necessary
• Maintains physical, psychological, emotional and spiritual
well-being
Responsibility
and
Accountability
• Responsible and accountable for the quality of midwifery
service/s
• Performs functions/tasks in accordance to the standards of
midwifery practice
• Follows, maintains, updates or improves own agency’s
policies, guidelines and procedures or complies with the
requirements
• Complies with all legal requirements in the delivery of
midwifery services
Code of Ethics
• Complies with the code of ethics for midwives
• Reports unprofessional conduct, malpractices, and/or other
violations of the code of ethics
• Demonstrates the values of honesty and integrity
• Protect the client’s right to confidentiality and information disclosure
• Provides care to client irrespective of their religious and cultural
beliefs
• Advocate client’s right to autonomy, respect, privacy, dignity
and access to information
• Shares knowledge and skills to other midwives
Midwifery
Practice
• Performs comprehensive assessment
• Develop a plan of care (collaboration)
• Updates plan of care based on results of regular assessment
• Implements planned interventions
• Use clinical practice guidelines
• Demonstrates sound decision making
• Makes timely referrals
• Evaluate/monitors progress of and/or results of interventions
• Revises/modifies plan of care
Communication
• Allocates enough time to listen to the client
• Reassures client through touch and use of therapeutic communication
• Communicates with patient and family to ensure needs were
attended to and to provide continuity of care
• Establish collaborative partnerships
• Use appropriate information technology
Continuing
Professional
Development
• Identifies own strength, limitations, learning needs, goals
and aspirations
• Constantly strive to pursue higher level formal education
• Participates in conferences, workshops and other continuing
education program
Records
Management
• Sees to it that required data is recorded promptly, legibly,
and concisely
• Records and maintains documentation
• Records all medications, procedures, and care provided to
the client
• Keep clients’ record private and confidential
• Maintains an organized system of filing clients’ records
• Properly signs patient’s records
PROFESSIONA
L GROWTH
AND
DEVELOPMEN
T
Professional 01 Professional Growth
• Gaining new skills and work
Growth and experience

Development • Development or better use of talents

and skills that lead to improved
outcomes

02 Professional Development
• Continuing education and career
training
Recommended Activities for
Professional Development
• Management and leadership training
⚬ Helps develop the professional’s confidence and impact
employees across your organization
• Professional Certifications
⚬ Great-middle ground options that don’t take the same
level of commitment as degrees - moving into new roles
or taking on additional responsibilities
• Technical Skills Training
⚬ Maintain competitiveness, providing technical training
can keep talent in-house
• Communication and Interpersonal Skills Training
⚬ Emotional Intelligence, communication and collaboration
Benefits of Growth and
Development
• Expands your knowledge base
• Boosts confidence and credibility
• Increases opportunity to be hired and earning
potentially high salary
• Professional credentials, certifications provide easy
ways to increase professional’s value
• Can provide networking opportunities
• Can open the door to future career changes
Importance of Professional
Development
• Enables individuals to keep abreast with the latest
trends and updates relevant to the industry
• Staying relevant and up-to-date in your workplace
and the outside competitive world
• Improves your confidence and adds to your
credibility
• Allows you to make meaningful contributions and to
become more effective
• Opens up doors for new possibilities, increases
earning potential, and improves the scope to get hired
Importance of Professional
Development
• Enables individuals to keep abreast with the latest
trends and updates relevant to the industry
• Staying relevant and up-to-date in your workplace
and the outside competitive world
• Improves your confidence and adds to your
credibility
• Allows you to make meaningful contributions and to
become more effective
• Opens up doors for new possibilities, increases
earning potential, and improves the scope to get hired
Continuing Continuing Professional Development
(CPD)
Professional • Inculcation of advanced knowledge, skills,

Development and ethical values (RA 10912 sec 3f)

• Mandatory requirement in the renewal of
for Midwives professional license and accreditation system
for the practice of professions (RA10912 sec
10)
• Validated and recognized CPD credit units
shall be earned by a professional and shall be
accumulated and transferred in accordance
with the Pathways of Equivalencies of the
PQF (RA 10912 sec 11)
Objectives of Continuing
Professional Development
• Improve the quality of the country’s reservoir of
registered professionals
• Provide support to lifelong learning in the
enhancement of competencies of Filipino
professionals towards delivery of quality and ethical
services
• Deliver quality continuing professional development
(CPD) activities aligned with the Philippine
Qualifications Framework (PQF) for national
relevance and global comparability and
competitiveness
Continuing Professional
Development Council
• Chairperson - member of the PRB, and chosen by
the PRB to sit in the CPD Council
• First Member - President or designated person by
the Accredited Professional Organization of PRC
• Second Member - President or any representative
authorized by the organization of deans or
department heads of schools, colleges or
universities
Continuing Professional
Development Activities
• Ethics
• Standards of Professional Practice
• Enhancement of Professional Practice and
Technical Committee
Career Career Progression
• Process of developing or moving
Pathways for towards a more advanced state in a

Midwives person’s job, title, position, or

profession;
• Outlines the route one may follow in
order to reach identified career
development goals (Sec. 3 (c) of IRR
of PQF Act)
• Process of developing or moving
towards a more advanced state in a
person’s qualifications, job, title,
position or profession
Importance of Career
Progression
• For access to qualifications, career growth and
performance development
• For recognition of Filipino professionals
internationally
• For better job opportunities to prevent jobs skills
mismatch
The Philippine Qualifications
Framework
• Describe the levels of educational qualifications
and set the standards for qualification outcomes
• A quality-assured national system for the
development, recognition and award of
qualifications based on standards of knowledge,
skills and values acquired in different ways and
methods by learners and workers of the country
• PATHWAYS: refers to mechanisms or access
ramps that provide access to qualifications and
assist people to move easily and readily between
these sectors and the labor market which includes
professional work experience
• CAREER PATHWAY: series of structured and
connected education programs and support
services that enable the professionals to advance
over time to better jobs and higher levels of
education and training
Job Opportunities of Midwives
• Diploma in Midwifery: Staff Midwife
• BS in Midwifery: Clinician, CI, Clinic Manager,
Entrepreneur, Researcher Assistant, Mentor,
Facilitator
• Master ’s Degree: Dean/Principal,
Assistant/Associate Professor, Researcher,
Entrepreneur, Supervisor, Clinician, Mentor,
Trainer
• Doctoral Degree: Dean/Principal of Midwifery
Program, Researcher, Consultant, Professor,
Entrepreneur, Clinician
 Personality
• Refers to the total person
Personality • Core of each individual
• Includes the things that you say as well as
Development think
• It is shown through a person’s total
behavior and by the responses of other
people to that behavior
• Can be acquired or can be developed
• A woman with strong personality is
physically, mentally and morally well
(Sy)
• Pleasing personality: can easily work with
people
Aspects of Personality
• Physical Aspect
• Social Aspect: to do the right thing at the right
time, to act in the proper manner, to get along
with others
• Intellectual Aspect: how a person talks and what
she talks about
• Emotional Aspect
• Moral Aspect: shown in the way we judge whether
our actions and the actions of others are right and
wrong
Importance of Pleasing
Personality
• It commands respect
• It wins appreciation, admiration and recognition
• It conveys hospitality in one’s feelings of willingness
to be a friend and to be of service
• It comforts patients and other people who are not
physically ill
• It is an asset to get a good position
• It contributes to a pleasant atmosphere to the place
• It is an asset to a successful daily living and
undertaking
Technique to Improve
Personality
• Realize that improvement is needed
• Have a strong motive or desire to improve
• Take an inventory or checklist of the strong
and weak point of what is to be improved
• Have a step by plan for improvement
Grooming
• Daily appearance reflects personality - it makes your
impression on others
• Personal cleanliness - adds to our general feeling of
wellness, confidence in our self

Uniform
• To gain the respect, trust, confidence and admiration
of those who they work with and those she serves

Health
• To cope up with her everyday activities
Personal Hygiene
• Principle of maintaining cleanliness and grooming of the
external body
• In general - looking after you
• Poor personal hygiene - have significant implications on the
success of job applications or promotion

Voice
• Can be a guide in judging the personality of the
midwife
• Can be a reflection of power, attraction, motivation,
and concern
• Can give the midwife the kind of attitudes, trust, and
confidence
Carriage
• Proper deportment and bearing - personal assets that cannot
be taken for granted
• Good impression on others, be relaxed and poised

Poise
• Dignity in bearing
• Adds to your appearance and confidence

Conduct
• Dignity in bearing
• Adds to your appearance and confidence
Conduct
• One’s course of action or behavior, or the way an individual
act
• Unprofessional conduct - conduct that violates the rules of
ethical conduct of midwifery, conduct that is unbecoming of
a member of a profession in good standing
• Dishonorable conduct - an act, deportment, or behavior of a
person as would elicit or bring censure, reproach, or shame
upon him, or any conduct on his part which tends to stain
his character or lessen his reputation
Manners
• Refers to polite, civil, well-bred behavior
• Etiquette - conventional rules of behavior, the customs that
are handed down to us or the ones we formulate to meet
specific situation

Social Media Etiquette

• Refers to the guidelines that companies and
individuals use to preserve their reputation online
 Most compelling reason to be
Applying for prepared in your job application:

a Job Your chances of being successful are

greatly enhanced by taking a holistic
approach in your application

In applying, you have to beat all the odds

- you should want to have as many things
working in your favor as possible
Types of Interviews
• Competency-based interviews (Structured Interview)
⚬ Include questions that are designed to help the
candidate give evidence of the personal qualities
which are needed to perform well in the job
⚬ Usual questions:
￭ Describe a situation where you had to make
decisions, working in a team environment, and
questions that will show the skills of the
candidate
￭ Examples on how candidates demonstrates the
qualities in the past
Types of Interviews
• Traditional Interviews
⚬ Questions are based largely on the curriculum
vitae or from your application form
⚬ Interviewers may focus in some areas that are of
particular interest or relevance to the position
applied for
⚬ Conversational (conversation with a purpose)
Types of Interviews
• Traditional Interviews
⚬ Typical Questions:
￭ Tell me about yourself
￭ Explaining gaps on your application form
￭ How would the experiences you describe be
useful in this company
￭ What are your main strengths and weaknesses
￭ What other jobs/careers are you applying for
￭ Where do you see yourself in five years’ time
Dressing for the Job Interview
• Wear a neutral or subtle two-piece business suit,
which should be wrinkle-free and light material
• Wear light make-up, avoid red lipstick and heavy
eyeliner
• Wear accessories that will only flatter your
appearance
• Wear the traditional pump shoes
• Always carry a clean handkerchief or tissue
Preparation for the
interview
• Enthusiasm is important
• Review application form
• Prepare questions to ask the interviewer
• Do not be late
• Dress properly, neatly, and smartly
• Research the career area fow which you are applying
for
• Study the organization
First Impressions
• They set the tone for the rest of the interview
• Reasons why some applicants are not hired because
of first impressions:
⚬ Interviewers were put off by a weak handshake or
lack of eye contact
⚬ Poor body language
⚬ Poor posture
⚬ Knowledge of the industry and their aptitude of
the job
Tips in Making a Good
Impression
• Shake hands firmly and warmly
• Wait to be invited to sit down
• Always smile and keep up good eye contact
• Try to relax
• Sit erect and do not slouch
• Try to speak clearly and give yourself a moment to
think about your replies
• Be conscious of your body language
Following up
• Record some notes where you could have responded
poorly or failed to answer questions
• Follow up result of interview in the designated date
• If you fail to pass the interview - try to ask the
interviewer politely your weak parts during the
interview
Job Resignation
• Reasons:
⚬ seek better opportunities in other agency and
other country
⚬ family concerns
⚬ transfer of residence
⚬ dissatisfaction
⚬ inability to adjust with working condition
Guideline in Resigning from a
Job
• DO:
⚬ know how to resign from your job gracefully and
professionally
⚬ prepare to resign by removing all personal items
and files from your office and computer
⚬ make the transition as easy and as smooth as
possible
⚬ give proper notice to your current employer
⚬ leave on good terms with your co-workers and
supervisor
Guideline in Resigning from a
Job
• DO:
⚬ stay a productive member of the team as long as
you are connected with job
⚬ make sure you receive all your stored up
compensation and benefits
• DON’T
⚬ make any statements or express any opinions that
you may regret later
⚬ feel guilty about leaving
RESIGNATION LETTER
• Formal, brief but concise, neat and polite
• State the reason for resigning
• Express your gratitude and appreciation for them
during your stay
• Do not get personal
• Do not criticize people in the company or complaints
• Offer a positive aspect of the company and current
position
• End your letter with a positive note
• Always keep a copy of your letter
ETHICS AND
MIDWIFERY
ETHICS
 Ethics
• Came from the Greek word “ ethos” which means,
a characteristic way of acting
• Refers to those rules of conduct recognized in
respect to a particular class of human actions
• A study of standards of conduct and the moral
judgment and values upon which these standards
are made
• A science that which guides human reaction and
which tends to make a man’s action and man
himself good
Importance of Ethics
• It teaches us to distinguish right
from wrong
• It helps us make the right
judgements and decisions
Ethical Theories
• Natural Law
• Deontology
• Utilitarianism
• Virtue Theory
• Rights
Natural Law
• Holds that man should live life
according to an inherent human nature
• Says that human beings possess
intrinsic values that govern their
reasoning and behavior
• Maintains that these rules of right and
wrong are inherent in people and are
not created by society or court judges
Deontology
• States that people should adhere to
their obligations and duties when
analyzing an ethical dilemma
• It holds that certain unbreakable
moral rules govern the most important
aspects of our lives
• Upholding one’s duty is what is
considered ethically correct
Utilitarianism
• Promotes good or valued ends
• Utilitarianism holds that the most ethical choice is
the one that will produce the greatest good for the
greatest number
• 2 types:
⚬ Act Utilitarianism - A person performs the acts
that benefit the most people, regardless of
personal feelings or societal constraints such as
laws
⚬ Rule Utilitarianism - It takes into account the
law and is concerned with fairness. They seek
to benefit the most people but through the
fairest and most just means available
Virtue Theory
• Judges a person by his character
rather than by an action that may
deviate from his normal behavior
• It takes the person’s morals,
reputation and motivation into
account when rating an unusual and
irregular behavior that is considered
unethical
Rights
• The rights set forth by a society that
is protected and given the highest
priority
• Considered ethically correct and valid
since a large or ruling population
endorses them
• Individuals may also bestow rights
upon others if they have the ability
and resources to do so
DIVISION OF
ETHICS
General Ethics
• Refers to all the diverse ethical
formulations of general and universal
concepts and principles which serve
as the foundation of morality
General Ethics
• The ultimate end of man
• Human acts: involves the use of both
free will and intellect; actions are
performed with use of reasons
⚬ Acts of Man - actions that does
not involve the use of intellect and
free will; actions done
unconsciously and without reason
General Ethics
• Morality of Human Acts: One that proceeds from knowledge
and free will
⚬ Morals: deal with the conduct of man, the right and wrong
behavior of man in his relationship with his fellow men
⚬ Mores: customs, belief enforced by social pressure
⚬ Morality: system of behavior in regards to standards of
wight or wrong behavior
⚬ Determinants of Moral Quality of Actions
￭ Object: which the action is essentially concerned
￭ Circumstance: can make an otherwise good action evil
￭ Intention or End Purpose: to be morally correct, a doer
must have good intention
General Ethics
• Law of Conscience or Natural Law
⚬ Law - “ordinance of reason, promulgated for the
common good by the one who has charge of a society” -
St. Thomas; or to protect society at large
⚬ Conscience - practical judgment of reason upon an
individual’s act of good, or as evil and to be avoided
⚬ Laws of Conscience - ensure that people cannot be
forced to facilitate practices or procedures to which they
object for reasons of conscience
• Virtue: good habit that enables us to act according to right
reason, enlightened by faith; it is a firm disposition to act
according to God’s will and disregard the contrary impluses
of our own will
General Ethics
⚬ 4 Cardinal Virtues:
￭ Prudence - able to judge between actions with
regard to appropriate actions at a given time
￭ Justice - proper moderation between self-
interest and the rights and needs of others
￭ Restraint or Temperance - practicing self-
control, abstention, and moderation
￭ Courage or Fortitude - forbearance,
endurance, and ability to confront fear and
uncertainty, or intimidation
General Ethics
⚬ Capital Virtues
￭ Humility - counters pride, true humility clears a path for
holiness; modest behavior, selflessness and the giving of
respect
￭ Generosity - willingness to give freely and without request for
commendation
￭ Chastity - embraces moral wholesomeness and purity, treat
God’s gifts of sexuality with due reverence or respect
￭ Meekness - patiently seeking appropriate resolution to
conflicts, and on the ability to forgive and show mercy
￭ Temperance - self-control and moderation
￭ Kindness - love for one’s neighbor
￭ Diligence - zealous attitude toward living and sharing the Faith
General Ethics
⚬ Three Theological Virtues
￭ Faith - by which we believe in God and believe all that
he has said and revealed to us
￭ Hope - by which we desire the kingdom of heaven and
eternal life as our happiness, placing our trust in
Christ’s promises
￭ Charity - by which we love God above all things for his
own sake, and our neighbor as ourselves for the love of
God
Applied Ethics
• Applies the general concepts and principles but also specifies
that particular situation in life in which they are valid and
legitimate moral
• Also called Special Ethics
⚬ Individual Ethics: duties to God, one self and others
⚬ Social Ethics: right to life, property and marriage
⚬ Political ethics: deals with the state, political and
international authority
⚬ Professional Ethics: branch of moral science which treats
the obligation of a professional member to the public, to
the profession, to his colleagues, and client
 • Ethics of Biology, biological
research, and the applications of

Bioethics that research

• Brings together medicine, the law,
social sciences, philosophy,
theology, politics, and other
discipline to address questions
related to clinical decision-making
and medical research
Importance of Bioethics in
Health Care
• Explores critical issues in clinical and
research medicine
• Enables ethical reflection to keep pace with
scientific and medical breakthroughs
• Challenges the presumptions of international
and population-based efforts in public health
and the delivery of health care in
economically underdeveloped parts of the
globe
Ethical Frameworks for
Decision Making
• Ethical System and Principles
⚬ not all ethical principles are applicable in
all situations because of different
variables that may affect every situation
⚬ Moral principles: helps in making a moral
analysis of ethical issues in the
professional practice
Ethical Frameworks for
Decision Making
• Patient’s Bill of Rights: enumerates the privileges the patient
duly deserves and the ethical behavior that the health care
professionals should observe
⚬ Right to considerate and respectful care
⚬ Right to obtain complete and current information
concerning his diagnosis, treatment and prognosis
⚬ Right to receive information necessary to give informed
consent
⚬ Right to refuse treatment
⚬ Right to every consideration of his privacy
⚬ Right to expect that all communications and records
pertaining to his care should be treated as confidential
Ethical Frameworks for
Decision Making
⚬ Right to expect within its capacity, a hospital must take
reasonable response to the request of a patient for service
⚬ Right to obtain information as to any relationships his
hospital has to other health care and educational
institutions
⚬ Right to be advised if the hospital proposes to engage in
or perform human experimentation
⚬ Right to expect reasonable continuity of care
⚬ Right to examine and receive and explanation of his bill
⚬ Right to know what hospital rules and regulations apply
to his conduct as patient
Ethical Frameworks for
Decision Making
• Professional Code of Ethics
⚬ outlines how professionals should practice the
profession in ethical and moral manner
• Institutional Policies
⚬ This guides the professional in her practice in the
institution where she is connected
• Laws
⚬ An ordinance promulgated for the common good
by one who has legitimate authority
⚬ A rule of being or of conduct
⚬ Moral: it is the will of God
Principles of
Bioethics
• AUTONOMY
⚬ Emphasizes the personal responsibility we
have for our own lives
⚬ Make own decisions and to control what is
done to ourselves
⚬ Respecting the autonomy of the patient
when it comes to decision-making
Principles of
Bioethics
• NONMALEFICENCE
⚬ Imposes the obligation not to harm someone
intentionally or directly
• BENEFICENCE
⚬ Positive expression of nonmaleficence
⚬ Highlights that we have a positive obligation
to advance the healthcare interests and
welfare of others, assist others in their
choices to live life to the fullest
Principles of
Bioethics
• JUSTICE
⚬ Allocation if healthcare resources according to a just
standard
⚬ 2 Basic Types:
￭ Comparative Justice: involves balancing the competing
claims of people for the same health care resources;
what one receives is determined by one’s particular
condition and needs
￭ Distributive Justice: determines the distribution of
health care resources by a standard that is independent
of the claims of particular people; “non-comparative
justice”; distribution is determined according to
principles rather than individual or group need
ETHICAL ISSUES
• ABORTION
⚬ Infanticide - legally and socially treated as murder
⚬ Killing of unborn infants - legally and socially acceptable
• EUTHANASIA
⚬ The practice of deliberately easing into death an individual who is
suffering from a painful or incurable disease
⚬ Passive Euthanasia - withholding of life-giving sustenance
• LIVING WILLS
￭ Written document which speaks for the patient if he become
incompetent
• DONATION OF ORGANS AND THE BODY
⚬ Should not be looked upon as some way to achieve immortality,
but as a gesture of life to someone in need
PRINCIPLES THAT WILL GUIDE
THE MIDWIFE IN HER PRACTICE
• THE GOLDEN RULE
⚬ “Do unto others what you would like others to do unto you”
• THE TWO-FOLD EFFECT
⚬ Aims to provide specific guidelines for determining when it is
ethically permissible for a human being to engage in conduct in
pursuit of a good end with full knowledge that the conduct will
also bring about bad results
• PRINCIPLE OF TOTALITY
⚬ An individual may not dispose of his organs or destroy their
capacity to function, except to the extent that this is necessary for
the general well-being of the whole body
• EPIKIA “EXCEPTION TO THE RULE”
Midwifery • System of principle governing
conduct of midwives

Ethics • Connotes the conduct or behavior

of midwifery practitioners, which
by reason of public approval or
practice of the group, has become
customary among practicing
midwives
INTERNATIONAL CODE OF
ETHICS FOR MIDWIVES
PREAMBLE
Aim: Improve standard of care provided to women,
babies and families throughout the world though the
development, education, and appropriate utilization
of the professional midwife
THE CODE
I. MIDWIFERY RELATIONSHIPS
⚬ Respect a woman’s informed right of choice and promote the
woman’s acceptance of responsibility
⚬ Work with women, supporting their right to participate
actively in decisions about their care
⚬ Work with policy and funding agencies to define women’s
needs for health services
⚬ Support and sustain each other in their professional roles
⚬ Work with other health professionals, consulting and referring
as necessary
⚬ Recognize the human interdependence within their field of
practice
THE CODE
II. PRACTICE OF MIDWIFERY
⚬ Provide care for women and childbearing families with respect
for cultural diversity
⚬ Encourage realistic expectations of childbirth by women
within their own society
⚬ Use their professional knowledge to ensure safe birthing
practices
⚬ Respond to the psychological, physical, emotional and
spiritual needs of women
⚬ Act as effective role models in health promotion
⚬ Actively seek personal, intellectual, and professional growth
THE CODE
III. THE PROFESSIONAL RESPONSIBILITIES OF MIDWIVES
⚬ Hold in confidence client information
⚬ Responsible for their decisions and actions
⚬ May refuse to participate in activities for which they hold deep
moral opposition
⚬ Participate in the development and implementation of health
policies

IV. ADVANCEMENT OF MIDWIFERY KNOWLEDGE AND PRACTICE

⚬ Ensure that the advancement of midwifery knowledge is based on
activities that protect the rights of women as person
⚬ Develop and share midwifery knowledge
⚬ Participate in the formal education of midwives
PHILIPPINE CODE OF ETHIC FOR
MIDWIVES
PREAMBLE
AIM: Help midwifery practitioners, as individuals and as a
professional group to pursue and maintain a high level of ethical
conduct in the practice of midwifery

SECTION I
Primary objective: to render service within the scope of their
legitimate functions, to respect patients as human beings

SECTION II
midwife should try her best to continually improve her knowledge
and skills
PHILIPPINE CODE OF ETHIC FOR
MIDWIVES
SECTION III
The midwife is expected to practice on a scientific basis and to desist
in the performance of any midwifery procedure which is of doubtful
or questionable propriety

SECTION IV
Contribute to the safeguarding of public health and should protect
itself against the admission of those who are deficient in professional
competence and requisite moral character

SECTION V
Should render service to the patient the best of her ability
PHILIPPINE CODE OF ETHIC FOR
MIDWIVES
SECTION VI
Should not compromise her services to the patients under terms or
conditions which would impair the quality of patients-care

SECTION VII
Must confine the source of income to the midwifery services she has
actually rendered

SECTION VIII
Performance of midwifery services only to normal pregnant women
and normal newborn infants
PHILIPPINE CODE OF ETHIC FOR
MIDWIVES
SECTION IX
Not reveal any information given by her patient

SECTION X
Dedication of the midwives’ capabilities not only to individuals but
also to the community

SECTION XI
Participate in researvh activities

SECTION XII
Should work with interest and concern
 LAW, CRIMES,
CIVIL CODES AND
THE MIDWIFE
 LAW
• skeleton of our society

Laws and the • it controls what we do, when we do it

and how we do it

Midwife • Merriam Dictionary:

⚬ system of rules, usually enforced
through a set of institutions
⚬ it shapes politics, economics and
society and serves as a primary
social mediator of relations
between people
• a rule of conduct or action fomrally
recognized as binding and enforced by
a controlling authority
Importance of Laws to Society
• To regulate relationships between people with conflicting
interests
• Ensures the safety of future generations
• Enforced to maintain peace

Characteristics of Law
• It is a rule of conduct or action which determines what can be
done and what cannot be done
• Obligatory
• Promulgated by legitimate authority
• Common observance and benefit
Sources of Law
• Two primary sources:
⚬ Statues or Statutory Law
￭ defined as the written enactment of the will of the
legislative branch of the government rendered authentic
by certain prescribed forms or enactment of the congress
￭ 2 types:
• Constitution
• Legislative
⚬ Jurisprudence or case law
￭ cases decided or written opinion by courts and by
persons performing judicial functions
￭ All rulings in administrative and legislative tribunals
 • Importance:

Legal • Able to perform her tasks easier as

she will know how to conduct herself
Responsibilities legally

of a Midwife • Avoid criminal liability due to

incompetence or negligence
• Be careful in the execution of her
duties

• Only apply skills that are within her

scope of function in the care of the
patient
• Every position that a midwife will
handle is paired with legal
implications
Professional Negligence
• It is the commission or omission of an act, pursuant to a duty,
that a reasonably person in the same or similar circumstance
would or would not do, acting or the non-acting of which is the
proximate cause of injury to another person or his property

• ELEMENTS:
⚬ Existence of a duty on the part of the person charged to use
due care under circumstances
⚬ Failure to meet the standard of due care
⚬ The foreseeability of harm resulting from failure to meet
standard
⚬ The fact that the breech of this standard resulted in an
injury to the plaintiff
Professional Negligence
• Examples:
⚬ Failure to report observations
⚬ Failure to exercise the degree of diligence which the
circumstances of the particular case demands
⚬ Mistaken identity
⚬ Wrong medicine, wrong concentration, wrong rout, wrong
dose
⚬ Defects in equipment that may result in injuring the patients
⚬ Errors due to family assistance
⚬ Administrations of medicine without a doctor prescription
Doctrine of Res Ipsa Liquitor
• The things speaks for itself
• Refers to situations that are assumed that a person’s injury was
caused by the negligent action of another party

Doctrine of Respondent Superior

• Respondent Superior - let the superior reply
• Used to describe the legal relationship between the employer and
employee for purposes of determining the employers’ liability for
acts of employee

Doctrine of Force Majure

• Force Majure - greater force
• Excuses a party from liability if some unforeseen event beyond the
control of that party prevents it from performing its obligations
under the contract
• Failure to perform cannot be avoided
Midwifery Situations and Circumstances with
Legal Implication
• Registration of Births
⚬ The physician or midwife who attended the birth is required to register
the child
⚬ Birth Certificate - correctly accomplished with accurate information and
data
• Hospital Records as Evidence
⚬ Proves the condition of the patient at the time of confinement
⚬ Privileged Communication - a communication which one cannot legally
be compelled or required to divulge or reveal
• Incident Report
⚬ Used by healthcare agencies to document the occurrence of anything out
of ordinary that results in, or has the potential to result in harm
Revocation and Suspension of License
• License
⚬ a right granted to a person under certain circumstances or condition
⚬ Failure to comply with the condition that goes with it may mean
revocation or suspension
• Revocation
⚬ it is the cancellation of the midwife’s certificate or license due to
failure to meet the condition that is inherent to her license
⚬ can no longer practice the profession
• Suspension
⚬ temporary withdrawal or a right, privilege, or license to practice
midwifery profession
⚬ temporarily prohibited to practice midwifery
Cause of Revocation
• Criminal Offense: act punishable by law
• Moral Turpitude: gross violation of standards of moral conduct, personal conduct
which goes against public morals
• Negligence: commission of an act that a prudent person would not have done or
the omission of a duty that a prudent person would have fulfilled
• Misfeasance: improper and unlawful execution of an act than in itself is lawful
and proper
• Malfeasance: the doing of an act which a person ought not to do at all
• Nonfeasance: omission of an act which a person ought to do
• Malpractice: professional misconduct, lack of ordinary skill, or breach of duty
• Incompetence: no adequate ability, knowledge, fitness, and qualitites to meet
requirements to perform her duties
• Ignorance: “lack of knowledge or awareness of a particular thing”, inability of
the midwife to apply professional skills
Fraud and Deceit
• FRAUD
⚬ an intentional perversion of truth for the purpose of obtaining
some valuable thing or promise form another
⚬ it is a crime, and also a civil law violation
• DECEIT
⚬ fraudulent representation of a material fact made with knowledge
of its falsity, or without reasonable grounds for believing its truth
and with intent to induce reliance on it

Both terms means giving false impression causing someone to believe

something that is false
Gross Misconduct
• MISCONDUCT
⚬ legal term meaning a wrongful, improper, or unlawful conduct
motivated by premeditated or intentional purpose
⚬ it is where something is seen as unacceptable but is not a criminal
offence
• GROSS MISCONDUCT
⚬ midwife is dismissed straight away as it is serious enough to justify
suspension and revocation of license
⚬ examples:
￭ intoxication, theft, dishonesty, sabotage
￭ fighting or physical abuse
￭ indecent behavior, serious breaches of health and safety
￭ gross insubordination
Laws affecting
Midwifery
Practice
RA 7392
• Midwifery Act of 1992
• Expanded the functions of the midwife
• Curriculum revision was mandated to
prepare the midwife for her added function
• Expansion from basic midwifery to
postgraduate programs
RA No. 10354
• Responsible Parenthood and Reproductive Health (RPRH) Act of 2012
(Enacted on December 21, 2012)
• Elements:
⚬ Family Planning information and services
⚬ Maternal, infant and child health and nutrition, including
breastfeeding
⚬ Prevention of abortion and management of post-abortion
complications
⚬ Adolescent and youth reproductive health guidance and counseling
⚬ Prevention and management of RTI, HIV/AIDS, STI
⚬ Elimination of VAWC and other forms of sexual gender-based violence
RA No. 10354
• Elements (cont.):
⚬ Education and counseling on sexuality and reproductive health
⚬ Treatment of breast and reproductive tract cancers and other gyne
problems
⚬ Male responsibility and involvement and men’s RH
⚬ Prevention, treatment and management of infertility and sexual
dysfunction
⚬ RH education for the adolescents
⚬ Mental health aspect of reproductive health care
RA No. 10354
• Provisions that Affects Midwifery Practice:
⚬ Midwives for skilled birth attendance - mandates every city and
municipality to employ adequate number of midwives
⚬ Emergency Obstetric Care - establishment and operation of
hospitals with adequate facilities and qualified personnel
⚬ Hospital-based Family Planning - ligation, vasectomy, IUD
placement to be available in all government hospitals
⚬ Contraceptives as essential medicines - RH products shall be
considered essential medicines and supplies and shall form part of
the National Drug Formulary
RA No. 10354
• Provisions that Affects Midwifery Practice: (cont)
⚬ Reproductive Health Education - shall be taught adequately by
trained teachers
⚬ Employers’ responsibilities - respect the reproductive health
rights of all their workers
⚬ Capability building of community-bases volunteer workers -
undergo additional and updated training on the delivery of
reproductive health care services
RA No. 10912
An Act Mandating and Strengthening the Continuing Professional
Development Program for All Regulated Professions, Creating the
Continuing Professional Development Council, and Appropriating
Funds therefore, and for other Related Purposes

• CPD
⚬ ensures the capabilities of the professionals at pace with the
current standards of others in the same field
⚬ it delivers benefits to the individual, their profession and the
public
⚬ mandatory requirement for the renewal of the PRC ID
RA No. 11210
An Act Increasing the Maternity Leave Period to One Hundred Five
(105) Days for Female Workers with an Option to Extend for an
Additional Thirty (30) Days without Pay, and Granting an Additional
Fifteen (15) Days for Solo Mothers, and for Other Purposes

• Grant of additional maternity leave benefits to working mothers

from 60 to 105 days (paid), with seven (7) days transferrable to
fathers
• Additional 15 days to single mothers
RA No. 11223
An Act Instituting Universal Health Care for All Filipins, Prescribing
Reforms in the Health Care System, Appropriating Funds Therefore,
and for other Purposes
• Universal Health Care Law
⚬ entitles all Filipino citizens to automatically be enrolled into a
National Health Insurance Program (contributory or non-
contributory)
⚬ ensures that every Filipino citizen are entitled to a healthy
living, working, and schooling conditions
⚬ Financed by the National Government through the Department
of Health
• Membership to Philippines Health Insurance
⚬ Direct Contributors
⚬ Indirect Contributors
RA No. 11223
Responsibilities of the Government Agencies
• Department of Health
⚬ Conduct population-based interventions
⚬ Finance population-based services, set standards
⚬ Formulate and implement the health human resource
⚬ Ensure the regulation of safe and quality care of the health
workers, standards of care, licensing
⚬ Deliver health interventions to the community
⚬ Improve the doctor-to-patient ratio and increase the number of
hospital beds and equipment, establishment of hospitals in
remote ares
RA No. 11223
Responsibilities of the Government Agencies
• PhilHealth
⚬ Focus on individual-based health interventions
⚬ Finance all individual-based level services
⚬ Delivery of the following services: individual hospitalization,
rehabilitation, and emergency healthcare provision
• DOH and PRC
⚬ set up registry of health professionals indicating the current
number of practitioners and location of practice
RA No. 11223
Responsibilities of the Government Agencies
• DOH, PRC, CHED, and TESDA
⚬ develop and plan the expansion of the existing and new allied
and health-related degree and training programs
⚬ regulate the number of enrollees in each program
• CHED and DOH
⚬ expand scholarship grants for allied and health0related
undergrad programs
• CHED, PRC, and DOH
⚬ reorientation towards production of health workers who are
competent in the provision of primary services
RA No. 11223
Responsibilities of the Government Agencies
• DOH and DepED
⚬ formulate programs and modules on health literacy and rights
to be integrated into the existing curricula
• Return Service of DOH Scholars in the Public Sectors
⚬ graduates are required to work in the public sector for at least
three years

Sources of Funds
• DOH Annual Budget
• PhilHealth (subsidies to indigents and contributions)
• PAGCOR, PCSO
• Sin tax proceeds
RA 11036
An act establishing a national mental health policy for the purpose of enhancing the
delivery of integrated mental health services, promoting and protecting the rights of
persons utilizing psychiatric neurologic and psychosocial health services,
appropriating funds therefore, and for other purposes
• Objectives
⚬ strengthen effective leadership and governance for mental health
⚬ develop and establish a comprehensive, integrated, effective, and efficient
national health care system
⚬ protect the rights and freedoms of person with psychiatric, neurologic, and
psychosocial health needs
⚬ strengthen information systems, evidence and research for mental health
⚬ integrate mental health care in the basic health services
⚬ integrate strategies promoting mental health in educational institutions,
workplace, and in communities
RA 11148
“Kalusugan at Nutrisyon ng Mag-Nanay Act”
• act scaling up the National Health and
Nutrition Programs though a strengthened
integrated strategy for Maternal, Neonatal,
Child Health and Nutrition in the First 1000
days of life
RA No. 10069
An act declaring May 7 of every year as Health
Workers Day

RA No. 9710
An act providing for the Magna Carta of Women
• comprehensive women’s human rights law
that seeks to eliminate discrimination against
women
RA No. 9709
An act establishing a universal newborn hearing
screening program for the prevention, early
diagnosis, and intervention of hearing loss
• hearing test before the discharge of the infant
• babies who are not born in a hospital - within
first three month
RA No. 10028
Expanded Breastfeeding Act
“An act providing incentives to all government and
private health institutions with rooming-in and
breastfeeding practices for other purposes”

RA No. 9502
Universally Accessible Cheaper and Quality Medicines
Act of 2008
RA No. 9288
An act promulgating a comprehensive policy and a national
system for ensuring newborn screening
Aims:
• to ensure that every newborn has access to newborn
screening
• to establish and integrate a sustainable newborn screening
system
• to ensure that all health practitioners are aware of the
advantages of newborn screening
• to ensure that parents recognize their responsibility in
promoting their child’s right to health and full development
Administrative
Orders
AO No. 2015-0020
Guidelines in the Administration of life-saving drugs during
maternal care emergencies by nurses and midwives in birthing
clinics

2014-0045-A
Amendment to AO 2014-0045: Guideline on the implementation
of the expanded newborn screening

2018-003
National Policy on the prevention of illegal and unsafe abortion and
management of post-abortion complications
2017-002
Guidelines on the certification of free-standing family planning
clinics

2017-0005
Guidelines in achieving desired family size through accelerated
and sustained reduction in unmet need for modern family
planning methods

2017-0007
Guideline in the provision of the essential health service packages in
emergencies and disasters
2017-0012
Guideline on the adoption of baseline primary health care
guarantees for all Filipinos

2017-0014
Framework for redefining Service Delivery Networks

2016-0005
National Policy on the minimum initial service package for sexual
and reproductive health in health emergencies and disasters
2016-0029
Rules and regulations governing the licensure of ambulances
and ambulance service providers

2017-0035
Guideline on the provision of quality antenatal care in all
birthing centers and health facilities providing maternity case
services

2016-0041
National Policy on the prevention and management of abortion
complications (PMAC)
2016-0042
Guideline in the application for DOH Permit to Construct

2015-0002
Creation of a national implementation team and regional implementation
teams for RA No. 10354 “Responsible parenthood and reproductive health
law of 2012”

2015-0003
Rescission of AO No. 2011-0014 “Guidelines on the certification of health
facilities with Basic Emergency Obstetrics and Newborn Care (BEmONC)
Capacity
2015-0006
Inclusion of Progestin subdermal implant as one of the modern methods
recognized by the National Family Planning Program

2015-0012
Amendment to AO No. 2012-0012 “Rules and regulations governing the
new classification of hospitals and other health facilities in the
Philippines”

2015-0033
Guideline on the implementation of the Universal Health Care High Impact Five
Strategy for DOH Hospital
Executive Orders
EO 12
Attaining and sustaining zero, unmet need for modern family planning
through the strict implementation of the Responsible Parenthood and
Reproductive Health Act

EO 26
Establishment of smoke-free environments which prohibits smoking in
public spaces

EO 28
Providing for the Regulation and Control of the use of firecrackers
EO 51
Adopting a National Code of Marketing of Breast Milk Supplements and
related products

EO No. 12, s. 2017

Zero unmet need for modern family planning

Philhealth CIrcular 22 s. 2014

Social Health Insurance coverage and benefits for women about to give birth

2019-0026
National Policy in the provision of Birthing Assistance to Primigravida and
Grand Multigravida Women
Presidential
Decrees and
Other
Proclamations
PD No. 856
Code on sanitation of the Philippines

PD No. 651
Requiring the registration of births and deaths in the Philippines

PD No. 996
Providing for compulsory Basic Immunization for infants and children below
eight

PD No. 965
A decree requiring applicant for marriage license to receive instruction on
FP and responsible parenthood

PD No. 79
Revising the population act of 1971
 CRIME
• act or omission punishable by law
• act that cause serious damage or death

Crimes and CRIMINAL LIABLITY

the Midwife • may be incurred if midwife committed
felony or an act which would be an
offense against another person or
property

CRIMINAL LAW
• branch of law that defines crimes,
treats of their nature and provides
their punishment
Crime punishable by law
• FELONY
⚬ an act or omission that is committed by means of deceit (dolo) and fault
(culpa)
⚬ Deceit - deliberate intent
⚬ Fault - when a wrongful act has resulted from imprudence, negligence, lack
of skills
⚬ Deliberate intent - an act or omission that is committed with freedom and
intelligence and the person is below 9 years of age
⚬ Classification of Felonies According to Stages of Execution
￭ Attempted Felony
￭ Frustrated Felony
￭ Consummated Felony
⚬ Classification of Felonies According to their Gravity
￭ Grave Felonies
￭ Less Grave Felonies
￭ Light Felonies
Crime punishable by law
• CONSPIRACY TO A CRIME
⚬ exists when 2 or more persons come to an agreement
concerning the commission of a felony and decide to
do it
⚬ Classification of Persons who are criminally liable for
conspiracy
￭ Principals: direct participation
￭ Accomplices: cooperated in the execution of the
crime
Circumstances Affecting Criminal
Liability
• JUSTIFYING CIRCUMSTANCES
⚬ act of the person is said to be in accordance with the law
⚬ Includes the following:
￭ anyone who acts in defense of his person or rights (self-defense)
￭ anyone who acts in defense of the rights of other person (within
the 4th degree)
￭ anyone who acts in defense of the rights of persons or strangers
￭ does not act which causes damage to another
￭ acts in the fulfilmment of a duty
￭ acts in obedience to order issued by a superior
Circumstances Affecting Criminal
Liability
• EXEMPTING CIRCUMSTANCES
⚬ complete absence of intelligence or freedom of action on the part of
the accused
⚬ Example:
￭ imbecile or insane
￭ below nine years old
￭ person over nine but below fifteen years old
￭ person performing a lawful act causes an injury by mere
accident without intention or fault
￭ impulse of uncontrollable fear
￭ fails to perform an act required by law, when prevented by some
lawful or insuperable case
Circumstances Affecting Criminal
Liability
• MITIGATING CIRCUMSTANCES
⚬ do not constitute justification or excuse of the offense in question
⚬ reduces liability of the offender but does not change the nature of
the crime
⚬ Examples:
￭ below 18 years old or over 70
￭ no intention to commit
￭ acted upon impulse
￭ voluntarily surrendered
￭ deaf and dumb, blind, or suffering physical defects
￭ ill
Circumstances Affecting Criminal
Liability
• AGGRAVATING CIRCUMSTANCES
⚬ attending to the commission of a crime that increases the criminal liability
of the offender or makes his guilt even more severe
⚬ Example:
￭ the advantage be taken from the offender of his public position
￭ crime committed in contempt or insult to public authorities
￭ with abuse of confidence or obvious ungratefulness
￭ committed in the nighttime or uninhabited place
￭ crime committed in consideration of a price, reward or promise
￭ committed with armed men
￭ crime committed with event premeditation
Circumstances Affecting Criminal
Liability
• ALTERNATIVE CIRCUMSTANCES
⚬ which may be taken into consideration
⚬ Kinds:
￭ Degree of instruction and instruction of the offender
￭ Intoxication
￭ Relationship is when the offended part is the spouse,
descendant, ascendant, natural or adopted brother or sister, or
relative by affinity in the same degree of the offender
Crimes Against Persons
• PARRICIDE
⚬ killing of father, mother, or child
⚬ punished by the penalty of reclusion perpetua to death
• MURDER
⚬ not falling under Article 246 shall kill another and shall be punished by
reclusion temporal in its maximum period to death
⚬ Circumstances:
￭ with treachery, superior strength, aid of armed men
￭ in consideration of a price, reward, or promise
￭ fire, explosion, shipwreck, stranding of a vessel, derailment or assault
￭ premeditation
￭ with cruelty
• HOMICIDE
⚬ not falling under Article 26 shall kill another without the attendance of any
of the circumstances enumerated
Crimes Against Persons
• DEATH CAUSED IN A TUMULTUOUS AFFRAY
• PHYSICAL INJURIES INFLICTED IN A TUMULTUOUS AFFRAY
• GIVING ASSISTANCE TO SUICIDE
• INFANTICIDE
⚬ killing of a child less than 3 days of age
• ABORTION
⚬ expulsion of the fetus before it is capable of sustaining life
⚬ TYPES:
￭ Intentional
￭ Unintentional
￭ Abortion practiced by the woman herself or by her parents
￭ Abortion practiced by a physician or midwife and dispensing of
abortive
Crimes Against Persons
• MUTILATION
• PHYSICAL INJURIES
⚬ Serious physical injuries
⚬ Less serious physical injuries - incapacitates
offended party form ten days or more
⚬ Slight physical injuries and maltreatment -
incapacitates person from one to nine days
Crimes against property
• ROBBERY
• ROBBERY WITH VIOLENCE AGAINST OR
INTIMIDATION OF PERSONS
• THEFT
• SWINDLING (ESTAFA)
• DESTRUCTIVE AROSN
• MALICIOUS MISCHIEF
Crimes against chastity
• ADULTERY
⚬ committed by any married woman
• CONCUBINAGE
⚬ committed by any married man
• RAPE
• ACT OF LASCIVIOUSNESS
• SEDUCTION
⚬ Simple seduction
⚬ Qualified Seduction
• ABDUCTION
⚬ Forcible abduction
⚬ Consented abduction
• CORRUPTION OF MINORS
Crimes against civil status of a
person
• SIMULATION OF BIRTHS, SUBSTITUTION OF ONE CHILD
FOR ANOTHER, AND CONCEALMENT OR ABANDONMENT
OF A LEGITIMATE CHILD
• USURPATION OF CIVIL STATUS
• ILLEGAL MARRIAGES
⚬ Bigamy
⚬ Marriage contracted against provisions of laws
⚬ Premature Marriages
⚬ Performance of illegal marriage ceremony
Crimes against Honor
• LIBEL
• SLANDER OR ORAL
DEFAMATION
Quasi Offenses
• NEGLIGENCE
⚬ Types:
￭ Contractual Negligence
￭ Civil Negligence
￭ Criminal Negligence
• IMPRUDENCE: lack of judgment or act of
carelessness
⚬ Simple imprudence
⚬ Reckless imprudence
 CIVIL CODE OF THE PHILIPPINES
The Civil Code • defined as the collection of laws

and the Midwife which regulate the private relations of

the members of the society
• general law that governs family and
property relations in the Philippines

FEATURES:
• persons and family relations
• property
• succession
• obligation and contracts
• special contracts
Family Code
• covers fields of significant public interest, especially
the law of marriage, conjugal property relations
• Purpose:
⚬ bringing the family closer to Filipino customs,
values, ideals and reflects contemporary trends
and condition
⚬ family as a basic institution and ensure quality
between men and women
Contract
• meeting of minds of two people whereby one binds
himself, with respect to the other
• Requisites:
⚬ consent of contracting parties
￭ Consent: manifested by the meeting of the
offer
￭ Offer: proposal made by one party
￭ Acceptance: manifestation of the offeree of his
assent to the terms of the offeror
Contract
• Kinds of Contract
⚬ Informal contract: written or oral contract
⚬ Formal contract: which require special formalities
⚬ Implied contract: concluded as the result of acts of
parties to which an objective intention to enter in
account
⚬ Expressed contract- orally or writing by both parties
⚬ Void contracts: does not have effect at all or invalid
due to fictitious conten
⚬ Illegal Contract: contrary to the law
Succession and Wills
• Succession - mode of acquisition that is transmitted
through death
• Descendant
• Inheritance

• Will - person is permitted to control to a certain

degree the disposition of this estate, to take effect
after his death
ISSUES AND
TRENDS
AFFECTING
MIDWIFERY
PRACTICE
 Section 12, Article III of RA No. 10912 or

Career progression the Continuing Professional Development

Act of 2016
and specialization
of midwives Career pathway: provides the opportunities
to assume higher positions
Career specialization: process of focusing
midwives’ occupational concentration on a
specific area of expertise

CPD Law Transition Period

Section 10. Mandatory Requirement in the
renewal of the PRC License and the
accreditation system for the practice of the
profession
WHO ANC: defined as the care provided by
Recommendations on skilled healthcare professional to pregnant
Antenatal Care for women and adolescent girls in order to

Positive Pregnancy ensure the best health conditions for both

mother and baby
Experience
Components:
• Risk identification
• Prevention and management of
pregnancy-related or concurrent diseases
• health education and health promotion
 AO 0013-2013
National Health Policy and Strategic
Adolescent Health and Framework on Adolescent Health and
Development Program Development

Strategies:
• Health promotion and behavior change
• Improving access to quality-friendly
health care services
• Expanding health insurance of
adolescents
• Enhancing skills of health service
providers
• Strengthening partnerships among
adolescent groups
 • a 5 year project of the DOH and LGU’S

Women’s Health and Reason for development:

Safe Motherhood • to reduce maternal mortality and

Program morbidity
• to support efforts at the local level to
provide women’s health services to
targeted groups of women
• at the natioanl level to strengthen DOH
capability to support LGUs in carrying
out these services/activities
Emergency Obstetric Are the elements of obstetric and newborn
care needed for the management of normal
and Newborn Care and complicated pregnancy, delivery,
(EMONC) postpartum periods and the newborn

Inclusion:
• early detection and treatment of problem
pregnancies
• management of emergency complications
Basic Emergency Refers to functions provided by a team of
experienced and trained skilled attendants
Obstetric and at the primary level in providing basic
Newborn Care emergency care to mothers and babies to

(BEMONC) prevent maternal and newborn mortality

Components:
• Doctor
• Nurse
• Midwife
 Includes a wide range of promotive,
preventive, treatment and rehabilitative
Mental Health services
Programs
Program Components
• Wellness of Daily Living
• Extreme Life Experience
• Mental Disorder
• Neurologic Disorder
• Substance Abuse and other Forms of
Addiction
Rural Health
Midwives Placement RHMPP: Aim to provide competent
midwives to areas that have not
Program (RHMPP) / performed well in terms of facility-
Midwifery based deliveries, fully immunized child
Scholarship Program and contraceptive prevalence rates,
of the Philippines improve facility-based health services
(MSPP)
MSPP: aims to produce competent
midwives from qualified residents of
priority arease
 • Refers to the development
perspective and process that is
Gender and participatory and empowering,

Development equitable, sustainable, free from

violence, respectful of human
rights, supportive of self-
determination and actualization of
human potentials
• Seeks to achieve gender equality
Thank You