Scenario Analysis: This scenario presents a professional challenge due to the inherent complexities of integrating novel research findings into established global midwifery practice. Midwives are ethically bound to provide evidence-based care, but the rapid pace of translational research and the development of new innovations can outstrip the dissemination and adoption processes. Balancing the imperative to adopt beneficial advancements with the need for rigorous validation, ethical oversight, and equitable access across diverse global settings requires careful judgment. The potential for unproven interventions to cause harm, exacerbate existing inequalities, or lead to resource misallocation necessitates a structured and responsible approach to innovation adoption. Correct Approach Analysis: The best professional practice involves a systematic and collaborative approach to evaluating and integrating translational research and innovations. This begins with robust validation of research findings through peer review and replication, followed by careful assessment of their applicability and safety in diverse midwifery contexts. Establishing clear pathways for the ethical implementation of new practices, often through pilot programs and phased rollouts, is crucial. Furthermore, actively engaging with global midwifery professional bodies and regulatory agencies ensures that innovations align with established standards of care and are disseminated responsibly. This approach prioritizes patient safety, evidence-based practice, and equitable access to advancements, aligning with the core ethical principles of midwifery and the overarching goal of improving maternal and newborn health outcomes globally. Incorrect Approaches Analysis: One incorrect approach involves the immediate and widespread adoption of any promising innovation or research finding without adequate validation or contextual assessment. This bypasses essential steps of scientific rigor and ethical review, potentially exposing mothers and newborns to unproven or even harmful interventions. It fails to consider the diverse resource landscapes and cultural nuances present in global midwifery, leading to inequitable implementation and potential for adverse events. Another unacceptable approach is to dismiss or ignore emerging translational research and innovations due to a reluctance to deviate from established practices. This stance hinders professional development and denies women and newborns access to potentially life-saving advancements. It represents a failure to uphold the principle of continuous improvement in healthcare and can lead to a stagnation of midwifery practice, failing to meet evolving global health needs. A third flawed approach is to prioritize the commercial interests or novelty of an innovation over its demonstrated efficacy, safety, and ethical implications. This can lead to the promotion of interventions that are not truly beneficial or may even be detrimental, undermining public trust and potentially causing harm. It neglects the fundamental responsibility of midwives to act in the best interests of their patients and to advocate for evidence-based, ethically sound practices. Professional Reasoning: Professionals should adopt a framework that emphasizes critical appraisal, ethical deliberation, and collaborative implementation. This involves staying abreast of relevant translational research, actively participating in professional development, and engaging in dialogue with peers and regulatory bodies. When considering new innovations, a structured assessment process should be employed, evaluating the evidence base, potential benefits and risks, ethical considerations, and feasibility of implementation within specific contexts. Prioritizing patient well-being, evidence-based practice, and equitable access should guide all decisions regarding the adoption and integration of new knowledge and technologies in global midwifery.

The review process indicates a recurring challenge in ensuring consistent and high-quality midwifery care across diverse European healthcare systems, particularly concerning the recognition of qualifications and the adherence to evolving best practices. This scenario is professionally challenging because it requires navigating varying national regulations, cultural expectations, and professional standards within the framework of pan-European collaboration, demanding a nuanced understanding of both universal midwifery principles and specific jurisdictional requirements. Careful judgment is required to balance patient safety, professional autonomy, and regulatory compliance. The approach that represents best professional practice involves proactively engaging with the European Midwifery Regulatory Network (EMRN) guidelines for cross-border practice and qualification recognition. This approach is correct because it directly addresses the core of the challenge by leveraging the established pan-European framework designed to harmonize standards and facilitate mobility. Adherence to EMRN guidelines ensures that midwives are operating within a recognized and regulated system, prioritizing patient safety through standardized assessment of competencies and adherence to ethical principles common across member states. This proactive engagement demonstrates a commitment to professional development and regulatory compliance, fostering trust and ensuring continuity of care for mobile populations. An incorrect approach involves relying solely on the national licensing body of the originating country for practice in a new European Union member state, without consulting pan-European guidelines. This is professionally unacceptable because it ignores the regulatory complexities of cross-border practice. While national licensure is a prerequisite, it does not automatically confer the right or ensure compliance with the specific requirements of another member state or the overarching EMRN framework. This can lead to practicing outside of established protocols, potentially compromising patient safety and violating regulatory expectations for mobility within the EU. Another incorrect approach is to assume that professional experience alone is sufficient to meet the standards of a new European country, bypassing formal recognition processes. This is professionally unacceptable as it disregards the legal and ethical imperative to have qualifications and competencies formally assessed and recognized by the relevant authorities in the host country. Professional experience, while valuable, must be validated against the specific regulatory requirements and scope of practice in the new jurisdiction to ensure patient safety and uphold professional standards. A further incorrect approach involves seeking informal advice from colleagues in the new country without consulting official regulatory bodies or EMRN resources. This is professionally unacceptable because informal advice, while potentially helpful, cannot substitute for official regulatory guidance. It risks misinterpretation of regulations, overlooking critical compliance steps, and ultimately practicing in a manner that is not legally or ethically sanctioned, thereby jeopardizing patient care and professional standing. Professionals facing such situations should employ a decision-making framework that prioritizes a thorough understanding of the regulatory landscape. This involves: 1) Identifying the specific jurisdictions involved and their respective regulatory bodies. 2) Consulting official pan-European guidelines, such as those from the EMRN, for cross-border practice and qualification recognition. 3) Contacting the regulatory authority in the host country to understand their specific requirements for licensure and practice. 4) Documenting all steps taken and seeking clarification from official sources when in doubt. This systematic approach ensures that decisions are grounded in regulatory compliance and ethical practice, safeguarding both the professional and the patients they serve.

Scenario Analysis: This scenario presents a professional challenge rooted in the ethical imperative to provide culturally sensitive and respectful care while adhering to established professional standards and regulatory frameworks for midwifery practice across diverse European jurisdictions. The core difficulty lies in balancing individual patient autonomy and cultural beliefs with the universal requirements for safe and effective midwifery care, particularly when those beliefs might conflict with evidence-based practices or established protocols. Navigating these differences requires a high degree of cultural competence, clear communication, and a robust understanding of both ethical principles and relevant European directives on healthcare provision and patient rights. Correct Approach Analysis: The best professional approach involves a collaborative discussion with the expectant parents, acknowledging and validating their cultural beliefs and concerns regarding the birth process. This discussion should then focus on clearly explaining the rationale behind recommended midwifery interventions, emphasizing their role in ensuring the safety and well-being of both mother and baby, and exploring how these interventions can be adapted, where possible, to align with their cultural practices without compromising clinical standards. This approach is correct because it upholds the principles of informed consent and shared decision-making, central to European healthcare ethics and patient rights directives. It prioritizes open communication and mutual respect, fostering trust and enabling the development of a care plan that is both culturally appropriate and clinically sound. This aligns with the European Union’s emphasis on patient-centered care and the recognition of diverse cultural needs within healthcare settings. Incorrect Approaches Analysis: One incorrect approach involves proceeding with standard hospital protocols without adequately addressing the parents’ cultural concerns, assuming their beliefs are secondary to established procedures. This fails to respect patient autonomy and cultural diversity, potentially leading to distrust, non-compliance, and a breakdown in the therapeutic relationship. It disregards the ethical obligation to engage in meaningful dialogue and shared decision-making, which is a cornerstone of European patient rights. Another incorrect approach is to immediately dismiss or override the parents’ cultural beliefs as incompatible with safe midwifery practice without attempting to understand their origins or explore potential compromises. This demonstrates a lack of cultural competence and can be perceived as discriminatory, violating principles of respectful care and potentially leading to significant ethical and legal challenges under European human rights and healthcare legislation. A further incorrect approach would be to agree to practices that demonstrably compromise the safety of the mother or baby, solely to accommodate cultural preferences, without robust clinical justification or exploration of safer alternatives. This directly contravenes the fundamental duty of a midwife to provide safe and effective care, as mandated by professional standards and regulatory bodies across Europe, and would expose both the midwife and the healthcare institution to significant risk. Professional Reasoning: Professionals should employ a decision-making framework that begins with active listening and empathetic engagement to understand the patient’s cultural context and concerns. This should be followed by a clear, evidence-based explanation of recommended care, highlighting the benefits and risks. Crucially, the framework must include a process for exploring potential adaptations and compromises that respect cultural values while upholding clinical safety and professional standards. When conflicts arise, professionals should seek consultation with colleagues, ethics committees, or cultural liaisons to ensure a balanced and ethically sound resolution that prioritizes the well-being of the patient and respects their rights.

This scenario presents a professional challenge because the applicant’s prior experience, while extensive, does not directly align with the specific advanced competencies required for the Pan-European Global Midwifery Licensure Examination. Navigating the eligibility criteria requires a nuanced understanding of how to demonstrate equivalence and meet the examination’s stated purpose, which is to ensure a standardized high level of practice across participating European nations. Careful judgment is required to avoid misrepresenting qualifications or pursuing an ineligible pathway, which could lead to wasted resources and professional disappointment. The correct approach involves a thorough review of the examination’s official documentation, specifically focusing on the stated purpose and detailed eligibility requirements. This includes understanding the types of advanced clinical experience, theoretical knowledge, and professional development activities that are recognized as fulfilling the criteria. By meticulously comparing their own qualifications against these specific benchmarks, the applicant can accurately assess their eligibility and identify any potential gaps that need to be addressed. This proactive and detailed self-assessment aligns with the ethical obligation to be truthful and transparent in professional applications and respects the regulatory framework established by the examination board, which aims to uphold standards of midwifery practice across Europe. An incorrect approach would be to assume that extensive general midwifery experience automatically equates to meeting the advanced requirements. This fails to acknowledge the specific, higher-level competencies the examination is designed to assess. Ethically, this is problematic as it could lead to a misleading application. Another incorrect approach is to focus solely on the duration of practice without considering the nature and scope of that practice in relation to the advanced competencies. This overlooks the qualitative aspects of experience that are crucial for advanced licensure. Furthermore, relying on anecdotal advice or informal interpretations of the eligibility criteria, rather than consulting the official documentation, introduces a significant risk of misinterpretation and non-compliance with the regulatory framework. Professionals should employ a decision-making framework that prioritizes accuracy and adherence to established guidelines. This involves: 1) Clearly identifying the objective (passing the advanced licensure examination). 2) Gathering all relevant information (official examination guidelines, personal qualifications). 3) Critically evaluating personal qualifications against the objective’s requirements. 4) Seeking clarification from the examination authority if any aspect of the requirements is unclear. 5) Making a decision based on a comprehensive understanding of the requirements and one’s own qualifications, ensuring transparency and integrity throughout the process.

This scenario presents a professional challenge due to the inherent conflict between a patient’s expressed wishes and the midwife’s professional obligations, particularly concerning the provision of information and the patient’s autonomy. The midwife must navigate the complex ethical landscape of reproductive rights, informed consent, and the potential for coercion or undue influence, all within the framework of European Union directives and national legislation governing healthcare provision and patient rights. Careful judgment is required to uphold the patient’s dignity and self-determination while ensuring she receives comprehensive and unbiased information. The approach that represents best professional practice involves providing the patient with complete and accurate information about all available family planning and reproductive health options, including contraception and abortion services, without expressing personal opinions or biases. This aligns with the fundamental ethical principles of autonomy and beneficence, as well as the legal requirements for informed consent, which mandate that patients receive all necessary information to make decisions about their own healthcare. European Union directives on patient rights emphasize the right to information and the right to consent or refuse treatment. Furthermore, professional midwifery codes of conduct across Europe stress the importance of non-judgmental care and supporting women’s reproductive choices. An incorrect approach would be to withhold information about abortion services due to personal moral objections. This fails to respect the patient’s autonomy and right to make informed decisions about her reproductive health. It constitutes a breach of professional duty to provide comprehensive care and can be seen as a form of coercion by omission, potentially leading the patient to make a decision based on incomplete or biased information. Such an action would violate ethical principles and potentially contravene national laws that protect a woman’s right to access reproductive healthcare services. Another incorrect approach would be to strongly advocate for a specific family planning method, such as long-acting reversible contraception, without fully exploring the patient’s individual circumstances, preferences, and understanding of all options. While promoting effective contraception is part of good practice, undue pressure or persuasion undermines the principle of informed consent. The patient must be empowered to choose the method that best suits her life, values, and health status, not one chosen for her by the healthcare provider. This approach risks infringing on the patient’s autonomy and could lead to dissatisfaction or non-adherence to the chosen method. A further incorrect approach would be to refer the patient to a religious counselor for decision-making support without first ensuring she has received all necessary medical and factual information from the midwifery team. While spiritual or moral guidance can be important for some individuals, the primary responsibility of the midwife is to provide accurate, evidence-based information about medical options. Such a referral, without adequate prior information provision, could be interpreted as abdicating professional responsibility or imposing external values on the patient’s healthcare decisions. The professional decision-making process for similar situations should involve a structured approach: first, actively listen to and understand the patient’s concerns, values, and current situation. Second, provide comprehensive, unbiased, and evidence-based information about all relevant reproductive health and family planning options, addressing any misconceptions. Third, explore the patient’s understanding of the information and her preferences, facilitating her decision-making process. Fourth, document the discussion and the patient’s decision thoroughly. Finally, offer ongoing support and follow-up, respecting her chosen path.

Strategic planning requires careful consideration of examination policies to ensure fairness, transparency, and the maintenance of professional standards. In the context of the Advanced Pan-Europe Global Midwifery Licensure Examination, understanding the blueprint weighting, scoring, and retake policies is crucial for both candidates and the examination board. This scenario is professionally challenging because it involves balancing the integrity of the licensure process with the need to support candidates who may face unforeseen circumstances or require additional preparation. Decisions regarding retake policies, in particular, can impact a candidate’s career progression and the availability of qualified midwives across Europe. The examination board must ensure that policies are applied consistently and ethically, while also acknowledging the human element involved. The best approach involves a thorough review of the candidate’s documented extenuating circumstances against the established retake policy, prioritizing objective evidence and consistent application of rules. This approach ensures that decisions are fair, transparent, and defensible, upholding the credibility of the examination. It acknowledges that while policies exist to ensure a standard, there may be valid reasons for deviations that do not compromise the overall integrity of the licensure process. This aligns with ethical principles of justice and fairness, ensuring that candidates are not unduly penalized due to circumstances beyond their control, provided sufficient evidence is presented. An approach that immediately denies a retake without a formal review of extenuating circumstances is professionally unacceptable. This fails to uphold the principle of fairness and can be seen as an arbitrary application of policy. It neglects the ethical obligation to consider individual circumstances that may have legitimately impacted a candidate’s performance. Another unacceptable approach is to grant a retake solely based on a candidate’s stated desire or perceived hardship, without requiring any objective evidence of extenuating circumstances. This undermines the rigor of the examination process and can lead to perceptions of bias or favoritism, compromising the examination’s credibility and the standards of midwifery practice. Finally, an approach that involves publicly discussing a candidate’s retake request and the reasons for it with other candidates or unauthorized personnel is a severe breach of confidentiality and professional ethics. This violates privacy regulations and erodes trust in the examination process. Professionals should approach such situations by first understanding the specific examination’s policies on retakes, including the definition of extenuating circumstances and the required documentation. They should then objectively assess the submitted evidence against these policies. If the situation falls outside the clearly defined policy, or if there is ambiguity, seeking guidance from a designated appeals committee or supervisor is the appropriate next step. Maintaining clear, consistent, and confidential communication throughout the process is paramount.

This scenario presents a professional challenge due to the inherent tension between a client’s cultural beliefs and established midwifery best practices, particularly within the context of continuity of care. The midwife must navigate this delicate balance to uphold both the client’s autonomy and the safety and well-being of both mother and infant, while adhering to professional standards and ethical guidelines prevalent in Pan-European global midwifery practice. The requirement for cultural safety means recognizing and respecting diverse cultural practices and beliefs without judgment, and ensuring that care is delivered in a way that is sensitive and appropriate to the individual’s background. The approach that represents best professional practice involves a collaborative and educational dialogue with the client and her family. This entails actively listening to understand the cultural significance of their requested practices, explaining the potential risks and benefits of these practices in relation to current evidence-based midwifery care, and jointly developing a care plan that integrates cultural preferences where safely possible, while clearly outlining any non-negotiable safety boundaries. This approach is correct because it prioritizes informed consent, respects client autonomy, and embodies the principles of cultural safety by seeking to understand and accommodate rather than dismiss cultural practices. It aligns with ethical principles of beneficence (acting in the client’s best interest) and non-maleficence (avoiding harm) by ensuring that any deviations from standard care are carefully considered and managed. Furthermore, it fosters trust and strengthens the continuity of care relationship by demonstrating respect and a willingness to work collaboratively. An approach that dismisses the family’s cultural requests outright, citing only standard protocols, fails to acknowledge the importance of cultural safety and can alienate the client, potentially leading to a breakdown in trust and a reluctance to engage with professional care. This can undermine the continuity of care model, which relies on a strong therapeutic relationship. Another incorrect approach would be to agree to the cultural practices without thoroughly assessing their safety or discussing potential risks with the family. This would violate the midwife’s ethical duty to ensure the safety of both mother and baby and could lead to adverse outcomes, demonstrating a failure in professional responsibility and potentially breaching regulatory guidelines concerning safe practice. Finally, an approach that involves imposing the midwife’s own cultural or professional beliefs without genuine engagement with the family’s perspective is also professionally unacceptable. This demonstrates a lack of cultural humility and can be perceived as paternalistic, hindering the development of a trusting and effective therapeutic relationship essential for continuity of care. Professionals should employ a decision-making process that begins with active listening and empathetic inquiry to understand the client’s cultural context. This should be followed by a thorough risk-benefit analysis of the requested practices, informed by current evidence and professional guidelines. Open and honest communication, involving shared decision-making, is crucial. When cultural practices pose significant risks, the professional must clearly articulate these risks and explore culturally sensitive alternatives or modifications that can achieve similar cultural goals while ensuring safety. Documentation of all discussions and decisions is also a critical component of professional practice.

The audit findings indicate a recurring theme of candidates struggling with the Advanced Pan-Europe Global Midwifery Licensure Examination, specifically concerning their preparation resources and adherence to recommended timelines. This scenario is professionally challenging because it directly impacts the integrity of the licensure process, potentially leading to unqualified individuals practicing midwifery, which poses a significant risk to public health and patient safety. It requires careful judgment to balance the need for rigorous standards with the accessibility and fairness of the examination process for all candidates. The correct approach involves a proactive and comprehensive strategy that integrates evidence-based preparation methods with a structured, realistic timeline. This includes utilizing official examination syllabi, reputable midwifery textbooks, peer-reviewed journals, and engaging in practice assessments that mirror the examination format. Furthermore, it necessitates a personalized study plan that accounts for individual learning styles, existing knowledge gaps, and a realistic assessment of the time required to master the extensive curriculum. This approach is ethically sound as it prioritizes candidate competence and patient safety by ensuring thorough preparation, aligning with the professional responsibility to uphold high standards of midwifery practice as mandated by pan-European professional bodies and ethical codes that emphasize continuous learning and evidence-based practice. An incorrect approach would be to rely solely on informal study groups and anecdotal advice from past candidates without cross-referencing with official examination guidelines. This is professionally unacceptable as it bypasses the authoritative sources of information, potentially leading to a superficial understanding of the required knowledge and skills. It fails to address the specific learning objectives outlined by the examination board and may result in candidates focusing on irrelevant material or neglecting critical areas, thereby compromising their readiness and potentially leading to examination failure. This approach also ethically fails to uphold the duty of care to future patients by not ensuring adequate preparation. Another incorrect approach is to adopt an overly compressed study timeline, cramming material in the weeks leading up to the examination. This is professionally unsound because it is unlikely to facilitate deep learning and retention of complex midwifery concepts. The pan-European examination requires a nuanced understanding and application of knowledge, which cannot be effectively achieved through rote memorization or superficial review. This method increases the risk of burnout and anxiety, negatively impacting performance and failing to demonstrate the sustained competence expected of a licensed midwife. Ethically, this approach prioritizes expediency over thoroughness, potentially jeopardizing patient well-being. A final incorrect approach involves exclusively using outdated or non-peer-reviewed online resources without verifying their accuracy or relevance to the current examination syllabus. This is professionally negligent as it can lead to the acquisition of misinformation or outdated practices, which are detrimental to safe and effective midwifery care. The rapid evolution of medical knowledge and best practices necessitates reliance on current, evidence-based resources. Relying on unverified sources fails to meet the professional obligation to practice according to the highest current standards and can lead to significant ethical breaches if incorrect information is applied in clinical settings. Professionals should adopt a decision-making framework that emphasizes a systematic and evidence-based approach to preparation. This involves: 1) Thoroughly understanding the examination’s scope and objectives by consulting official syllabi and guidelines. 2) Identifying reliable and current preparation resources, prioritizing those recommended by professional midwifery bodies. 3) Developing a personalized, realistic study plan that allocates sufficient time for each topic and incorporates regular self-assessment. 4) Seeking guidance from experienced mentors or educators when needed. 5) Regularly reviewing and adapting the study plan based on progress and feedback. This framework ensures a robust and ethical preparation process that maximizes the likelihood of success while upholding professional standards.

Scenario Analysis: This scenario presents a professional challenge due to the inherent tension between a midwife’s duty to provide evidence-based, patient-centered care and the potential for personal bias or external pressures to influence decision-making. The midwife must navigate a situation where a patient’s expressed wishes, while valid, may not align with the most current clinical guidelines or the midwife’s professional judgment regarding optimal outcomes. Maintaining patient autonomy while ensuring safety and quality of care requires careful ethical deliberation and adherence to professional standards. Correct Approach Analysis: The best professional practice involves a comprehensive and collaborative approach. This includes actively listening to and validating the patient’s concerns and preferences, thoroughly explaining the rationale behind recommended interventions, and exploring all available options, including potential risks and benefits of both the recommended course and the patient’s preferred approach. The midwife should then work with the patient to develop a care plan that respects her autonomy while integrating evidence-based practices and ensuring safety. This aligns with the European Midwives Association (EMA) Code of Ethics, which emphasizes respecting the woman’s right to self-determination and informed decision-making, alongside the midwife’s responsibility to provide safe and effective care based on current knowledge and skills. The goal is shared decision-making, where the patient is empowered to make informed choices within a framework of safe and ethical midwifery practice. Incorrect Approaches Analysis: One incorrect approach involves dismissing the patient’s expressed wishes outright due to a perceived lack of alignment with standard protocols. This fails to uphold the ethical principle of autonomy and can erode patient trust. It disregards the patient’s lived experience and potential valid reasons for her preferences, potentially leading to a breakdown in the therapeutic relationship and a suboptimal care experience. Another incorrect approach is to proceed with the patient’s preferred method without adequately exploring the underlying reasons for her request or thoroughly discussing the potential implications and risks. This could lead to a situation where the patient is not fully informed of the consequences of her choices, potentially compromising her safety and well-being, and failing to meet the midwife’s duty of care as outlined by professional regulatory bodies. A third incorrect approach is to impose a care plan based solely on the midwife’s personal beliefs or experiences, without engaging in a dialogue with the patient to understand her perspective and involve her in the decision-making process. This represents a paternalistic approach that undermines patient autonomy and violates the principles of patient-centered care, which are central to ethical midwifery practice across Europe. Professional Reasoning: Professionals should employ a structured decision-making process that prioritizes open communication, shared decision-making, and adherence to ethical principles and professional guidelines. This involves: 1) Active Listening and Empathy: Understand the patient’s perspective and concerns. 2) Information Sharing: Provide clear, unbiased information about all options, including risks and benefits. 3) Collaborative Planning: Work with the patient to develop a care plan that respects her autonomy and aligns with safe, evidence-based practice. 4) Ethical Reflection: Consider the ethical principles of autonomy, beneficence, non-maleficence, and justice in all decisions. 5) Consultation: Seek advice from colleagues or supervisors when faced with complex ethical dilemmas.

The monitoring system demonstrates a need for nuanced professional judgment when a birthing person expresses a desire for a non-pharmacological pain management strategy that deviates from the standard protocol. This scenario is professionally challenging because it requires balancing the midwife’s duty of care, adherence to established clinical guidelines, and the birthing person’s autonomy and right to make informed decisions about their care. The midwife must assess the safety and feasibility of the requested approach while ensuring the birthing person fully understands the implications. The best approach involves a comprehensive discussion with the birthing person, exploring their rationale for requesting the alternative pain management, thoroughly explaining the evidence-based benefits and risks of both their proposed method and standard options, and collaboratively developing a care plan that respects their wishes while ensuring safety. This aligns with the principles of shared decision-making, which are central to ethical midwifery practice across Europe. Regulatory frameworks and professional guidelines emphasize the importance of respecting patient autonomy and providing information that enables informed consent. This collaborative process ensures that the birthing person is an active participant in their care, leading to greater satisfaction and potentially better outcomes. An incorrect approach would be to dismiss the birthing person’s request outright without adequate exploration or explanation. This fails to uphold the principle of autonomy and can lead to a breakdown in trust. Ethically, it is a failure to engage in shared decision-making. Another incorrect approach is to agree to the request without a thorough assessment of its safety or without ensuring the birthing person fully understands potential risks. This could constitute a breach of the duty of care, as the midwife has a responsibility to ensure the well-being of both the birthing person and the fetus. Furthermore, agreeing without proper understanding or communication could violate professional standards that require evidence-based practice and informed consent. Professionals should employ a decision-making process that begins with active listening to the birthing person’s concerns and desires. This should be followed by a clear, jargon-free explanation of available options, including their respective benefits, risks, and alternatives. The midwife should then facilitate a dialogue to understand the birthing person’s values and preferences, and together, they should formulate a care plan that is safe, evidence-based, and respects the birthing person’s autonomy. This process is iterative and requires ongoing communication and reassessment.