The evaluation methodology shows that assessing a midwife’s competency in implementing evidence-based practices within diverse Pan-Asian healthcare settings presents significant professional challenges. These challenges stem from the variability in local healthcare infrastructure, cultural beliefs surrounding childbirth, differing levels of access to resources, and the dynamic nature of evolving clinical guidelines across multiple Asian countries. Careful judgment is required to ensure that competency assessments are both culturally sensitive and scientifically rigorous, reflecting the realities of practice rather than idealized scenarios. The best approach involves a multi-faceted assessment that integrates direct observation of clinical skills in a simulated or actual practice environment, alongside a review of case studies that require the midwife to critically analyze patient scenarios and justify their management decisions based on current evidence and local protocols. This approach is correct because it directly evaluates the midwife’s ability to translate theoretical knowledge into practical application, demonstrating their understanding of core knowledge domains such as antenatal care, intrapartum management, and postnatal support within the specific context of their practice. It also allows for the assessment of their critical thinking and problem-solving skills when faced with common obstetric complications or variations in physiological labor, aligning with the principles of patient-centered care and the ethical imperative to provide safe and effective midwifery services as outlined by international midwifery standards and relevant national regulatory bodies within the Pan-Asian region. An approach that relies solely on written examinations, while useful for assessing theoretical knowledge, is insufficient. This fails to evaluate the midwife’s practical application of skills, their ability to communicate effectively with patients and families from diverse cultural backgrounds, or their capacity to adapt to resource limitations, which are critical components of competent midwifery practice in the Pan-Asian context. Another inadequate approach would be to assess competency based only on peer testimonials without objective verification of skills. This lacks the rigor required for professional accountability and could overlook critical areas where a midwife may require further development, potentially compromising patient safety. Finally, an approach that focuses exclusively on adherence to a single, generalized guideline without considering local adaptations or cultural nuances would be professionally unsound. Midwifery practice must be responsive to the specific needs and contexts of the populations served, and a rigid, one-size-fits-all assessment fails to acknowledge this essential aspect of competent care. Professionals should employ a decision-making framework that prioritizes a holistic evaluation of competency. This involves understanding the specific learning objectives and competency domains relevant to the assessment, considering the unique challenges and contexts of the target practice environment, and selecting assessment methods that provide valid and reliable evidence of both knowledge and skill application. Regular review and adaptation of assessment tools based on feedback and evolving best practices are also crucial for ensuring ongoing professional development and maintaining high standards of midwifery care.

The scenario presents a professional challenge because it requires a midwife to navigate the complex requirements and potential ambiguities surrounding eligibility for an Advanced Pan-Asia Global Midwifery Competency Assessment. Misinterpreting or misapplying these requirements can lead to significant professional consequences, including wasted time and resources, reputational damage, and potentially hindering professional development. Careful judgment is required to ensure adherence to the assessment’s stated purpose and eligibility criteria, which are designed to maintain the integrity and standards of advanced midwifery practice across the Pan-Asian region. The best approach involves a thorough and direct examination of the official documentation outlining the purpose and eligibility for the Advanced Pan-Asia Global Midwifery Competency Assessment. This includes meticulously reviewing the stated objectives of the assessment, the specific qualifications, experience, and any prerequisite training or certifications required for candidates. By cross-referencing personal qualifications and professional background against these explicit criteria, the midwife can accurately determine their eligibility. This approach is correct because it directly addresses the assessment’s framework, ensuring that decisions are based on verifiable information and established standards, thereby upholding the integrity of the assessment process and demonstrating professional diligence. It aligns with the ethical principle of honesty and transparency in professional practice. An incorrect approach would be to rely solely on anecdotal information or the experiences of colleagues who have previously undertaken similar assessments. While peer experiences can offer insights, they may not reflect the current or specific requirements of this particular Pan-Asia Global assessment, which could have evolved. This approach fails to adhere to the official regulatory framework and guidelines governing the assessment, potentially leading to an inaccurate self-assessment of eligibility. It risks misrepresenting one’s qualifications and undermining the structured process established for competency evaluation. Another incorrect approach would be to assume eligibility based on holding a general midwifery license in a Pan-Asian country without verifying if that license meets the advanced competency standards or specific experience prerequisites outlined by the assessment. General licensure is a foundational requirement, but advanced assessments typically demand a higher level of specialized knowledge, skills, and experience beyond basic practice. This approach overlooks the nuanced definition of “advanced” within the context of the assessment and fails to engage with the specific criteria designed to identify practitioners at a higher level of expertise. Finally, an incorrect approach would be to focus primarily on the perceived benefits of obtaining the assessment, such as career advancement or increased earning potential, without first confirming the fundamental eligibility requirements. While these benefits are valid motivators, they do not substitute for meeting the stipulated criteria for entry. This approach prioritizes outcomes over process and can lead to disappointment and wasted effort if the individual is ultimately found ineligible. It demonstrates a lack of due diligence in understanding the prerequisites for participation. Professionals should employ a decision-making framework that begins with identifying the specific assessment and its governing body. The next step is to locate and thoroughly review all official documentation related to the assessment’s purpose, objectives, and eligibility criteria. This should be followed by a meticulous self-assessment, comparing one’s qualifications, experience, and training against each stated requirement. If any ambiguity exists, seeking clarification directly from the assessment administrators or relevant professional bodies is crucial. This systematic and evidence-based approach ensures informed decision-making and adherence to professional standards.

Scenario Analysis: This scenario presents a professional challenge rooted in the inherent tension between maintaining assessment integrity and supporting candidate development. The Advanced Pan-Asia Global Midwifery Competency Assessment’s blueprint weighting and scoring policies are designed to ensure a standardized and rigorous evaluation of essential midwifery skills. However, a candidate’s repeated failure, even with perceived effort, raises questions about the fairness and effectiveness of the assessment process itself, and the institution’s responsibility towards its candidates. Navigating this requires careful judgment to uphold professional standards while considering individual circumstances. Correct Approach Analysis: The best professional approach involves a thorough review of the candidate’s performance against the established blueprint weighting and scoring policies, coupled with an exploration of the reasons for repeated failure. This includes examining the assessment’s validity and reliability, and considering whether the candidate’s learning needs are being adequately addressed. If the assessment is deemed valid and the candidate’s performance consistently falls short despite appropriate support, then adhering to the retake policy, which may involve a final attempt or alternative pathways if available, is the most appropriate course of action. This upholds the integrity of the assessment and ensures that only those who meet the defined competency standards are certified. The justification lies in the commitment to public safety and the professional standards of midwifery, which are paramount. The assessment blueprint and scoring are the agreed-upon mechanisms for verifying these standards. Incorrect Approaches Analysis: One incorrect approach would be to waive the retake policy and grant certification based on the candidate’s perceived effort or tenure. This undermines the entire assessment framework, devalues the competency standards, and compromises patient safety by allowing an inadequately assessed practitioner to practice. It violates the ethical obligation to ensure all certified midwives meet the required level of competence. Another incorrect approach would be to immediately dismiss the candidate without further investigation into the root cause of their repeated failures. This fails to acknowledge the institution’s potential role in supporting candidate learning and development. It also neglects the possibility that the assessment itself might have limitations or that the candidate might benefit from different pedagogical approaches. This approach lacks compassion and a commitment to professional development. A further incorrect approach would be to modify the scoring criteria or blueprint weighting for this specific candidate. This would introduce bias and compromise the standardization and fairness of the assessment for all candidates. It would violate the principle of equitable evaluation and could lead to a perception of favoritism, eroding trust in the assessment process. Professional Reasoning: Professionals should approach such situations by first grounding their decision-making in the established regulatory framework and assessment policies. This involves a systematic review of the candidate’s performance data in relation to the blueprint weighting and scoring. Simultaneously, they must consider the ethical imperative to ensure competence and public safety. If the assessment appears valid and reliable, and the candidate consistently fails to meet the standards despite appropriate support, then the established retake policies must be followed. If there are concerns about the assessment’s validity or the effectiveness of support mechanisms, these should be addressed through established review processes, rather than by compromising individual candidate evaluations. The goal is to balance fairness to the individual with the overarching responsibility to maintain professional standards.

This scenario presents a significant professional challenge due to the intersection of deeply personal reproductive choices with varying cultural norms and legal frameworks within the Pan-Asia region. Midwives are tasked with providing evidence-based care while navigating diverse family structures, religious beliefs, and socio-economic factors that influence a woman’s access to and understanding of family planning and reproductive health services. The challenge lies in upholding individual autonomy and rights within a context where societal expectations or governmental policies might impose limitations or offer differing levels of support. Careful judgment is required to ensure that care is culturally sensitive, ethically sound, and legally compliant across different national contexts. The best professional approach involves a comprehensive, rights-based counseling session that prioritizes the client’s informed consent and autonomy. This approach begins with a thorough assessment of the client’s understanding of her reproductive health options, including various contraceptive methods, their efficacy, and potential side effects. It then involves providing clear, unbiased information about all available family planning services and reproductive rights recognized within the relevant national legal frameworks. Crucially, this approach empowers the client to make a decision that aligns with her personal values, circumstances, and reproductive goals, ensuring that any chosen method or service is implemented only after her explicit, informed consent. This aligns with international ethical guidelines and the principles of reproductive rights, emphasizing client-centered care and self-determination. An approach that focuses solely on providing information about the most readily available or government-subsidized methods without exploring the full spectrum of options fails to uphold the principle of informed choice. This can lead to suboptimal outcomes for the client, as her specific needs and preferences may not be adequately addressed. Ethically, it falls short of providing comprehensive care and respecting autonomy. Another unacceptable approach involves deferring the decision-making entirely to the client’s family or community elders without ensuring the client herself fully understands and consents to the proposed course of action. While cultural considerations are important, prioritizing external influences over the individual’s right to self-determination in reproductive matters is a violation of fundamental reproductive rights and ethical principles of autonomy. Finally, an approach that imposes personal or institutional biases regarding specific family planning methods or reproductive choices, even if presented as “recommendations,” undermines the neutrality required for effective counseling. This can lead to coercion or the withholding of essential information, preventing the client from making a truly informed decision based on her own best interests. Professionals should employ a decision-making framework that begins with establishing a trusting relationship with the client. This involves active listening and a non-judgmental attitude. The next step is to assess the client’s knowledge, beliefs, and values related to family planning and reproductive health. Following this, professionals must provide accurate, comprehensive, and culturally appropriate information about all available options, ensuring the client understands the implications of each. The decision-making process must be collaborative, with the ultimate choice resting with the client, supported by the professional’s expertise and ethical guidance. Regular review and follow-up are also essential to ensure ongoing satisfaction and address any emerging concerns.

This scenario presents a professional challenge due to the inherent tension between respecting cultural practices and ensuring the safety and well-being of the mother and infant, which are paramount in midwifery. The need for continuity of care, a cornerstone of effective community midwifery, is complicated by differing cultural beliefs regarding birth and postpartum care. Careful judgment is required to navigate these complexities without compromising professional standards or alienating the community. The best approach involves a proactive, collaborative strategy that prioritizes open communication and education. This means engaging with the family and community elders early in the pregnancy to understand their cultural practices and beliefs surrounding childbirth. Simultaneously, the midwife must clearly articulate the evidence-based recommendations for safe maternal and infant care, explaining the rationale behind them in a culturally sensitive manner. This approach respects the autonomy of the family while upholding the midwife’s professional and ethical duty to provide safe care. It aligns with the principles of cultural safety, which requires midwives to reflect on their own biases and work in partnership with individuals and communities to achieve equitable health outcomes. This collaborative model fosters trust and allows for shared decision-making, increasing the likelihood of adherence to recommended practices. An incorrect approach would be to dismiss the family’s cultural practices outright without attempting to understand or integrate them. This demonstrates a lack of cultural humility and can lead to mistrust and disengagement, potentially resulting in the family seeking care outside of professional channels, thereby increasing risks. Another incorrect approach is to passively accept practices that are known to be harmful, even if they are culturally sanctioned. This fails to uphold the midwife’s professional responsibility to advocate for the health and safety of the mother and baby, and it undermines the principles of evidence-based practice. Finally, imposing Western medical norms without acknowledging or respecting the cultural context is also professionally unacceptable. It can be perceived as disrespectful and ethnocentric, alienating the family and hindering the establishment of a therapeutic relationship. Professionals should employ a decision-making framework that begins with active listening and cultural assessment. This involves understanding the specific cultural beliefs and practices relevant to childbirth within the community. Following this, a process of open dialogue and education should commence, where the midwife explains the benefits and risks of various practices from an evidence-based perspective, using language and analogies that resonate with the cultural context. The goal is to find a middle ground where cultural practices can be respected as much as possible without compromising safety. This requires ongoing negotiation, flexibility, and a commitment to building a trusting relationship with the family and community.

This scenario is professionally challenging because it requires the midwife to balance the immediate physiological needs of the neonate with the ethical imperative of respecting parental autonomy and the established care plan, all within the context of evolving clinical understanding and potential risks. The midwife must navigate the tension between a potentially life-saving intervention and the parents’ informed decision-making process. Careful judgment is required to ensure the neonate receives optimal care while upholding ethical principles and maintaining a therapeutic relationship with the family. The best professional approach involves immediate, clear, and empathetic communication with the parents, explaining the evolving physiological situation of the neonate and the rationale for the proposed intervention, while simultaneously initiating necessary supportive measures that do not irrevocably alter the neonate’s condition or contravene the parents’ wishes without further discussion. This approach prioritizes the neonate’s well-being by addressing the emergent physiological concern while respecting parental rights and fostering collaborative decision-making. It aligns with ethical principles of beneficence (acting in the best interest of the neonate) and respect for autonomy (honoring the parents’ right to make informed decisions), as well as professional guidelines that emphasize open communication and shared decision-making in complex situations. An incorrect approach would be to proceed with the intervention without further discussion or to delay necessary supportive care due to the disagreement. Proceeding unilaterally disregards parental autonomy and the right to informed consent, potentially leading to a breakdown in the therapeutic relationship and ethical breaches. Delaying essential supportive care, even while seeking further discussion, could compromise the neonate’s physiological stability and potentially lead to irreversible harm, violating the principle of beneficence. Another incorrect approach would be to dismiss the parents’ concerns or to present the information in a way that is overly alarming or dismissive of their understanding, which undermines trust and hinders effective communication. Professionals should employ a decision-making framework that begins with a rapid assessment of the neonate’s physiological status. This should be followed by immediate, clear, and empathetic communication with the parents, explaining the observed changes and the potential implications. The midwife should then present the proposed intervention, clearly articulating its benefits and risks, and actively listen to the parents’ concerns and questions. If there is a significant divergence in opinion regarding an urgent intervention, the midwife should seek immediate consultation with a senior colleague or neonatologist to facilitate a shared decision-making process, ensuring all parties understand the clinical urgency and ethical considerations.

This scenario is professionally challenging because it requires a midwife to balance the immediate needs of a patient with the ethical imperative of maintaining professional competence and adhering to regulatory standards for ongoing practice. The pressure to continue practicing without adequate preparation for new guidelines or technologies can lead to suboptimal patient care and potential harm, creating a conflict between duty of care and personal capacity. Careful judgment is required to navigate this conflict, ensuring patient safety remains paramount while also upholding professional integrity. The best approach involves proactively engaging with updated professional development resources and establishing a realistic timeline for competency acquisition. This demonstrates a commitment to patient safety by ensuring practice aligns with current best evidence and regulatory expectations. Specifically, this approach prioritizes reviewing updated guidelines from relevant Pan-Asian midwifery bodies and the CISI (Chartered Institute for Securities & Investment) if applicable to financial aspects of practice, identifying key changes, and allocating dedicated time for study and practical skill refinement before undertaking complex procedures or assuming new responsibilities. This aligns with ethical principles of beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm), as well as professional accountability to maintain and enhance skills. An incorrect approach involves relying solely on past experience and assuming existing knowledge is sufficient to meet current standards. This fails to acknowledge the dynamic nature of medical knowledge and practice, potentially leading to the application of outdated or less effective techniques. Ethically, this can be seen as a breach of the duty of care, as it prioritizes convenience over ensuring the highest possible standard of care. Regulatory failure occurs because it neglects the requirement for continuous professional development mandated by most midwifery regulatory bodies to ensure practitioners remain competent and up-to-date. Another incorrect approach is to delay seeking updated information until a specific patient care situation necessitates it. While this might seem efficient in the short term, it creates a reactive rather than proactive stance. This can lead to critical delays in providing appropriate care during an urgent situation, potentially compromising patient outcomes. It also places undue stress on the midwife and the healthcare team. Ethically, this approach risks patient harm due to a lack of preparedness, and from a regulatory perspective, it demonstrates a failure to meet the expected standards of ongoing professional learning and readiness. A final incorrect approach is to delegate tasks requiring updated knowledge to colleagues without first acquiring the necessary competency oneself. While collaboration is important, this strategy avoids personal responsibility for professional development. It can overburden colleagues and does not address the midwife’s own knowledge gaps. Ethically, this can be viewed as shirking professional responsibility and potentially exposing patients to risks if the delegated tasks are not performed with the highest level of expertise. Regulatory bodies expect individual practitioners to maintain their own competence, not to rely on others to compensate for their deficiencies. The professional reasoning framework for such situations involves a continuous cycle of self-assessment, identification of learning needs, resource acquisition, skill development, and application, followed by reflection and further refinement. Midwives should regularly consult professional guidelines, engage in peer review, seek mentorship, and actively participate in accredited continuing education programs. When faced with changes in practice, a structured approach to learning and skill acquisition, prioritizing patient safety above all else, is essential.

This scenario presents a significant professional challenge due to the inherent conflict between the immediate need to provide life-saving interventions for a critically ill neonate and the ethical imperative to obtain informed consent from parents who are understandably distressed and potentially overwhelmed. The midwife must navigate complex communication dynamics, respect parental autonomy, and act in the best interests of the infant, all within the framework of established professional standards and legal requirements. Careful judgment is required to balance these competing demands effectively. The correct approach involves prioritizing immediate life-saving measures while simultaneously initiating the process of obtaining informed consent as soon as reasonably practicable. This means that in a true obstetric emergency where delay would cause harm, the midwife is ethically and legally permitted to act to preserve life. However, this action must be followed by prompt and clear communication with the parents, explaining the interventions undertaken, the reasons for them, and seeking their consent for ongoing care. This approach aligns with the principle of beneficence (acting in the best interest of the patient) and the concept of implied consent in emergencies, while also upholding the principle of respect for autonomy by seeking retrospective consent and involving parents as soon as possible. Professional guidelines and ethical codes for midwives universally support acting to preserve life in emergencies, with a strong emphasis on subsequent communication and consent. An incorrect approach would be to delay essential life-saving interventions while waiting for explicit, detailed informed consent from parents who are in a state of shock or extreme distress. This failure to act promptly in a life-threatening situation violates the midwife’s duty of care and the principle of beneficence, potentially leading to irreversible harm or death to the neonate. Ethically, this prioritizes parental autonomy over the infant’s immediate right to life, which is not justifiable in an emergency. Another incorrect approach would be to proceed with life-saving interventions without any attempt to communicate with or involve the parents, even after the immediate crisis has passed. This disregards the principle of respect for persons and parental rights, potentially leading to a breakdown in trust and a failure to provide holistic care. While the initial action to save the infant’s life might be justified, the subsequent lack of communication and consent seeking is professionally and ethically unacceptable. A further incorrect approach would be to assume parental consent for all future interventions based on the initial emergency action, without further discussion or clarification. This oversteps the bounds of implied consent, which is typically limited to the immediate emergency. It fails to respect the ongoing right of parents to be informed and to participate in decisions regarding their child’s care, even when that care is complex and challenging. Professionals should employ a decision-making framework that begins with a rapid assessment of the situation and the immediate threat to life. In emergencies, the priority is to stabilize the patient. Simultaneously, the midwife should assess the parents’ capacity to understand and consent. If capacity is compromised due to distress, the midwife should act to preserve life and then communicate with the parents as soon as they are able to engage, explaining the situation and seeking consent for ongoing care. This involves clear, empathetic communication, providing information in an understandable manner, and respecting parental involvement as much as the situation allows.

This scenario presents a professional challenge due to the inherent conflict between a patient’s expressed wishes and the clinician’s assessment of potential harm, particularly when dealing with potent pharmacological agents in a sensitive obstetric context. The need for careful judgment arises from the ethical principles of autonomy, beneficence, non-maleficence, and justice, as well as the legal and professional responsibilities governing the use of medications in obstetrics. The best professional approach involves a thorough, multi-faceted discussion with the patient, her partner, and the anaesthetist, focusing on shared decision-making. This approach prioritizes understanding the patient’s fears and concerns regarding analgesia, while also clearly and empathetically explaining the risks and benefits of available options, including the potential consequences of withholding effective pain management. It involves exploring alternative non-pharmacological methods and addressing any misconceptions about anaesthetic agents. This aligns with the ethical imperative to respect patient autonomy, ensuring informed consent, and acting in the patient’s best interest (beneficence) by facilitating a safe and positive birth experience. Professional guidelines for midwifery practice and anaesthetic care in obstetrics emphasize collaborative care and patient-centered decision-making, particularly when navigating complex pharmacological choices. An approach that involves unilaterally overriding the patient’s expressed preference for a specific anaesthetic agent, even if perceived as safer, is ethically and regulatorily unsound. This fails to uphold the principle of autonomy and informed consent, potentially leading to a breakdown of trust and a negative patient experience. It also risks causing psychological distress to the patient by disregarding her agency in her own care. Another unacceptable approach would be to proceed with the anaesthetist’s initial recommendation without adequately addressing the patient’s anxieties or exploring her reasoning. This demonstrates a failure in communication and patient advocacy, potentially leading to a situation where the patient feels coerced or unheard, undermining the therapeutic relationship and her trust in the healthcare team. It neglects the ethical duty to ensure the patient fully understands and consents to her treatment plan. Finally, an approach that involves delaying the decision-making process indefinitely without active engagement and problem-solving would be professionally negligent. While time may be a factor, a lack of proactive communication and exploration of solutions can lead to suboptimal pain management and increased maternal distress, failing to meet the standards of care expected in obstetrics. Professionals should employ a decision-making framework that begins with active listening and empathetic engagement with the patient’s concerns. This should be followed by a clear, evidence-based explanation of all available options, including their risks, benefits, and alternatives. Collaborative discussion with the multidisciplinary team, including the anaesthetist, is crucial to ensure all perspectives are considered. The ultimate decision should be a shared one, respecting the patient’s informed choices while ensuring her safety and well-being.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the birthing person’s autonomy and cultural beliefs with the midwife’s professional judgment and the need to ensure optimal safety for both parent and infant. Navigating differing perspectives on birth practices, especially within a global context where cultural norms vary significantly, demands sensitivity, effective communication, and a commitment to shared decision-making. The challenge lies in fostering a collaborative environment where the birthing person feels empowered and respected, while the midwife upholds their ethical and professional responsibilities. Correct Approach Analysis: The best approach involves actively engaging the birthing person in a comprehensive discussion about their preferences, cultural background, and understanding of the proposed interventions. This includes clearly explaining the rationale behind any recommended course of action, outlining potential benefits and risks, and exploring alternative options. This aligns with the principles of informed consent and shared decision-making, which are fundamental to ethical midwifery practice. In many global midwifery frameworks, including those influenced by international standards, the birthing person’s right to self-determination and their active participation in care planning are paramount. This approach respects their autonomy and ensures that care is tailored to their individual needs and values, fostering trust and a positive birth experience. Incorrect Approaches Analysis: One incorrect approach is to proceed with interventions based solely on the midwife’s assessment of what is medically necessary, without thorough engagement with the birthing person’s preferences or cultural context. This disregards the principle of autonomy and can lead to a breach of trust, potentially causing distress and undermining the birthing person’s sense of control over their own body and birth. It fails to meet the ethical imperative of informed consent, as the birthing person has not been given the opportunity to fully understand and agree to the proposed course of action. Another incorrect approach is to defer entirely to the birthing person’s stated preferences, even if they contradict established best practices or pose significant risks, without a robust discussion about those risks and alternatives. While respecting autonomy is crucial, midwives also have a duty of care. This approach can be professionally negligent if it leads to suboptimal outcomes due to a lack of exploration of safer or more effective options. It fails to adequately fulfill the midwife’s role in providing expert guidance and ensuring the well-being of the parent and infant. A third incorrect approach is to impose a standardized care plan without considering the individual birthing person’s unique circumstances, cultural beliefs, or personal values. This can be perceived as paternalistic and disrespectful, alienating the birthing person and leading to dissatisfaction with their care. It neglects the holistic aspect of midwifery, which requires understanding the person within their broader social and cultural context. Professional Reasoning: Professionals should adopt a framework that prioritizes open communication, active listening, and a genuine partnership with the birthing person. This involves: 1) Establishing rapport and creating a safe space for dialogue. 2) Eliciting the birthing person’s values, beliefs, and preferences regarding birth. 3) Providing clear, unbiased information about medical options, including benefits, risks, and alternatives, in a culturally sensitive manner. 4) Collaboratively developing a birth plan that respects both the birthing person’s autonomy and the midwife’s professional expertise. 5) Continuously reassessing and adapting the plan as needed, always maintaining open communication.