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＜Core Competencies of Midwives 2021＞

What are Core Competencies of Midwives? Image of the Core Competencies of Midwives Competency 1: 〈Ethical Sensitivity〉 Competency 2: 〈Maternity Care Competency〉 Competency 3: 〈Women’s Health Care Competency〉 Competency 4: 〈Professional Autonomy Competency〉

What are the Core Competencies of Midwives?

“Core competencies of midwives” are essential practical skills required of midwives in Japan.

The core competencies of midwives consist of four elements: 〈Ethical Sensitivity〉, 〈Maternity Care Competency〉, 〈Women’s Health Care Competency〉, and 〈Professional Autonomy Competency〉. The reason why these elements are required as practical skills of midwives is based on the “Midwifery Philosophy” specified in the “A Statement by Midwives,” namely, 〈respect for life〉, 〈respect for nature〉 and 〈respect for wisdom〉.

The specific contents of the four elements of the core competencies of midwives, namely, 〈Ethical Sensitivity〉, 〈Maternity Care Competency〉, 〈Women's Health Care Competency〉, and 〈Professional Autonomy Competency〉, reflect the practical contents specified in the “Code of Ethics for Midwives” and “Roles and Responsibilities of Midwives” in the “A Statement by Midwives.”

  • Competency 1:

    〈Ethical Sensitivity〉

    Competency to reflect in practice the moral obligations of midwifery activities that are specified in the “Code of Ethics for Midwives.”

  • Competency 2:

    〈Maternity Care Competency〉

    Competency to reflect in practice the roles and responsibilities of caregivers during the stages of pregnancy, delivery, the postpartum, and lactation that are specified in Section IV-1 of the “Roles and Responsibilities of Midwives.”

  • Competency 3:

    〈Women's Health Care Competency〉

    Competency to reflect in practice the roles and responsibilities of caregivers for women’s health that are specified in Section IV-2 of the “Roles and Responsibilities of Midwives.”

  • Competency 4:

    〈Professional Autonomy Competency〉

    Competency to reflect in practice the content specified in “V. Roles and Responsibilities in Midwifery Management” and “VI. Roles and Responsibilities to Maintain Autonomy as a Professional."

Image of the Core Competencies of Midwives

Image of the Core Competencies of Midwives

Explanation

The core competencies of midwives consist of four elements: 〈Ethical Sensitivity〉, 〈Maternity Care Competency〉, 〈Women’s Health Care Competency〉, and 〈Professional Autonomy Competency〉.〈Ethical Sensitivity〉 is an essential basic competency required for exercising 〈Maternity Care Competency〉, 〈Women’s Health Care Competency〉, and 〈Professional Autonomy Competency〉. The richness of 〈Ethical Sensitivity〉 is reflected in 〈Maternity Care Competency〉, 〈Women’s Health Care Competency〉, and 〈Professional Autonomy Competency〉. At the same time, 〈Ethical Sensitivity〉 further expands and deepens with an increase in 〈Maternity Care Competency〉, 〈Women’s Health Care Competency〉, and 〈Professional Autonomy Competency〉. In this way, 〈Ethical Sensitivity〉 has a mutual and reciprocal relationship with 〈Maternity Care Competency〉, 〈Women’s Health Care Competency〉, and 〈Professional Autonomy Competency〉. The midwifery philosophy (respect for life, respect for nature, and respect for wisdom) is at the center of the four core competencies of midwives, playing a role of directing each competency appropriately.

Competency 1: 〈Ethical Sensitivity *〉

“Midwives respect each individual woman and respond ethically to their needs.”

Explanation

Midwives are professionals who embody in their activities the basic midwifery philosophy, that is, respect for life, respect for nature, and respect for wisdom, by respecting each individual woman, child, and their family members, and acting based on a mutual relationship of trust and respect. For this purpose, midwives are required to have competency to accurately identify and respond to the needs of the women and children they treat to be able to respect life and human dignity and the rights of them and their family members as far as possible; competency to provide the best, fair care while building a trust relationship with women, children and their family members, and competency to protect the privacy of the recipients of their care by thoroughly protecting information about women, children and their family members.

Practice Standards

Midwives shall:

  • practice in accordance with the Code of Ethics for Midwives.
  • respect and defend the life, human dignity and rights of women, children and their family members.
  • provide equal care to all women, children and their family members without any discrimination based on such factors as nationality, race, religion, social status, lifestyle, gender, sexual orientation, or gender identity.
  • build mutual relationship of trust with women, children and their family members to provide the best care.
  • thoroughly protect the information about women, children and their family members to protect individuals’ privacy.
  • provide support to empower women, children and their family members for their informed decisions with useful and sufficient information.
  • respect the rights of women, children and their family members to know and make decisions themselves, as well as to support them to accept the results of their own decisions.
  • take responsibility for their own decisions and actions, and take accountability for the care they provide to women, children and their family members.
  • recognize that their own beliefs and values may affect their midwifery practice.
  • establish/participate in midwives’ associations, share information with each other, and improve the quality of care.
  • collaborate with multidisciplinary professionals to provide the necessary care to women, children and their family members.
  • strive to manage, maintain and promote self-health.
  • recognize the professional roles of midwives and strive to maintain their dignity and social trust.

* Ethical Sensitivity:

Competency to understand the meaning of the actions and behavior of those whom they treat and respond ethically. “Respond ethically” refers to identifying the needs that require assistance while getting involved with those whom they treat, and providing support while sharing information with them so that they are better prepared to make a decision.

Competency 2: 〈Maternity Care Competency〉

“Midwives provide safe and effective midwifery care throughout the maternity cycle centered around childbirth.”

Explanation

Midwives are professionals providing care to mother and child as well as their family members during pregnancy, delivery, the postpartum and lactation. Therefore, they provide the necessary care to mother and child as well as their family members by integrating their knowledge and skills throughout the entire period. They take the responsibility to provide assistance during normal delivery and take care of newborns and infants. When providing support, they plan, implement, and evaluate the support, and strive to improve the care so that the wishes and requests of the woman in their care are reflected. They assist mother and child through safe and satisfactory childbirth.
They support mothers and their family members for the birth of high-risk babies, which has become possible as a result of advanced medical care, in collaboration with other professionals, to ensure continuous care of these babies according to their development level from birth through infancy. They also provide support for advanced medical care, such as prenatal diagnosis, in cooperation with doctors and other professionals.

Practice Standards

Midwives shall:

  • diagnose the pregnant mother and child from physical, psychological, and social aspects, and provide the necessary care to maintain a stable pregnancy.
  • provide the necessary information about pregnancy, childbirth (including the determination of the place and method of childbirth), and childcare, and support women’s decision-making.
  • understand the needs related to pregnancy, childbirth, and childcare, and plan, implement, and evaluate individual and group education.
  • support pregnant women who deviate from the normal course of pregnancy progresses through cooperation with doctors and specialists in other fields.
  • diagnose the onset and progress of labor, and delivery and the health condition of mother and child.
  • provide care and support to mother and child and their family members depending on the progress of labor.
  • promote the physiological process of labor and assist with vaginal birth so that mother and child can exert their inherent power.
  • make a judgment on any abnormality, provide temporary emergency care, and provide care through collaboration with doctors and other professionals so that they can receive appropriate medical care at an appropriate time.
  • depending on the condition of mothers, review pregnancy and childbirth and listen to their experiences.
  • diagnose the health condition of the woman during the postpartum from physical, psychological, and social aspects, and provide care to maintain stable life during the postpartum.
  • promote progressive and regressive changes during the postpartum period enhance the self-care abilities of the puerperal women, and support them so that they can learn the basics of childcare behaviors, including breastfeeding.
  • support the mother and child and family members to understand and utilize community resources and systems.
  • determine the status of physiological adaptation to extrauterine life of the newborn and support a smooth transition.
  • support the mother and family members to develop bonding with the child.
  • support the mother and family members to properly take care of the baby according to their stage of growth and development.
  • provide support to the targets of midwifery care for their health maintenance and enhancement through health checkups, counseling and visits, according to the situations of mother and child and their family members based on the characteristics of the area where they live.
  • provide care to high-risk pregnant and parturient women from physical, psychological and social aspects through cooperation and collaboration with doctors and other professionals.
  • provide support to mother and child, and their family members through cooperation and collaboration with doctors, other professionals and peer supporters etc., through the period from the birth of high-risk infants to infancy.
  • provide support of decision making, emotional support in relation to prenatal diagnosis through collaboration with doctors and other professionals.
  • provide care to a pregnant and puerperal woman and her family members who face a psychological crisis due to miscarriage, premature birth, fetal abnormality, intrauterine fetal death, stillbirth, neonatal death, etc.

Competency 3: 〈Women's Health Care Competency〉

“Midwives support women throughout their lives, and build partnerships with each other.”

Explanation

Midwives promote the maintenance and improvement of the health of women, and support women through daily life care so that they can manage their health self-care. Specifically, from the viewpoint of reproductive health/rights, with respect to issues concerning the entire family, including women’s life stage and genetics, midwives support women to handle various issues related to health through health education, dissemination and enlightenment of knowledge, health consultations, and health guidance.

Practice Standards

Midwives shall:

  • support women so that they can practice self-care to maintain and improve their health in cooperation and collaboration with multidisciplinary professionals.
  • based on the specific changes in secondary sexual characteristics and the diversity of the sexuality of people in the adolescent period, provide support so that those whom they treat can make personal decisions to take action.
  • support women in setting up their own family plan with their partners involving birth control.
  • support women and their partners with infertility issues and their family members according to their situation and needs.
  • provide continuous support, in collaboration with multidisciplinary professionals, to women with a history of pregnancy with and birth of high-risk children, and women, their partners and family members who have concerns about the health of the children.
  • understand physical, psychological, and social changes specific to middle-aged and older women, and support their health promotion to improve the quality of their daily life.
  • uncover violence against women and provide support in collaboration with multidisciplinary professionals and related institutions.
  • according to the situation and needs of women with conflicted feelings about pregnancy, provide support in collaboration with multidisciplinary professionals and related institutions, and also support partners, depending on the situation.
  • provide pre-conception care to promote the health of women and partners.

Competency 4: 〈Professional Autonomy Competency〉

“Midwives organize and transmit their professional power to society.”

Explanation

As autonomous professionals, midwives manage their own facilities or participate in management and administration, strive to appropriately respond to emergencies and prevent medical accidents, while contributing to health, medical care, and welfare.
To maintain and improve autonomous professional activities, midwives are required to be competent to organize professional associations, conduct social activities and transmit information. They are also required to participate in research in the midwifery field and aim to reform midwifery care and improve the quality of care through mutual interactions between midwives as well as with care recipients, physicians, and other professionals. Competency to nurture junior midwives and continuous improvement of themselves are also important to maintain and develop autonomous professional activities.

Practice Standards

Midwives shall:

  • reflect on the care they provided and improve the competencies for midwifery practice based on self-evaluation and evaluation by others.
  • periodically evaluate the content of practice using objective indices to improve the level of midwifery practice.
  • conduct Evidence Based Practice in Midwifery (EBPM), gather research data and apply the results in practice.
  • establish standards and procedures for providing midwifery care in line with the association’s philosophy and goals, and obtain agreement of the association to provide safe and comfortable care.
  • have a management perspective, secure the necessary human and material resources, and coordinate human relationships while improving the operations. In particular, those who manage facilities shall ensure their sound financial operation.
  • understand the legal systems applying to for midwifery practice and conduct in accordance with these regulations, and also manage documents and records appropriately.
  • develop systems to respond to emergencies and provide care of the high-risk pregnant woman and child, and ensure medical safety management systems to prevent medical accidents, infections, disasters, etc., in collaboration with multidisciplinary professionals and institutions.
  • actively engage in midwifery education activities to support the development and professional growth of junior midwives.
  • organize professional associations and promote to act social roles as professionals.
  • establish networks with multidisciplinary professionals to work collaboratively, based on the trends and needs of society.
  • participate with care recipients in the decision-making process concerning policy proposals and administrative policies on midwifery work and education to improve maternal and child health services.
  • acquire the latest knowledge and skills, maintain and improve their knowledge and skills, and continue self-improvement as professionals to perform safe and high-quality midwifery practice.
  • pay close attention to social trends and measures, and always improve the individual and association’s operations and systems based on the latest knowledge.
  • acquire specialized knowledge in the fields of medical care, health, and welfare, and collaborate with multidisciplinary professionals and institutions to provide the necessary support to the woman and child and family members.