First Draft Midwifery Student Bill of Rights

Future Midwives Alliance

As radicalization, engaged democracy, and direct action gain momentum around the world the Future Midwives Alliance (FMA) serves as a birthing place for this work within the midwifery community. The ripples of this will be felt and realized by the birthing m/others we serve and by the aspiring midwives joining our ranks.
We see today as ripe with opportunity. We seek to work to improve conditions under which people become midwives, thereby strengthening the midwifery community, leading to the potential for greater unity among future midwives and creating opportunities for future midwives of currently marginalized communities.
The Midwifery Students Bill of Rights serves to empower all people called to midwifery so that they may be more able to empower the clients they serve. The FMA intends for this document to support midwives in their educational paths because we believe that respectful, compassionate educational standards and opportunities will transform the future of midwifery in North America.

A document containing our additional recommendations and considerations for supporting the apprentice/preceptor relationship will be made available upon final release of the Bill of Rights, and will be titled Appendix A, Recommendations. This document is still in the creation stage.

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The goal of providing the following definitions is to create a touchstone from which students and preceptors can feel empowered to negotiate the terms of their agreements. The first set of definitions are taken directly from the dictionary. We understand that these may be different from the definitions currently in use within the midwifery community.

  • Apprentice: A person who is learning a trade from a skilled practitioner, having agreed to work for a fixed period at agreed compensation in exchange for the educational opportunity provided and subsequent mentoring.##
  • Intern: A person who works as an apprentice or trainee in an occupation or profession to gain practical experience, and sometimes also to satisfy legal or other requirements for being licensed or accepted professionally.#
  • Midwife Assistant: A person who assists the primary midwife at births for compensation in accordance with the community standard.
  • Preceptor: A midwife who participates in training a student/apprentice in the academic, clinical and/or professional aspects of midwifery.#
  • Apprenticeship: One bound by legal agreement to work for another for a specific amount of time in return for instruction in a trade, art, or business; One who is learning a trade or occupation, especially as a member of a labor union.# Specifically in the case of midwifery: an arrangement by which a midwife agrees to train a student/ apprentice in the practice of midwifery.

Working definitions: The following are working definitions defining the actual current landscape of the midwifery education community.
  • Apprentice- A student of midwifery learning through observation, supervised hands-on experience and mentorship from a midwife or other birth professional currently in practice. Often an apprentice is unpaid for her work, however additional arrangements include, but are not limited to: apprentice paying preceptor directly in the initial stages of training with payments decreasing as apprentice gains skills and compentencies, apprentice’s accredited school paying preceptor a set fee for births attended by apprentice (this fee is billed to the student via tuition fees), payment of the apprentice by the preceptor on a scale relating to level of skill that increases over time.
  • Apprenticeship, wherein the senior midwife trains an apprentice through the entire educational process which culminates in the apprentice’s ability  to practice independently (upon completion of training). Often this arrangement is based on work trade (knowledge/ experience for labor).
It may be worth considering the implications of such an agreement on the ability to train large numbers of midwives. As seen in the above definitions, traditionally apprentices are paid low, yet earn increasing wages as they gain knowledge and skills.
  • Internship, wherein the intern is temporarily placed, often through/by an accredited school, with a midwifery practice to gain certain skills or experience where the goal is to provide specific experiences.  
  • Mentorship, wherein an experienced student  midwife working in the primary role under supervision as required by NARM, or a new independently practicing midwife, is mentored by an elder or more experienced midwife as a way of supporting the new midwife’s integration into the midwifery community.

Midwifery Student Bill of Rights
Rights & Responsibilities

Responsibility to Society
  • Responsible to pursue education that continuously increases the student’s capacity to serve a diverse community of clients.
  • Responsible to be aware of social justice issues and access to care issues and to work to eliminate these.
  • Responsible to work toward the goal: a midwife for every woman.
Responsibility to the Profession of Midwifery
  • Responsible for upholding the integrity of midwifery practice.
  • Responsible to the larger midwifery community to maintain professional and ethical conduct.

Ethical Rights of the Apprentice
  • Right to know their explicit legal status in their role as student/apprentice in any environment where they are participating in client care.
  • Right to freedom from exclusion from an educational institution, clinical agency, or apprenticeship opportunity on the basis of race, creed, gender, national origin, spiritual beliefs, sexual orientation, parental status, marital status, ability, or age.
  • Right to privately express their concerns about the well being of the mother-baby to the preceptor at any point.
    • Right to file a complaint against a preceptor who is in breach of the apprenticeship contract/agreement.#
    • Right to a grievance process with a professional organization.
    • Right to report unprofessional or illegal conduct of a supervising midwife to a professional midwifery organization.
Ethical Responsibilities of the Student/ Apprentice
  • Responsible for protecting the confidentiality of their clients’ personal and health information.
  • Responsible for providing midwifery care to all clients.
  • Responsible for communicating professionally and discreetly when questions or concerns arise during client care.

Right to Due Process
  • Right to be served due process with fair representation in hearings, mediation, and appeals in any complaints process, peer review, or court case that relates to their presence or involvement with client care in the role of student/ apprentice.
  • Right to be safe against self-incrimination.

Educational Rights
  • Environment
    • Right to an education environment that is free from discrimination including but not limited to: sexual orientation, gender orientation, cultural background, ethnicity, nationality, age, or ability.
    • Right to learn in an environment that promotes equal opportunity and a climate of mutual respect and understanding, free from harassment and discrimination.
  • Communication
    • Right to clear agreements and written contract with their preceptor regarding, but not limited to: tasks and roles in all aspects of client care, compensation, and clinical skills acquisition.
    • Right to constructive feedback regarding their performance and progress.
    • Right to clear objectives at the beginning of any given time frame or task.
    • Right to transparent and objective evaluation with periodic advancement based on achievement of academic and clinical learning goals.
  • Academic
    • Right to current, accurate and credible evidence-based information and course content.
    • Right to have assignments evaluated and graded by the preceptor.
    • Right to feedback on academic performance.
    • Right to examine and discuss areas of study and/or specific clinical practice that are of interest to them with their colleagues and peers, while maintaining appropriate confidentiality. #
Educational Responsibilities
  • General
    • Responsible to actively pursue continuous learning and strive for excellence.     
    • Responsible for seeking out and using available evidence, best practices, current information, and research.
  • Academic
  • Responsible for maintaining  academic rigor and best practices in all academic work.
  • Responsible to participate in the evaluation and improvement of midwifery education.
  • Responsible for completing assignments and practicums according to the student’s plan of completion.

Clinical Rights
  • Right to clear timeline of expected progression through clinical skills.
  • Right to regular skills sign off based on competency evaluation.
  • Right to a steadily increasing progression of skills acquisition that is based on clearly communicated expectations and competency evaluation.
  • Right to have safe, adequate, and functional facilities and equipment.
  • Right to educational opportunities that aid in the development of critical judgment and allow engagement in sustained and collaborative inquiry.
  • Right to be included in professional peer reviews and chart reviews where the student/ apprentice was present and/or involved in the client care of the case being reviewed.
  • Right to be treated professionally in front of clients by preceptor.
  • Right to access charts of all clients in whose care the student/ apprentice participated.
  • Right to compensation for work provided consistent with level of skill mastery.  

Clinical Responsibilities
  • Jointly responsible with preceptor for negotiating progression through clinical skills.
  • Responsible for committing to the humane, conscientious, respectful and thoughtful service to clients and to the community.
  • Responsible for respecting and promoting the autonomy of clients. This may include: helping them to express their health needs and values as well as obtaining appropriate information about, and services for, their health.
  • Responsible for maintaining mother-baby/ client’s dignity and treating all clients and their families with respect.
  • Responsible for informing and educating themselves on unique circumstances that relate to their clients care and/or health rather than expecting the client to educate them on the specific special need/ topic. Please see recommendations document for further details about this point.
  • Responsible for maintaining professional behavior in all situations in client care.
  • Responsible for tracking one’s own clinical experiences.
Task Responsibilities
  • Responsible for performing midwifery tasks appropriate to degree of the assessed, determined, evaluated or agreed upon stage of learning and role.
  • Responsible for performing any tasks relevant to client care and maintenance of the clinical space as defined in the student-preceptor agreement..
Right Against Undue Tasks  
    • Right against performing tasks beyond the duties and responsibilities that do not directly relate to the learning of midwifery knowledge or skills.   Please see recommendations document for specific examples relating to this point.        
    • Right to refuse to participate in procedures that are against one’s convictions and religious beliefs.
    • Right to refuse to perform work outside of the learning arrangements defined in the preceptor-student agreement.
Responsibility to Preceptor  
  • Responsible to communicate needs and limitations with preceptor.
  • Responsible for treating their preceptor, mentors and colleagues with respect and courtesy.
  • Responsible to be familiar with preceptor’s/practices practice guidelines.
Responsibility to the Practice (for practices/clinical placements where appropriate)
  • Responsible for being available at short notice (amount of time to be agreed upon in written agreement based on location and circumstance) for births and postpartum care.
  • Responsible for consistently attending scheduled prenatal and postpartum appointments as agreed upon with preceptor/practice.

Right to Time Off
  • Right to take a leave of absence.
  • Right against undue suspension, dismissal, expulsion, and/or forced leave of absence.
  • Right to engage in a distance learning program which requires travel, as agreed in advance, in the preceptor-student contract.
Right to Organize, Representation and Mediation
  • Right to create, establish, and join organizations for academic, social, political, and/or spiritual development.
  • Right to have meaningful and significant representation at their individual institutions and in national organizations on matters concerning all aspects of midwifery education.      
  • Right to a participate in discussions that address the ongoing development of educational programs by being invited to engage in academic committees, conferences, symposiums, programs and evaluations that address midwifery education.
  • Right to culturally competent mediation.#

Right to Student Welfare
  • Right to learn in a safe and humane environment, wherein education is one of the primary goals without compromising patient care.
  • Right to be treated with compassion and respect.#

Responsibility to Self Care/Personal Well Being
  • The student/ apprentice is responsible for safeguarding their physical, mental and spiritual health in order to provide the best possible client care.
  • The student/ apprentice is responsible for safeguarding their family’s physical, mental and spiritual health.

Rights to Independent Practice Upon Completion of Training
  • Right to work with any client who seeks the new midwife’s services, based on both mutual agreement, disclosure of training and appropriate readiness for practice.
  • Right to be mentored by preceptor and/or other senior midwives in the community upon completion of training and subsequent beginning of independent practice.
  • Right to adequate and equal opportunities for employment and practice after completion of their training, in their home communities, and where applicable, the communities in which they apprenticed.#