M–103

PROFESSIONAL GROWTH AND

DEVELOPMENT

Marizol Veridiano-Dorado

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 Table of Contents

Module 1: History of Midwifery Profession 1

Introduction 1
Learning Outcomes 1
Lesson 1. Brief History in the World 2
Lesson 2. Brief History in the Philippines 7
Assessment Task 10
Summary 10
References 12
Module 2: Fundamentals of Ethics 13
Introduction 13
Learning Outcomes 13
Lesson 1. Importance of Ethics to the Profession 14
Lesson 2. The Code of Ethics for Midwives 16
Lesson 3. Guiding Principles in the Practice of Midwifery 19
Lesson 4. Principles of Bioethics and Application 25
Lesson 5. Ethical Issues Related to the Profession 34
Assessment Task 36
Summary 38
References 39

Module 3: Personality Development 40

Introduction 40
Learning Outcomes 41
Lesson 1. Personality 41
Lesson 2. Grooming 45
Lesson 3. Uniform 51
Lesson 4. Health 55
Lesson 5. Voice 57
Lesson 6. Poise 60
Lesson 7. Conduct, Manners and Behaviors 66
Assessment Task 68
Summary 69
References 70

Module 4: The Midwifery Profession 71

Introduction 71
Learning Outcomes 72
Lesson 1. Sphere of Midwifery Practice in the Philippines 72
Lesson 2. Skills and Abilities of Professional Midwife 74
Lesson 3. Qualifications of Applicants for Licensure 75
Lesson 4. The Midwifery Licensure Examination 76

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Assessment Task 81
Summary 81
References 82

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Course Code: M-103

Course Description: The course deals with the aspects of Midwifery Practice.
It includes the midwifery ethics, professional growth, career development,
current trends and issues including related laws affecting health care and
midwifery practice and principles of bioethics.

Course Intended Learning Outcomes (CILO):

At the end of the course, students should be able to:

1. Identify terminologies relevant to the course.

2. Recognize the importance of moral, ethical and legal principles in the
practice of Midwifery.
3. Apply the different moral, ethical and legal principles in the Midwifery as
a profession.
4. Respect and supports the dignity, rights and responsibilities of the
clients they serve.
5. Manage normal deliveries and essential newborn care on her/his own
responsibility and accountability.

Course Requirements:
 Assessment Tasks - 60%
 Major Exams - 40%
_________
Periodic Grade 100%

PRELIM GRADE = 60% (Activity 1-4) + 40% (Prelim exam)

MIDTERM GRADE = 30%(Prelim Grade) + 70 %[60% (Activity 5-7) + 40% (Midterm exam)]

FINAL GRADE = 30%(Midterm Grade) + 70 %[60% (Activity 8-10) + 40% (Final exam)]

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 MODULE 1
HISTORY OF MIDWIFERY PROFESSION

Introduction

Midwifery is an occupation based on helping women through the childbirth process that
has played a significant role through history. “It is generally recognised that the midwife has been
with us since biblical times and that midwifery is the oldest female occupation and without doubt
one of the most important”, stated by Maryland (1993). The characteristics of being soft, patient,
considerate and pleasant are significant to the part of the midwife’s role in relating effectively to
the woman. Those of sagaciousness and prudence relate to the importance of judgment and
decision making in safe practice. The ability to submit her thoughts to the faculty of the more
learned and skilful’ identifies the issue that the midwife is part of a team of supporters in childbirth
and needs to refer to the appropriate other team member when complications arise (Thomas,
n.d.).

Learning Outcomes

At the end of this module, students should be able to:

1. Demonstrate familiarity with the history of Midwifery as a profession.

2. Value how midwifery as a profession evolved locally and international.
3. Discuss the history of midwifery in the Philippines.

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Lesson 1. Brief History of Midwifery in the World
Few traditions have continued throughout the ages as has the practice of midwifery.
History contains many references speaking of midwives and their presence and involvement in
the community and lives of women. Even the word “midwife” typifies the nature of their work: its
literal meaning in English, as well as in Latin, Spanish and Portuguese is “with-women”, giving
the impression of woman-to-woman care (Martin, n.d.).

Tracing midwifery history through ancient history is somewhat difficult due to scarcity of
written material. The earliest recorded mention of midwives is contained in the books of Genesis
and Exodus in the Holy Bible. The author tells of a delivery aided by a midwife, and the mother’s
subsequent death; a midwife’s care at a successful twin birth; and finally, the time in Egypt where
the midwives were commanded to kill all infant boys. From these accounts, it can be implied that
midwifery was a common and usual part of life in that time (Martin, n.d.).

Other ancient references tell us that the mother of Socrates was a midwife, and that
midwives were women’s health providers in the Greek and Roman worlds. Pliny the elder and
Soranus both speak of the work of midwives, and wrote extensively about common midwifery and
obstetric practices of their day, some of which are used today. For example, Soranus spoke of
the birth stool used for deliveries, and also instructed those in training in the use of olive oil and
massaging of the perineum before birth (Martin, n.d.).

To continue our look at the history of this profession, we must jump many years and into
the Middle Ages. Many villages had a local woman who not only called upon to assist with births,
but also cared for the sick. Usually these women used herbs and other folk remedies in their
treatments. At times, midwives were suspected of witchcraft and sorcery, in part due to
superstitions concerning infant deformities and deaths, and thus were persecuted, arrested, and
even killed (Martin, n.d.).

By the early 1600’s, midwives in England worked under the supervision of the State
church, and were licensed by the priest. Midwives continued to be the usual attendant chosen to
assist childbirth, with male doctors being called on only in cases of emergencies. Significant
advances in the area of obstetrics were made throughout this period, one of which was the
invention of the forceps by the Chamberlin brothers. Their work amongst the royalty aided the

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beginnings of acceptance of male presence at childbirth. Several textbooks for midwives were
written throughout the fifteenth century, with the first English textbook being authored by Jane
Sharp in 1671 (Martin, n.d.).

When the first immigrants came to the New World, midwives were amongst the groups.
Birgit Lee Fuller was on the Mayflower, and delivered two babies during the voyage. The
traditional custom of midwives to give care from birth until death continued throughout the
colonies. Unlike earlier history, during this time we have many more written accounts of midwives’
work during the early days of our country, and it is interesting to see the role these women played
in the structure of their community and culture. As Richard and Dorothy Wertz state in their book
Lying-In, “The importance of midwives to the social order is shown in the fact that several New
England towns provided a house or lot rent free to a midwife on condition that ‘she doth not refuse
when called to it [a delivery]’ ” (Martin, n.d.).

Birth was considered a woman’s social event, with the expectant mother finding comfort
and help in the presence of trusted women relatives and companions. In the book Brought to Bed,
Judith Leavitt states that “The midwife orchestrated the events of labor and delivery, and the
women neighbors and relatives comforted and shared advice with the parturient.” One of the most
famous midwives of this period was Martha Ballard, whose diary contains record of many of the
deliveries she assisted with during her practice in Maine throughout the years 1785-1812.
Midwives continued to train mainly through the traditional method of apprenticeship, with many
skills being passed on from one generation to the next. There were others, however, who had no
formal training, but “learned their skills first at the bedsides of their neighbors. Through watching
and helping other women in labor, these women acquired a practical excellence that allowed them
to be valued attendants in part because of their developed skill and in part because of their
sex…They belonged in the birth chamber; they were part of the birth tradition” (Martin, n.d.).

As the years progressed, changes and the desire for modernization grew in America.
During the nineteenth century, male presence gradually became generally more accepted in the
area of midwifery and obstetrics. Women in the upper classes began to favor “male-midwives” or
physicians over the traditional midwife. The change of mindset, due in part to new ideas about
women and advancements made in the field of medicine, paved the way for birth to be considered
a medical problem to be managed by doctors. Doctors began to see this area as a way in which

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to profit financially, as is described in Varney’s Midwifery: “As the presence of medicine became
highly competitive, physicians and medical students were advised that their presence at a delivery
would ensure the entire family as grateful patients thereafter” (Martin, n.d.).

More and more information was made available regarding the female and reproductive
systems, giving more scientific light on subject that before was considered mysterious and
unknown. This left the traditional midwife ignorant on “modern” methods and knowledge, as
women were excluded from medical schools, and most new information was given only to
physicians. Due to financial and cultural reasons, midwives continued to serve the many
immigrant, impoverished, or minority groups that could not afford physicians. It is interesting to
note that midwives were reported to have a lower rate of passing on infection than doctors,
probably due in part to many times doctors went directly from a sick patient to a delivery (Martin,
n.d.).

Around the turn of the century, doctors were commanding more and more control over all
fields of medicine, and wanted to see midwifery abolished. Elizabeth Davis graphically portrays
this struggle in her book, Heart and Hands: “In the US, attacks against midwifery accelerated…In
medieval times, midwives were branded consorts of the Devil; now they became ‘loose women’
intent on their own ways of healing, in contrast to ‘good girls’ who pursued nursing and accepted
roles subservient to the physician and his methods.” The quest for pain relief during labor also
drove women to the hospitals where they could receive anesthetic not available at home (Martin,
n.d.).

The issue of pain relief escalated around 1910 with the advent of “Twilight Sleep”, a
method of anesthesia first used in Germany hospitals. Anne Frye, writing in Holistic Midwifery,
gives us the following insights as to how this affected midwifery and birthing at home. “These
drugs could only be administered in a hospital setting, causing many more middle and upper class
women to seek institutionalized care for the first time. This greatly assisted the transfer of birth
from the relative safety of the home environment into the hospital. Hospitals catering to the middle
and upper classes of the day were well appointed and well-staffed…this is where the notion that
the hospital is a safe haven of rest for birthing mothers originated. Desire for these modern
conveniences quickly accelerated as more and more women sought out ‘safe, sanitary and
scientific’ hospital care.” The “twilight sleep” method was short-lived when one of the leading

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supporters of this movement died during childbirth. That incident, however, just added to the
growing idea that childbirth is a complicated and unnatural event that necessitates medical help
and supervision (Martin, n.d.).

By the early 1920’s, midwifery had almost disappeared from the medical world, but they
had not disappeared from the life of common people. With the rise of governmental involvement
in community health services, those in authority sought to stamp out the practice of midwives
whom they saw as dirty, backwards and unknowledgeable. Those with limited resources could
not afford medical care and doctor’s fees, so midwives continued to serve those women who
otherwise would have done without care, although at times this service was illegal. Many of these
midwives were immigrants from other countries, who lacked proper training in hygiene and other
techniques, thus providing fuel for the fire of concern. In some areas of the country, steps were
taken to try and give basic training and licensure to the community midwives, while in other states
moves were made to outlaw all midwives (Martin, n.d.).

While studying the history of midwifery in general, one cannot overlook the entrance of
nurse-midwifery on the scene. Frontier Nursing Services, was begun in 1925 by Mary
Breckinridge. Trained in the British method of midwifery, which was still the usual birth attendant
in English families, Breckinridge’s goal was to provide health care and obstetric services in the
rural Kentucky mountains. With a professional background, and certification according to medical
standards, this program of public health services and midwifery training provided a new inroad for
women wishing to pursue obstetric training. Generally accepted by the medical community, other
nurse-midwifery schools were opened throughout the country, and gained in popularity. With
regulations to follow and oversight given by doctors, these women did not have the freedom that
traditional midwives did, but yet they were able to provide women-centered care and specialize
in women’s health issues (Martin, n.d.).

The publication of Dr. Grantley Dick-Read’s book Childbirth Without Fear around the
1930’s gave a new perspective on childbirth. His opinion that birth was to be a “natural, joyous
process that was never meant to be painful” aided in changing the population’s perspective on
drugs and interventions throughout labor and delivery. By the 1960’s, doctors and technology
overruled in the hospital, with monitors, restricted movement of mother throughout labor, doctor
being the one “in charge” versus the mother’s choice, and other such mindsets prevailed, making

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childbirth a dreaded and inhuman experience for many mothers. In the 70’s, the writing of
Maternal-Infant Bonding: The Impact of Early Separation or Loss on Family Development by
Klaus and Kennell caused some changes to be made concerning hospital regulations. Allowing
the husband’s presence at birth, and keeping the mother alert during delivery humanized the birth
process somewhat. However, interventions and technology were still commonplace, as doctors
concerned about the rise in lawsuits tried to play an active role in order to protect themselves
(Martin, n.d.).

About this time, there was a growing interest on the part of a small group of people in
pursuing more natural methods of childbirth. With hospital regulations and red-tape preventing
patient choices during labor and delivery, and an increase in cesarean sections, these couples
opted out of the conventional medical route and went back to the traditional and time-proven
choice of midwifery care. The lack of available midwives led to a growing interest of reviving this
tradition, due to consumer demand. Several alternative birthing centers opened, and the
publication of two textbooks written by midwives, served to offer training routes for other midwives
(Martin, n.d.).

In 1982, the Midwives Association of North America was started as an effort to bring
together the midwifery community. Providing communication and giving some type of credibility
to the profession were some of the organization’s goals, and this lead to the formation of the North
American Registry of Midwives in 1987. Setting a standard as to midwifery skills and practices,
NARM provides a method of certification to ensure quality care for women and babies. This has
served to improve the impression that many people had of midwives being unskilled and ignorant
to that of a profession who takes responsibility seriously and has extensive training and
experience (Martin, n.d.).

By the present time, midwifery has progressed to be a widely known and appreciated
alternative to childbirth. Midwives continue to be trained by apprenticeship, with those who have
experience passing on techniques and teaching the next generation. With a devotion to women-
to-women care, assisting women in their home or wherever they choose, involving the entire
family, and development of relationship by providing continuity of care, midwives continue to serve
women throughout the United States. Nurse-midwives may legally practice in all of the US, while

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the legality of lay-midwifery practice depends on each state, but organizations are working
continually to change and improve current laws (Martin, n.d.).

M. Brucker, CNM, states in her article entitled The Birth of Midwifery: “Midwives are the
most common birth attendant in the world. The average child born in this world is born into the
hands of a midwife.” Midwives continue to practice in Europe, Africa, Latin America, and other
places, continuing on the tradition of care that has been with us for generations. Nancy Sullivan
tells us that “Today, in much of the world, professional midwives are responsible for attending
women in labor and birth. In fact, the countries with the best pregnancy outcomes, midwives are
the primary providers of care to pregnant women.” May the tradition continue as women continue
to labor and deliver “with women” in the future (Martin, nd.).

Lesson 2. Brief History of Midwifery in the Philippines

Evolution of Midwifery in the Philippines
(Gandul, 2010)
Care of the sick in Primitive Times
 Animism. Babaylan, catalonan,
 Superstitious and mystical beliefs: wind theory, natural Order and forces (mangkukulam
or manggagaway)
Spanish Period
 Individual sin (Gaba or Bad Karrma), poot and Aswang
 Materia medica (MOrga. Governador-General in 1595-1596 noted used of wine as
medicine: Lambanog and Tuba)
 Fore runner of Filipino Red Cross
American Period
 Separation of Producers, distributors, and consumers of health
 Exchange calue
 Iloilo Mission Hospitals School of Nursing (1906)
Contemporary
Dr. Jose Fabella, first secretary of the department of health founded the first midwifery
school in the 1922 as a response to high infant mortality rate.

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Objectives of the First Midwifery Schools (Gandul, 2010):
 Train young women to replace hilots (traditional birth attendant)
 Train doctors and nurses for Rural assignments and
 Provide health service and education with emphasis on maternal and child health (MCH)

In the early years, Midwifery as a profession was relatively unknown until Dr. Jose Fabella,
founded the first school of midwifery in May 1992 – the Maternity and Children’s Hospital (now
called Dr. Jose Fabella Memorial Hospital). Dr. Fabella spearheaded the organization of the
premier school of midwifery in the country with the foremost objective of training young women in
midwifery to gradually supplant the unlicensed midwives. High school graduates were accepted
to train in midwifery for one year. From thereon, the services of graduate midwives were actively
utilized in the health care community. Cognizant of the need to further improve midwifery
education, the one year course was expanded to one-year and six month course with additional
training on domiciliary service (Integrated Midwives' Association of the Philippines, Inc, 2021).

Thereafter, the midwifery profession has reached a high standard and its activities have,
increased in scope. As a result, a group of dynamic midwives recognized the need to organize an
organization of midwives who can serve, train and provide health service and education among
colleagues and the community. It was in 1947 when the Philippine Midwifery Association was
born, headed by Atty. Angelina C. Ponce. It was composed of members from graduates of
midwifery schools in the country with the aim of improving midwifery and education (Integrated
Midwives' Association of the Philippines, Inc, 2021).

In August 1961, the Philippine Midwifery Association held its first national convention, an
eventful occasion that brought members of the Association together for the first time. With the
theme of “Better Midwifery Service Through Cooperative Undertaking”, the convention was
attended by then President of the Philippines, His Excellency Carlos P. Garcia. During the
convention, there was a schism resulting in the formation of another organization called the
Federation of Filipino Midwives (Integrated Midwives' Association of the Philippines, Inc, 2021).

The National Federation of Filipino Midwives was formally registered at the Securities and
Exchange Commission on August 22, 1961. The new association led by Mrs. Leoncia Chuatoco
aimed to have a more progressive profession and for better service to the citizens of our nation.

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The association organized its 1st annual convention October 28, 1962 at YMCA Family Pavilion,
with the theme of “The Role of Midwives in the Nation’s Growth” (Integrated Midwives' Association
of the Philippines, Inc, 2021).

In June 17, 1974, through the efforts of Mrs. Elisea Velasquez Loanzon, then acting
President of the National Federation of Filipino Midwives (NFFM), Presidential Proclamation No.
1275, “DECLARING THE PERIOD FROM October 22-26, 1974, AND THE THIRD WEEK OF
October of EVERY YEAR THEREAFTER AS MIDWIFERY WEEK” was passed. This is in grateful
recognition of the midwives contribution in the promotion of maternal and child health services in
the country (Integrated Midwives' Association of the Philippines, Inc, 2021).

Through the years, the association have made considerable growth in increasing the
membership so much so that the midwifery associations were integrated and accredited by the
Professional Regulation Commission and thus became known as the Integrated Midwives
Association of the Philippines (IMAP), Inc.. The integration was done possible through the efforts
of Dr. Ricardo B. Gonzales then Chairman, Board of Midwifery, Professional Regulation
Commission (Integrated Midwives' Association of the Philippines, Inc, 2021).

It was on March 17, 1976 that the Integrated Midwives Association of the Philippines was
registered at Securities & Exchange Commission. The Association was led by distinguished
presidents from 1976 who have given a special dimension to the growth of the Association with
their varied expertise. Through the efforts of the previous president, Mrs. Alice Sanz de la Gente,
IMAP, Inc. became an active member of the International Confederation of Midwives based in
London, England (Integrated Midwives' Association of the Philippines, Inc, 2021).

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 Assessment Task 1-1

1. As a midwifery student, what is the significance of having known the history of

Midwifery Profession?
2. Discuss your favorite part in the history of midwifery.
3. Enough of the past, let us look in the future. How would you like to continue the
history of the midwifery profession?

Summary

Midwifery is a health care profession in which providers, known as midwives, who can be
both men and women, offer care for childbearing women during pregnancy, labor and birth, and
during the postpartum period. They also care for the newborn and assist the mother with
breastfeeding. Midwives are mentioned in the Old Testament in Exodus, when midwives feared
God and disobeyed Pharaoh by allowing the male babies to live. Midwifery in the ancient Greco-
Roman world included a wide range of women, including old women who continued folk medical
traditions in the villages, as well as trained midwives and highly trained women who were
considered female physicians. In medieval times in Europe, a popular saying was, "The better the
witch, the better the midwife," and to guard against witchcraft, Christian church laws required
midwives to be licensed by a bishop and swear an oath not to use magic when assisting women
through labor. At the beginning of the 18th century in England, most babies were caught by a

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midwife, but by the onset of the 19th century, the majority of those babies born to persons of
means had a surgeon involved. Nurse-midwives were introduced in the United States in 1925 by
Mary Breckinridge for use in the Frontier Nursing Service (FNS) in remote areas. Today, a
Certified Professional Midwife (CPM) is a knowledgeable, skilled and professional independent
midwifery practitioner who has met the standards for certification set by the North American
Registry of Midwives (Bruner, 2011).

It was Dr. Jose Fabella founded the first school of Midwifery in May 1992, it was named
Maternity and Children’s Hospital before and its present name is Dr. Jose Fabella Memorial
Hospital. It was in 1947 when the Philippine Midwifery Association was born, headed by Atty.
Angelina C. Ponce. The National Federation of Filipino Midwives was formally registered at the
Securities and Exchange Commission on August 22, 1961. The association organized its 1st
annual convention October 28, 1962 at YMCA Family Pavillon, with the theme of “The Role of
Midwives in the Nation’s Growth”. In June 17, 1974, through the efforts of Mrs. Elisea Velasquez
Loanzon, then acting President of the National Federation of Filipino Midwives (NFFM),
Presidential Proclamation No. 1275, “Declaring the period from October 22-26, 1974, and the
third week of October of every year thereafter as “Midwifery Week” was passed. It was on March
17, 1976 that the Integrated Midwives Association of the Philippines was registered at Securities
& Exchange Commission (Bruner, 2011).

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 References

Bruner, B. (2011, June 3). A brief history of midwifery. https://azdailysun.com/news/local/a-brief-

history-of-midwifery/article_62a9383e-9583-11e0-b0e8-001cc4c002e0.html
Gandul, E. (2010. August 26). Professional Growth and Development.
https://www.scribd.com/doc/36450514/Professional-Growth-and-Development#download
Martin, K. n.d. Short history of midwifery. https://gentlemidwife.wordpress.com/a-short-history-of-
midwifery/
Integrated Midwives' Association of the Philippines, Inc, (2021). Brief history.
http://imapinc.org/public/imapinc/history.php#:~:text=In%20the%20early%20years%2
C%20Midwifery,Jose%20Fabella%20Memorial%20Hospital).&text=It%20was%20in%
201947%20when,was%20born%2C%20headed%20by%20Atty.
Thomas, G. (n.d.). Introduction to midwifery. https://memoriesofnursing.uk/articles/introduction-
to-midwifery

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 MODULE 2
FUNDAMENTALS OF ETHICS

Introduction

Ethics mean “character” for the ancient Greeks. For Aristotle, the study of ethics was the
study of excellence or the virtues of character. Notter and Spalding (1976) as cited in Sia (2008)
defined ethics as the principle of right or good conduct. While De la Torre (1993) defined ethics
as the science of the morality of the human behavior, both of the human acts and the acts of man.
Ethics is the philosophical study of voluntary human acts and the purpose of determining what
good, right is to be done, and what is bad, wrong and not be done. In short it is the study or
practice of the “good life”, the kind of life people ought to live. Human Acts are actions that involves
the use of both free will and intellect, these are actions performed with the use of reason. Human
acts are performed consciously and knowingly. Acts of Man are actions that does not involve the
use of intellect and free will, these are actions done unconsciously and without reason. Acts of
man are performed unknowingly and unconsciously (Sia, 2008).

Learning Outcomes

At the end of this module, students should be able to:

1. Demonstrate knowledge and incorporate ethics in midwifery practice.

2. Recognize the importance of ethics in the midwifery practice.
3. Discuss the importance of ethics in profession.

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Lesson 1. Importance of Ethics to the Profession
Function of Ethics

Ethics teaches us to distinguish what is right from what is wrong, it help us to make sound
judgments and decisions, aiding us to attain a happy and fruitful life which is the goal of every
human being. According to Aristotle, a Greek philosopher, a person finds happiness by fulfilling,
actualizing and developing all his potentials and talents. If he goes against his nature, man
become frustrated and unhappy. Ethics helps us to realize what is good for us by helping us to
make correct decisions and actions in different situations in life. Man is inherently good and ethics
teaches us how good man can be (Sia, 2008).

Ethical Systems

Ethical theories attempt to provide a system of principles and rules for resolving ethical
dilemmas. These theories consist of fundamental beliefs about what is morally right or wrong.
Two types of ethical theories that are frequently used as guide in ethical decision making (Sia,
2008):

1. Utilitarianism – (Teleology, Situation Ethics, Consequentialism). It determines what is right

or wrong based on an action’s consequences. It is an ethical system of utility. Using this
system, decision makers determine and choose those actions that will result in the
greatest good for the greatest number of people.
2. Deontology – A system of ethical decision making based on moral rules and unchanging
principles that centers on duty and obligation to others. Deontology emphasizes moral
obligation or commitment. A follower of pure deontology believes in the absoluteness of
principles regardless of the consequences of the decision. According to deontological
theory, honoring ethical obligations ensures good, even though actions may be difficult
and consequences are painful. Deontology is based on the belief that standards exist for
the ethical choices and judgments. These standards are fixed and do not change when
the situation changes.

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Professional Ethics
Today, the concept of ethics has broadened to include not only the characteristics of the
good person, but also the “best practices” in various professions. Professional ethics are basic
principles of conduct or right actions that a licensed practitioner must at all times observe and
uphold in the practice of his profession. They guide a person in his professional activity by
establishing standards of acceptable behavior. It helps the professional and the public know what
is expected and what is not permissible (Sia, 2008).
Many different disciplines, institutions and professions have norms for behavior that suit
their particular aims and goals. These norms of behavior, called code of ethics. Help members of
the discipline to coordinate their actions or activities and to establish the public’s trust on the
discipline. Almost every profession nowadays have their own professional code of ethics that
reflect the profession’s values and establish a standard of conduct or a written list of acceptable
behavior that every member is expected to observe. Not only do professional ethics define what
is expected and permissible, it also defines what is allowed in the practice of one’s profession
(Sia, 2008).

Functions of Professional Code of Ethics (cited from Cafferty and Sugarman by Sia, 20028)
1. Set forth basic principles and regulations to serve as guidelines.
2. Serve as resources for the orientation of new practitioners for their duties, rights and
privileges.
3. Serves as guides to identify and evaluate qualities synonyms with professional conduct.
4. Provide guideline for the establishment and operation of education programs to prepare
future members for service in the profession.
5. Identify common practices to be followed and those to be shunned.
6. Provide a guide for considering the relationships of individuals to their employers, co-
workers, society in general and to their own profession.
7. Serves as a basis for identifying standards of quality practice consistent with actions of
the qualified, competent practitioner.
8. Provide, by implication, for legal actions against incompetents and violators of the code
for liability of the consequences of their actions.

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 9. Provide for due process under the law for practitioners unjustly accused of misconduct in
the performance of their duties.

Lesson 2. The Code of Ethics for Midwives

Midwifery Ethics

Midwifery ethics are principles of right conduct that a midwife must observe in the practice
of her profession. It is concerned with the moral responsibilities of the midwife towards her
profession, patients, physician and superiors, co-workers and herself (Sia, 2008).

PHILIPPINE CODE OF ETHICS FOR MIDWIVES (Sia, 2008)

Preamble

The principles and rules of conduct embodied in this Code are aimed at helping midwifery
practitioners, as individuals and as a professional group, to pursue and maintain a high level of
ethical conduct in the practice of midwifery. These principles and rules do not carry legal force or
sanction. They are simply criteria or measure sticks by which a midwife may properly guide herself
in her professional conduct or in her professional dealing and relationship with her patients, co-
practitioners, members of allied professions and the public at large.

Section I

The primary objective of the midwifery profession for its members to render service
within the scope of their legitimate functions, having in mind that their patients, of whatever
religion and social or economic status deserve respect as human beings. A midwife should
endeavor to serve the confidence of the patients under her care rendering to each of them a
dedication and service to full extent of her skill and competence.

Section II

A midwife should try her best to continually improve her knowledge and skill for the benefit
of her patients and to share with her co-practitioners, any valuable or practical knowledge she
may have gained by experience in the practice of her profession.

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 Section III

A midwife is expected to practice midwifery on a scientific basis and not to voluntarily

take part in the performance of any midwifery procedure which is doubtful or questionable
propriety, from a standpoint of medical or scientific knowledge.

Section IV

The midwifery profession should contribute to the safeguarding of the public health and
should respect itself against the admission into its membership of midwives deficient in
professional competence and requisite moral character. It is incumbent upon every midwifery
practitioner to observe the law, to uphold the honor and dignity of her profession, and to adhere
faithfully to professional discipline. It is the professional duty of every midwife to bring to the
attention of the proper authority, through legitimate procedure the illegal or unethical conduct of
any co-member of the midwifery profession, without bias or personal animosity, but solely for the
good name of the profession and for the public interest and welfare.

Section V

A midwife who is accepted to take care of a patient should render service to the best of
her ability. She should not neglect the patient under any circumstance within her control.

Section VI

A midwife should not compromise her services to the patient under terms or conditions
which would interfere with or hamper the exercise of her judgment or skills. Or which would
impair the quality of patient care.

Section VII

In the practice of midwifery, a midwife must confine the source of her professional income
to the midwifery services she has actually rendered. Her fees should commensurate with the
services performed and if need be, with the patient’s ability to pay. It is highly improper for a
midwifery practitioner, presumed to be guided in her professional conduct by this Code, to pay or
receive a commission for referral of patients made to or by her.

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 Section VIII

A midwife’s legitimate functions cover performance of midwifery services only to normal

pregnant women and normal newborn infants. Accordingly, in a doubtful or difficult care, she
should seek consultation or refer such case to a qualified obstetrician or physician. She should
not persist in handling the case and thereby risk herself to liability for any injury that may arise.

Section IX

A midwife is bound by professional ethics not to reveal any information given by her patient
in the course of the patient’s care or treatment, whether such information is addressed to her or
to the attending physician, unless under the law, she is required to testify on such information to
serve the end of justice.

Section X

The ideals of service envisioned by the midwifery profession call for a dedication of the
midwife’s responsibilities not only to the individual patients but also to the community in which
she practices, to the end that she may be able to contribute to the improvement of the health of
the patients and to the health and well-being of the community.

Section XI

A midwife should participate in research activities or any effort of the midwifery practitioner
to improve training and practice, and to take part in establishing and maintaining conditions of
employment conducive to high quality of maternity and infant care.

Section XII

As a member of a health team, a midwife should work with interest and concern, together
with other members of the health team, in promoting efforts to meet the health needs of the public.

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Lesson 3. Guiding Principles in the Practice of Midwifery

Golden Rule
The most familiar version of the Golden Rule says, “Do unto others as you would have
them do unto you.” Moral philosophy has barely taken notice of the golden rule in its own terms
despite the rule’s prominence in commonsense ethics (Internet Encyclopedia of Philosophy, n.d.)
The golden rule is a moral principle which denotes that you should treat others the way
you want to be treated yourself. For example, the golden rule suggests that if you would like
people to treat you with respect, then you should make sure to treat them with respect to
(Effectiviology, 2021).

Mores, Morals and Morality

Mores
Mores is defined by Robles as customs enforced by social pressure. They are the society’s
established patterns of action to which an individual is expected to conform. If the person goes
against it, he risks disapproval and punishment. Mores vary from one society to another
depending on the culture of the society (Sia, 2008).

Morals
Morals come from the Latin word “mores”, which means customs or values. Morals deal
with the conduct of man, the right and wrong behavior of man in his relationship with his
fellowmen. Morals are fundamental standard of right and wrong, learned and internalized in early
childhood. Morals are often based on religious beliefs (Sia, 2008).

Moral Virtues (Sia, 2008)

1. Justice – is the virtue that allows man to give his neighbor what rightfully belongs to him.
2. Temperance – is the virtue that moderates the possible over-indulgence of the
concupiscible appetite.
3. Fortitude – is the virtue that gives courage to a man in times of overwhelming odds. When
a man is faced with hardships, fortitude enables man to be strong and to persist for the
attainment of his goal.

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 4. Prudence – is the virtue of knowing how things are to be done rightly and well. Tact is
closely related with this virtue. Prudence enables man to act and speak properly and
correctly in different situations.

Morality

Ethics is the science of morals which helps man to distinguish what is good from what is
evil while morality pertains to the goodness and badness of man’s actions as they conform to
some set of standards imposed by society. Morality is concerned with knowing and doing what is
right. Morality is a code of values to guide man’s choices and actions (Sia, 2008).

Elements of Determining Morality (Sia, 2008)

1. Act itself – Object

2. Purpose – Reason for which the act is performed, intention of the person performing the
act itself and from the purpose which may affect the morality of the act.
3. Circumstances – Situation surrounding the act, factors distinct from the act itself and from
the purpose which may affect the morality of the act

Principles of Judging Morality (Sia, 2008)

1. An act is morally good if the act itself, the purpose and the circumstance are substantially
good.
2. If an act is intrinsically evil (evil by its nature), the act is not morally allowable regardless
of the purpose or circumstances.
3. Circumstances may create, mitigate or aggravate the immorality of an act.
4. If the act is itself good or at least indifferent, its morality will be judged by the purpose and
circumstances.

Conditions Affecting Morality (Sia, 2008)

1. Ignorance – id the absence of intellectual knowledge in man.

2. Fear – is one of the passions but a very common one so it is not often given special
attention. It is the agitation of the mind caused by the apprehension of impending evil. It
ranges from slight disturbance to actual panic.

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 3. Concupiscence – are the passions of man which include love, hatred, joy, grief, desire,
aversion or horror, hope, despair, courage or daring, fear and anger which makes man
frail and prone to evil.
4. Violence – or coercion is external force applied to a person for the purpose of compelling
him to perform an act which is against his will.
5. Habit – refers to operative habit which is a lasting readiness and facility, born of repeated
acts, for acting in certain manner.

The Principle of Double Effect

Human Acts with Both Good and Bad Effect – When human act results in both good and bad
consequences or wanted and unwanted effects, it is called “double effect” and the human act to
be performed becomes an ethical problem. Often, this problem is solved using the Principle of
Double Effect or Principle of Two - Fold Effect (Sia, 2008).

The Principles of Two-Fold Effect (Sia, 2008)

To be judged as morally good, an action with double effect must meet the following criteria:

1. The action must be morally good and must not be evil in itself. Examples of actions which are
evil in itself are murder, lying, stealing etc.
2. The good effect must be willed and the bad effect merely allowed. The person intends only the
good effect and the evil effect, though foreseen and permitted, is not wanted.
3. The good effect must not come from an evil action but must come from the initial action itself
directly. The good effect must immediately occur after the action is performed or at least occur
simultaneously with the evil effect.
4. The good effect must have a greater effect than the bad effect. There should be a
proportionately grave reason to justify the evil effect.

The Morality of Cooperation

Man is a social being. He lives with other men. Therefore, morality’s subject matter is not
only man’s action by himself but also his actions as he works and with lives with other men. This
is the morality of cooperation. Man is morally responsible not only for his own actions but also of

21
the effect of his actions to other people, as well as his reaction to other men’s action. In everyday
life, man must constantly be aware of his own actions, be it good or evil. Before cooperating in an
act, he must judge if he is directly or indirectly, and willingly or unwillingly cooperating in an evil
or good activity. This awareness is of importance to a midwife who often works as a member of a
heath team and who is constantly faced with moral issues such as abortion, birth control,
euthanasia, etc. (Sia, 2008).

The Principle of Totality

An individual may not dispose of his organs or destroy their capacity to function, except to
the extent that this is necessary for the general well-being of the whole body. Destroying an organ
or interfering with its capacity to function prevents the organ from achieving its natural purpose.
This principle states that the whole is always greater than its parts. To save the patient’s life as a
whole, it is justified under the principle to surgically cut-off a disease body part of the patient
(Aquinas, n.d.).

Types of Cooperation with Evil (Sia, 2008)

1. Positive and Negative Cooperation
- Positive cooperation is voluntarily doing an act which contributes to the evil act of
another. A midwife who assists an obstetrician perform an abortion is committing
positive cooperation.
- Negative cooperation is cooperation by omission ij which the person did not do
anything to prevent another person from committing an evil act. A midwife who
saw under the midwife stealing medical supplies and does not stop the latter or
report the incident to her supervisor is committing cooperation by omission.
2. Immediate/Direct or Mediate/Indirect Cooperation
- Direct cooperation happens when a person’s cooperation occur while the act is
being performed. A midwife who acts as a “watch” while the doctor injects a fatal
dose of sedative to an unconscious patient is committing direct cooperation.
- Indirect cooperation is committed before or after the evil act itself. A midwife
destroys all evidence of an abortion although he did not assist while the surgical
procedure was being performed.

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Medical Situations in Which the Midwife may Commit Immoral Act by Cooperation
1. IUD Insertion
2. Abortion
3. Sterilization
4. Infertility studies in which a male patient may be required to collect semen specimen by
masturbation
5. In vitro fertilization
6. End of life “no resuscitation order”, euthanasia

Conscience
Conscience is a practical judgment of reason upon an individual act as good, or as evil
and to be avoided. It is also referred to as the act of reasoning out the right and wrong of a situation
(Sia, 2008).

Etiquette
Although ethics and etiquette are interrelated, the two are quite different terms. Etiquette
is a set of formal rules for social conduct based on social consideration for others and designed
to establish pleasant social relationships. Etiquette is designed by society to guide and regulate
conduct and social practices. It depends upon the mores and customs of people, thus, etiquette
varies from one place or society to another. Ethics, on the other hand, are formed form basic
principles, deep beliefs and values of man so they are more constant. Ethics is concerned with
all the actions of man and their morality, it is designed to help mean lead a meaningful, fruitful
and happy life in this world by setting up the basic principle on which man would base his actions
(Sia, 2008).

Ideals
Hernandez (1968) defined that an ideal is an idea grasped firmly in the mind, raised to a
standard of action and pursued consistently. An ideal is a mode of perfection or excellence which
we try to imitate. The ideals of a person influences his actions both consciously and unconsciously
(Sia, 2008).

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Values
Value comes from the Latin word “valere” – which means o be strong. Indeed they are
strongly held beliefs or convictions about what a person holds to be important and worthy in his
or her life. Values are ideals and concepts that give meaning to an individual’s life. A person’s
values are big determinants of his decisions and actions, both in his personal and professional
life. Values are shaped out of society’s norms, religion and family orientation. Values are not
permanent characteristics; they may change for the better or for the worse. People have many
values and it is important to know which takes priority and which is the least important. In addition,
people have different set of values. Because of these differences, value conflicts are common
even in the workplace. Value conflicts may arise among people working together like midwives,
nurses, doctors, administrators, patients and families. Sometimes personal values may also
conflict with one’s professional or work values and there is a need to make choices and to
prioritize. Thus, it is important to clarify one’s values, as these will strongly influence the choices
that a person makes in life, including those involving professional duties. What are the values of
a student who cheats on his examination? What are the values of a midwife who submits a fake
employment certificate when applying for a job? What are the values of a midwife who charge
exorbitant fees to her patients? (Sia, 2008)

Habit
Habit is also called our second nature. It refers to a pattern of action which is both
convenient and undeviating. It is a particular course of action that is difficult to change. They are
voluntary at the beginning but once formed, their performance becomes mechanical and
automatic. The character of a person is the aggregate of his moral habits. Good habits cultivate
a morally uprights character. Bad habits can enslave a person and deprive him of freedom, such
as the bad habit of smoking and alcoholic drinking. Once a person develop these habits, it will be
difficult for him to eliminate them (Sia, 2008).

Basic Rues to Follow in Forming Good Habits (Hernandez, 1968 as cited in Sia, 2008)
1. There must be strong desire or will to form a habit. A person should have the initiative to
be able to start the habit formation otherwise if there is only determination, the desire will
find no fulfillment.

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 2. Repetition and uninterrupted practice must be religiously observed. All opportunities to
make the act habitual must be taken advantage of.
3. No exceptions must be tolerated. The reason is this: if during the initial stage of habit
formation, a person would allow a day or two to pass without performing the act designated
to be habitual, he has to start all over again and the result would be deplorable waste of
time and energy.
4. The will must be daily strengthened by small sacrifices, penitential works and all other acts
which tend to strengthen the will.

Four Rules of Eliminating Bad Habits (cited from Hernandez, 1968 by Sia, 2008)
1. There must be strong desire or will to break the habit.
2. The breaking of the habit must be done gradually with no exceptions allowed.
3. Following the law of disuse, the person must refrain from performing the bad habit.
4. Substitute a (bad) habit of another (good habit)

Lesson 4. Principles of Bioethics and Application

Health care ethics is the field of applied ethics that is concerned with the vast array of
moral decision-making situations that arise in the practice of medicine in addition to the
procedures and the policies that are designed to guide such practice. Of all of the aspects of the
human body, and of a human life, which are essential to one’s well-being, none is more important
than one’s health. Advancements in medical knowledge and in medical technologies bring with
them new and important moral issues. These issues often come about as a result of
advancements in reproductive and genetic knowledge as well as innovations in reproductive and
genetic technologies. Other areas of moral concern include the clinical relationship between the
health care professional and the patient; biomedical and behavioral human subject research; the
harvesting and transplantation of human organs; euthanasia; abortion; and the allocation of health
care services. Essential to the comprehension of moral issues that arise in the context of the
provision of health care is an understanding of the most important ethical principles and methods
of moral decision-making that are applicable to such moral issues and that serve to guide our
moral decision-making. To the degree to which moral issues concerning health care can be

25
clarified, and thereby better understood, the quality of health care, as both practiced and received,
should be qualitatively enhanced (Taylor, n.d.).

Health Care Ethics deals with the conduct and moral issues that arise in the practice of
health care professionals, midwives included. It is concerned with health care, values, obligations,
rights and needs. it strives to resolve ethical issues that often confront health care professionals
such as choosing between what is best for the mother or what is best for the unborn child, what
is best for the individual or her relatives, what medical records can be disclosed and what must
be held in strictest confidentiality (LearnWell Institute Website, 2004 as cited in Sia, 2008).

Bioethics

Bioethics is the study of ethical, social, and legal issues that arise in biomedicine and
biomedical research. Bioethics includes medical ethics, which focuses on issues in health care;
research ethics, which focuses issues in the conduct of research; environmental ethics, which
focuses on issues pertaining to the relationship between human activities and the environment,
and public health ethics, which addresses ethical issues in public health. Bioethicists conduct
research on ethical, social, and legal issues arising in biomedicine and biomedical research; teach
courses and give seminars; help draft institutional policies; serve on ethics committees, and
provide consultation and advice on ethical issues. Bioethicists work for academic institutions,
hospitals and medical centers, government agencies, private corporations and foundations.
Bioethicists usually have a graduate degree in bioethics or a related discipline, such as
philosophy, law, medicine, nursing, public health, psychology, political science, biology, or
theology (Resnik, n.d,).

Ethical Principles Used in Health Care

Ethical principles are derived from ethical theories. Important ethical principles used in
health care include respect for individuals, autonomy, non-maleficence, beneficence, justice,
confidentiality, fidelity and veracity.

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 a. Principle of Respect for Individuals
Respect for persons is an overarching maxim of morality that influences all other ethical
principles like beneficence, non-maleficence and justice. The concepts of informed consent,
confidentiality, accountability and veracity have evolved out of the principle of Respect for
Individuals. Respect for Individuals is fundamental to recognition of the autonomy of individuals
as it incorporates ethical convictions that individuals should be treated as autonomous agents,
and that person with diminished autonomy (such as children and mentally insane) are entitled to
protection (cited from Belmont Report, 1979 by Sia, 2008).

b. The Principle of Autonomy

The concept of autonomy means that “…individuals are to be permitted personal liberty to
determine their own actions”, stated by Fowler and Fry (1988) as cited in Sia (2008).

Characteristics of Autonomy (Miller, 1995 as cited in Sia, 2008)

1. Autonomy as free action – to be considered free action, it must be the intentional and
conscious choice of the person. Right to free action is violated by any suggestion of
coercion, duress, undue influence or withholding of information.
Example: When a midwife influences the client to decide in favour of a specific
contraceptive method by misinforming the client that all other contraception are not as
effective and safe, the client is unable to exercise his autonomy fully.
2. Autonomy as authenticity – Autonomy as authenticity means that the action of the
individual is consistent with his attitudes, values, dispositions and life plans. The decision
is aligned with his past usual pattern of behavior and their motivation. An inauthentic action
is unusual or unexpected and has no apparent or preferred explanation.
Example: Although the client is free to decide for himself the midwife should investigate
further if she sees that the client’s decision is not within his cultural beliefs, values and
unusual way of thinking.
3. Autonomy as effective deliberation – This pertains to action that is done only after giving
it clear thought, giving proper considerations to the alternatives and their consequences.
When a person acts out of impulse, he engages in thoughtless action for there is no
opportunity to think. An action is considered an effective deliberation, when all information

27
 are available. The action is non-effective when all the information is not known to the
person, when his deliberation of the alternatives is inconsistent with his values and
priorities or when he has not fully understood the alternatives and consequences.
Example: to be able to exercise effective deliberation, the patient must be informed of all
information necessary for him to be able to make a decision. However, during emergency
situation, patient or relatives must make decisions under pressure of time and other
emotions that make decision making difficult. The supportive role of the midwife is very
important during this period to that patient or his family can make appropriate decisions.
4. Autonomy as moral reflection – this is the deepest and most demanding sense of
autonomy for as Miller has pointed out, it involves a deeper level of self-introspection which
involves the ability for rigorous self-analysis, awareness of alternative set of values
(personal values of the individual), commitment to a method of assessing them and an
ability to put them in place. In comparing reflection with authenticity, he says that the
former will determine the sort of person one will be, while authenticity can be judged by
acts conforming to deliberated values.

Application of Autonomy in Health Care Ethics (Sia, 2008)

1. Informed Consent – Autonomy is the main tenet from which informed consent has evolved.
It obliges health care providers such as doctors, nurses and midwives to seek a valid
consent because the consenting party is an autonomous person. The respect for the
autonomy of the patient means that the patient has the capacity to act intentionally, with
understanding and without controlling influences that would act against a free and
voluntary act such as coercion or undue influence. Therefore, midwives should not provide
advice or recommendations as to what course of action the patient and his family must
resort to. The primary task of the health care provider is to inform the patient or the persons
responsible for the patient all the information there is about the options available, including
their cost, procedure, benefit and risks and it is the patient and his family who shall make
their own voluntary choice and decision. The patient’s decision must be complied with
even if the health care provider disagrees with him or her. It must also be remembered
that autonomy is not absolute for the law has set forth certain limitations. For example, a

28
 person in the acute stage of contagious disease must be isolated, even against his will, in
order to prevent the spread of the disease and protect the greater public.
2. Paternalism/ Parentalism – it means acting in a fatherly manner which involves engaging
in behaviors associated with those of the traditional roles of the father of a family such as
leadership, decision making, discipline and protection. In health care, the concept of
paternalism is applied when health care givers, especially physicians, assume the
authority to make decisions for the patients. Many are against paternalism as it limits the
patient’s freedom of choice. Paternalism is often thought of as a violation of the patient’s
autonomy or the right to make his own decisions, but in instances where patients have
diminished decision making capacity (such as when they are mentally incompetent,
delirious, unconscious or under the influence of substances), health care providers and
family members can make the decision for the patient to promote patient’s well-being or
to protect patient from harm or injury. Most ethical theorists believe that paternalism is
justified only to prevent harm to the patient.
3. Standard of best interest – Pertains to health care providers making decisions about a
client’s health care when they are unable to make informed decisions about their own
care. In this situation, the health care provider must decide what the best course of action
for the patient and carry it out.

Justification for the Overriding of Autonomy (Sia, 2008)

1. Harm Principle – a person’s liberty is justifiable restricted to prevent that person from
harming others.
2. Offense Principle – A person’s liberty is justifiably restricted to prevent that person from
offending others.
3. Principle of Paternalsm – A person’s liberty is justifiably restricted to prevent that person
from harming himself or herself.
4. Principle of Extreme Paternalism – A person’s liberty is justifiably restricted to benefit that
person.
5. Principle of Legal Moralism – A person’s liberty is justifiably restricted to prevent that
person from acting immorally.
6. Social Welfare Principle – A person’s liberty is justifiably restricted to benefit others.

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 c. Beneficence
The principle of beneficence demands that above all, an individual should do only good
and contribute to the welfare of others. This principle is one of the oldest requirements of health
care providers which illustrate their primary role of doing well for the client or patient under their
care. Therefore the goal of health care providers should be that which would benefit the patient,
as well as to take positive steps to prevent and remove harm from the patient. These goals are
applied both to individual patients and to the good of the society as a whole. For example,
providing wound treatment to a particular patient is goal geared to individuals and the prevention
of disease through research and immunization is the same goal expanded to the population at
large (Sia, 2008).
The duty of beneficence becomes complex if two patients appeal for treatment at the same
moment. For example, a midwife received two home delivery call at the same time. Some criteria
of urgency of need might be used or some principle of first come first served, to decide who should
be prioritized. Sometimes there is also difficulty in determining what is exactly good for the patient
especially when health care professionals or family members disagree over what course of action
is the patient’s best interest (Sia, 20028).

d. Nonmaleficence
The principle of nonmaleficence is based on a person’s rigorous obligation to avoid injuring
another individual. The legal requirements of duty of care and accountability clearly arise from
this principle. This principle obliges health care providers to DO NOT HARM. An extension of this
principle id the obligation of the health care providers to protect form harm those who cannot
protect themselves such as children, mentally incompetent and unconscious patients (Sia, 2008).
The principle of nonmaleficence requires us that we do not intentionally create needless
harm or injury to the patient, either through negligent acts or commission or omission. Providing
a proper standard of care that avoids or minimizes the risk of harm is supported not only by our
commonly held moral convictions, but by the laws of society as well. In a professional model of
care one may be morally and legally accountable if one fails to meet the standards of due care,
this principle affirms the need for professional competence. It is clear that mistakes and accidents
occur; however, this principle articulates a fundamental commitment on the part of the health care

30
professionals to protect their patients form harm by anticipating such mistakes and accidents.
(Sia, 20028).
The principle of nonmaleficence may justly be violated in some medical situations. An
example is when a pregnant woman with advanced cardiac disease must have an abortion. It is
also violated in short term to produce a greater good for the patient in the long term such as when
a painful or disfiguring surgery is performed like readical neck dissection for the purpose of
prolonging life in a patient with advanced laryngeal cancer. Another illustration is when a diabetic
patient with gangrenes must lose a limb to amputation to prevent the spread of infection to other
parts of the body (Sisa, 2008).
Midwives sometimes face dilemmas of nonmaleficence when they are in conflict of
whether or not “blow the whistle” in a situation like when a nurse believes another staff member’s
actions have compromised patient safety. Will she report to protect the patient but loss the
friendship of other midwife who could be suspended or worst, lose her job or will she be keep
quiet (Sia, 2008)?
Maleficence is the opposite of beneficence. While the former means bad or harm, the latter
means good or benefit. The main difference of nonmaleficence and beneficence is that in
nonmaleficenece “one must accept substantial risk to one’s safety in order not to cause harm to
others, whereas acceptance of even moderate risk is not generally required to benefit others” in
beneficence cited form (Beauchamp and Childress, 1994 by Sia, 2008).

e. Justice
The principle of justice provides the obligation to be fair to all. This principle requires the
social benefits (e.g. health care services) and social burdens (e.g. taxes) be distributed in
accordance with the demands of justice. There have been many and different analysis of justice.
The great philosopher Aristotle had said that justice involves “giving to each that what is his due”.
According to Johnstone (1988) justice is an ethical principle can be examined in terms of
“fairness”, “desert” and “entitlement”. Rawls (1971) discussed justice as fairness in terms of
impartiality. Impartiality that being all persons considered free and equal, with each person having
an equal right to the comprehensive system of liberty offered by society. Justice underlies the
midwife’s commitment to provide services with respect for human dignity and render care to the

31
best of her ability to every patient irregardless of religion, sex, race, economic status and physical
beliefs (Sia, 2008).
When the principle of justice is expanded to “distribute justice”, it means that every person
has the right to be treated equally regardless of sex, race, marital status, medical diagnosis, social
standing, economic level or religious belief. This implies the fair distribution, including burdens in
society. As we can see, distributive justice is the basis of the law that provides for equal access
to health care for all. However dilemmas arise when there is shortage of some resources and
services (Sia, 2008).
Our society uses different guideline to confront this ethical problem of supply and demand
(Sia, 2008):
1. To each person an equal share – All members are given equal services such as free
immunization to children below seven years old.
2. To each person according to need – when there is shortage of Hepatitis B vaccine, it is
provided only to high risk groups. Likewise, only health care workers assigned in high risk
areas are provided with free health check-ups, medications, including treatment and
vaccinations.
3. To each person according to contribution – Only people who are member of Phil Health
can avail of its medical services and privileges.
4. To each person according to free-market exchanges – the service is provided only to
those who can afford it like cosmetic surgery.
5. To each person according to merit – the principle involves the implementation of a set of
criteria or conditions that must be met before a privilege can be granted. Example is the
Philippine Charity Sweepstakes service of providing free health care assistance to those
who meets the required criteria, and that is having no financial capacity to provide it to
themselves and to their family.
6. To each person according to effort – this refers to the patient’s efforts to comply or not to
comply with medical advice. A diabetic client has the choice to comply or not to comply
with his medication and diet regimen.

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 f. Confidentiality
Confidentiality refers to the duty to protect privileged information and to share entrusted
information responsibly. It stems from the notion that a person’s wishes, decisions, and personal
information should be treated with respect. The duty of confidentiality can apply to individuals,
organizations, and institutions. In fields like medicine, the law, and counselling, there are explicit,
professional obligations to keep personal information in confidence, because the trust is the
foundation for meaningful professional relationships. As a general rule, health care providers have
a responsibility to avoid disclosing personal and medical information that has been entrusted to
them without the patient’s consent. In accordance with professional standards, when a patient’s
private information is shared, there is the expectation that health care providers will keep the
information in confidence. This might include details pertaining to a patient’s diagnosis, prognosis,
and history of illness, drug use, family history, and sexual activity (Miller School of Medicine,
2020).

Persons Required to Observe Confidentiality (Sia, 2008)

1. Physicians who deal with the patient even for a briefest time at various phases of the
patient’s illness or treatment.
2. Pharmacist who prepares and dispenses the medication prescribed to the patient.
3. All other health care professionals involved in the care of the patient such as nurses,
midwives, medical technologists, hospital chaplain, student nurses and social workers.
4. All other personnel who attended to the care of the patient such as janitors, hospital
receptionists, secretaries, accountant, treasures, etc.

When Confidentiality May End (Sia, 2008)

1. After the patient gives his consent to reveal information about him or his health care. For
example, when a patient avails himself of medical insurance from a private company, he
give his consent for that company to obtain information about his health and treatment. At
such, the insurance company any obtain information about the patient’s health condition
and treatment from the hospital or physician. In this case, the information may be revealed
only to the insurance company who also, must treat such information confidential.

33
 2. When its revelation is for the common good. If the patient is ill with a highly contagious
disease, the physician has the obligation to report the patient to proper authorities in order
to take measures to protect other people. Another example is the necessity of reporting
medico-legal cases, when a patient comes to the ER with a gunshot wound, the police
must be informed.

g. Fidelity
Fidelity refers to the obligation of a person to be faithful to agreements, commitments and
responsibilities that he has made to himself and to others. It is the main principle that supports
the concept of accountability of midwives to patients and employers (Sia, 2008).

h. Veracity
It refers to the principle of truthfulness. In midwifery, veracity is applied in the midwife’s
responsibility never to mislead or deceive a patient. This is observed when providing informed
consent where a midwife should provide accurate health teachings and answer patient questions
as truthfully and honesty (Sia, 2008).

Lesson 5. Ethical Issues Related to the Profession

When moral values are in conflict, the result may be an ethical dilemma or crisis.
Sometimes, no good solution to a dilemma in midwifery ethics exists, and, on occasion, the values
of the midwifery community conflict with the values of the individual patient, family, or larger
medical community. Conflicts can also arise between health care providers, or among family
members. Some argue for example, that the principles of autonomy and beneficence clash when
patients refuse blood transfusions, considering them life-saving; and truth-telling was not
emphasized to a large extent before the HIV era. The International Confederation of Midwives
states this about ethics in the profession of midwifery. "Midwives respect a woman's informed
right of choice and promote the woman's acceptance of responsibility for the outcomes of her
choices. Midwives work with women, supporting their right to participate actively in decisions
about their care, and empowering women to speak for themselves on issues affecting the health
of women and their families in their culture/society” (MidwiferyWisdom.com, 2020)

34
Ethical Dilemma

An ethical dilemma is the choice between two or more equally justifiable alternatives.
When there is only one course of action or when a conflict does not exist there is no ethical
dilemma. Sometimes it requires an individual to make a choice between two equally unfavourable
alternatives. Ethical dilemma occurs because people have different ethical philosophy, follows
different philosophy in life and see life situations at different perspectives. This is also true in the
health care field, nurses, doctors and patients may also differ. Ethical questions may arise
especially with life and death issues. All solutions available are real and choosing the best one
becomes difficult because the demarcation line between right and wrong are not apparent (Sia,
2008).

There are many moral dilemmas in the field of health care like difficult choices involving
justice or fairness such as when limited bed space or inadequate staffing must be divided among
patients with equal needs or with regards to midwives’ dependent functions such as whether or
not to follow a doctor’s order to administer a dangerously high dose of a narcotic drug. In many
instances, decisions must be made quickly because a patient’s medical condition is rapidly
deteriorating (Sia, 2008).

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Assessment Task 2-1

1. Differentiate utilitarianism and deontology.

2. We have different principles that guide us through our life that may affect our
profession. Express your own opinions on the following ethical issues. Are you in
favor or not? Support your answer.
a. Use of Artificial Contraceptives
b. In vitro fertilization
c. No Resuscitation Order
3. Read and understand the following cases and identify the ethical principles in
health care that you can view from the cases. Explain and support your answer
based on the situations.
a. A certain woman had been married for 4 years and really wanted to get
pregnant. She finally got pregnant and was happy and looked forward to the
birth of her baby. At 29 weeks of gestation, she developed severe
preeclampsia and termination of pregnancy was inevitable.

36
It was a difficult situation for the woman and her husband was not an option because
it was against their faith. After much counselling, the woman and her partner
accepted to consent for the termination of pregnancy but this disturbed them for a
long time.

b. An 18-year-old woman had a premature twin delivery. 1st twin weighed 750grams
and succumbed to death; the 2nd twin weighed 650grams and survived but needed
advanced neonatal care. Upon delivery the parents were advised to be referred to a
facility which could offer advanced neonatal care. They refused to be transferred as
they believed the baby would not survive and they also had limited financial
resources for any anticipated cost related to transfer. At one time they wanted to be
allowed to go home and leave the baby to die.

c. A patient x is 26 years old primigravida, who presented at 36 weeks gestation for

her normal antenatal clinic in a facility, she explained that she would like to be
induced the following day because her mother was very ill and was due for surgery
in the next three days and her prognosis was poor. The patient reported that she
would like her mother to see her baby prior to the surgery. She and her immediate
family were worried that her mother may not survive the operation. She had started
her antenatal clinic at 24 weeks, and all parameters were within the normal range.
Her supportive family members included husband, aunty and most fundamental the
ailing mother. The client was worried especially when speaking about the condition
and pending operation of the woman. The client insisted that she wanted the baby
born before her mother’s operation, given that the client was the only child of the
ailing mother. Following consultation with the medical officer in charge we were
forced to do as per the clients request and the team decided to induce her the
following day.

37
 Summary

Ethics teaches an individual from what is right and wrong and help in making judgments.
There are two types of ethical theories that are frequently used as guide in ethical decision
making, utilitarianism and deontology. Midwifery ethics are principles of right conduct that a
midwife must observe in the practice of the profession. Philippine Code of Ethics for Midwives set
as a guide for the midwives to practice their profession in an ethical manner, it is consist of 12
sections. The golden rule which is “Do Not Do unto Others as You Would Have Them Do unto
you” is also a guide for any profession. Mores are customs enforced by social pressure. Morals
deal with the conduct of man, the right and wrong behavior of man in his relationship with his
fellowmen. The moral virtues are justice, temperance, fortitude and prudence. Morality is a code
of values to guide man’s choices and actions. Ignorance, fear, violence, habit and concupiscence
are the conditions affecting morality. Conscience, Etiquette, Ideals, Values and Habit are also
some of the principles that guide the midwifery practice. Bioethics is the study of ethical, social,
and legal issues that arise in biomedicine and biomedical research. Bioethics includes medical
ethics, which focuses on issues in health care; research ethics, which focuses issues in the
conduct of research; environmental ethics, which focuses on issues pertaining to the relationship
between human activities and the environment, and public health ethics, which addresses ethical
issues in public health. The ethical principles that are used in health care are respect for individual,
autonomy, beneficence, nonmaleficence, justice, confidentiality, fidelity and veracity (Sia, 2008).

38
 References

Aquinas, T. (n.d.). Thomas Aquinas’ principles of double effect and totality.

http://www.pages.drexel.edu/~cp28/docdble.htm
Effectiviology.com (2021). The Golden Rule: Treat Others the Way You Want to Be Treated.
https://effectiviology.com/golden-
rule/#:~:text=The%20golden%20rule%20is%20a,treat%20them%20with%20respect%2
0too.
Internet Encyclopedia of Philosophy. (n.d.). The golden rule. https://iep.utm.edu/goldrule/
MidwiferyWisdom.com. (2020). Ethical issues in midwifery.
https://www.midwiferywisdom.com/ethicalissuesinmidwifery.html
Miller School of Medicine. (2020). Confidentiality and privacy - module 2.
https://bioethics.miami.edu/education/ethics-curricula/geriatrics-and-
ethics/confidentiality-and-privacy/index.html
Resnik, D. (n.d.) Bioethics. https://www.niehs.nih.gov/research/resources/bioethics/index.cfm
Sia, M. (2008). Midwifery law and ethics (2nd Ed). RMSIA Publishing Quezon City, Philippines
Taylor, S. (n.d.). Health care ethics. https://iep.utm.edu/h-c-ethi/

39
 MODULE 3
PERSONALITY DEVELOPMENT

Introduction

An individual’s personality refers to his/her appearance, characteristics, attitude, mind-

set and behavior with others. Personality development grooms an individual and helps him make
a mark of his/her own. Individuals need to have a style of their own for others to follow them.
Personality development not only makes you look good and presentable but also helps you face
the world with a smile. Personality development goes a long way in reducing stress and conflicts.
It encourages individuals to look at the brighter sides of life. Face even the worst situations with
a smile. Personality development helps you develop a positive attitude in life. An individual with a
negative attitude finds a problem in every situation. Rather than cribbing and criticizing people
around, analyze the whole situation and try to find an appropriate solution for the same. It is
essential for individuals to behave well with people around. Being polite with others will not only
make you popular among other people but also earn you respect and pride. You can’t demand
respect by being rude with people around (Juneja, 2015).

Personality development plays an essential role not only in an individual’s professional but
also personal lives. It makes an individual disciplined, punctual and an asset for his/her
organization. An in-disciplined individual finds it difficult to survive in the long run. Personality
development teaches you to respect not only your Boss and fellow workers but also family
members, friends, neighbours, relatives and so on. Never make fun of anyone at the workplace.
Avoid criticizing and making fun of your fellow workers. One should never carry his/her attitude or
personal grudges to work. Office is not a place where you can be rude to others just because you
had a fight with your friend last night. Personality development sessions help you differentiate
between your personal as well as professional life. It is really essential to keep a balance between
both the lives to lead a peaceful and stress free life (Juneja, 2015).

Personality development helps an individual to inculcate positive qualities like punctuality,

flexible attitude, willingness to learn, friendly nature, eagerness to help others and so on. Never

40
hesitate to share information with others. Always reach office on time. Some people have a
tendency to work till late. Late sittings not only increase your stress levels but also spoil your
personal life. Sitting till late at the office indicates that an individual is extremely poor in time
management skills (Juneja, 2015).

Personality development helps you develop an impressive personality and makes you
stand apart from the rest. Personality development also plays an essential role in improving one’s
communication skills. Individuals ought to master the art of expressing their thoughts and feelings
in the most desired way. Personality development makes you a confident individual who is
appreciated and respected wherever he goes (Juneja, 2015).

Learning Outcomes

At the end of this module, students should be able to:

1. Demonstrate knowledge on handling own self as a professional.
2. Identify different modes to manifest an appearance of being professional and with
good personality.
3. Discuss the qualities of a person with good personality.
4. Demonstrate good personality in dealing with patient, group mates and colleagues.

Lesson 1. Personality

What is Personality Development?

Personality development is defined as a process of developing and enhancing one’s

personality. Personality development helps an individual to gain confidence and high self-esteem.
Personality development also is said to have a positive impact on one’s communication skills and
the way he sees the world. Individuals tend to develop a positive attitude as a result of personality
development (Juneja, 2015).

41
 Personality refers to individual differences in characteristic patterns of thinking, feeling and
behaving. The study of personality focuses on two broad areas: One is understanding individual
differences in particular personality characteristics, such as sociability or irritability. The other is
understanding how the various parts of a person come together as a whole (American
Psychological Association, 2019).

Personality is nothing but the aggregate conglomeration of memories and incidents in an

individual’s entire life span. Environmental factors, family background, financial conditions,
genetic factors, situations and circumstances also contribute to an individual’s personality (Juneja,
2015).

In a layman’s language, how we behave in our day to day lives reflects our personality.
How an individual behaves depends on his family background, upbringing, social status and so
on. An individual with a troubled childhood would not open up easily. He/she would always
hesitate to open his heart in front of others. Some kind of fear would always be there within him.
An individual who never had any major problems in life would be an extrovert and would never
have issues interacting and socializing with others. You really can’t blame an individual for not
being an extrovert. It is essential to check his/her background or past life. It is quite possible that
as a child, he was not allowed to go out of his home, play and freak out with friends. These
individuals start believing that their home is their only world and they are not safe outside. Such
a mindset soon becomes their personality (Juneja, 2015).

Personality also influences what we think, our beliefs, values and expectations. What we
think about others depends on our personality. In a layman’s language personality is defined as
the personal qualities and characteristics of an individual. Personality is how we interact with
others. Personality is a sum of characteristics of an individual which makes him different from the
others. It is our personality which makes us unique and helps us stand apart from the crowd
(Juneja, 2015).

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Determinants of Personality

Following are the factors which help in shaping one’s personality (Juneja, 2015):

1. Heredity - Heredity refers to factors that are determined once an individual is born. An
individual’s physique, attractiveness, body type, complexion, body weight depend on
his/her parents biological makeup.
2. Environment - The environment to which an individual is subjected to during his growing
years plays an important role in determining his/her personality. The varied cultures in
which we are brought up and our family backgrounds have a crucial role in shaping our
personalities.
3. Situation - An individual’s personality also changes with current circumstances and
situations. An individual would behave in a different way when he has enough savings
with him and his behavior would automatically change when he is bankrupt.

An individual’s appearance, character, intelligence, attractiveness, efficiency, style determine

his/her personality (Juneja, 2015).

Personality Development Tips

Let us go through some tips for enhancing one’s personality (Juneja, 2015):

1. Smile a lot - Nothing works better than a big smile when it comes to interacting with people
around. Do not forget to flash your trillion dollar smile quite often. Believe me, it works! As they
say “a smile is a curve that sets everything straight”. A smiling face wins even the toughest
soul. Wear your smile while interacting with others. Smile not only helps in enhancing an
individual’s personality but also winning other’s heart.
2. Think positive - It is really essential to think positive. Remember there is light at the end of
every dark tunnel. Do not always think negative as it not only acts as a demotivating factor but
also makes an individual dull and frustrated. Don’t get upset over minor things. Be a little
flexible and always look at the broader perspectives of life.
3. Dress Sensibly - Dressing sensibly and smartly go a long way in honing one’s personality. One
needs to dress according to the occasion. How would a female look if she wears a sari to a

43
 discotheque? Obviously ridiculous! No matter how expensive your sari is, you can’t wear it to
a night club or a pub where everyone is dressed in smart casuals. Price has nothing to do with
smart dressing. An individual who is well dressed is respected and liked by all. No one would
take you seriously if you do not wear suitable clothes fitting with occasions. Do take care of the
fit of the dress as well. An individual should wear clothes as per his/her body type, height,
physique and so on. Someone who is bulky would not look very impressive in body hugging
clothes. It is not necessary that something which looks good on your friend would also look
good on you. Wear the right make up. You do not have to apply loud make up to look good
and attractive. Even minimal make up, if applied sensibly can really make you stand apart from
the rest.
4. Be soft-spoken - Do not always find faults in others. Fighting and quarrelling lead to no solution.
Be polite with others. Be very careful of what you speak. Avoid being rude and short tempered.
5. Leave your ego behind - An individual needs to hide his ego everywhere he goes. Be it office
or workplace you need to leave your ego behind if you wish to win appreciation from others.
An individual who is good from within is loved by all.
6. Avoid Backbiting - Backstabbing and criticizing people are negative traits which work against
an individual’s personality. Learn to appreciate others. If someone has done some
extraordinary task, do not forget to give a pat on his/her back. Believe me; the other person
will speak high of you even when you are not around. Do not spread unnecessary rumors
about someone. An individual should not try to interfere too much in someone’s personal life.
Dishonesty, cheating, lies tarnish your image and people start avoiding you in the long run. If
your friend is seeing someone, you have absolutely no rights to make his/her affair national
news.
7. Help others - Do not always think of harming others. Share whatever you know. Remember no
one can steal your knowledge. Always help others.
8. Confidence - Confidence is the key to a positive personality. Exude confidence and positive
aura wherever you go.
9. A Patient listener - Be a patient listener. Never interrupt when others are speaking. Try to
imbibe good qualities of others.

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Lesson 2. Grooming
Skills, experience and qualifications are important, but so is our grooming. Our
appearance is a statement of who we are. Our grooming should create a professional image at
work and we have to be attentive to our appearance and posture. Grooming is the combination
of style and discipline. Maintaining personal hygiene is necessary for many reasons; personal,
social, health, psychological or simply as a way of life. Keeping a good standard of hygiene helps
to prevent the development and spread of infections, illnesses and bad odors (Sudhakar, 2017).

Most people are very conscious of personal hygiene because (Sudhakar, 2017):

 We're taught of the importance of hygiene from an early age

 We may have been "picked-on" at school for a one-off or a persistent hygiene problem.
This may even have been an issue mistakenly related to hygiene by others - such as head
lice
 It is considered a way of making ourselves more attractive to the opposite sex
 It is off-putting to our friends and colleagues if we smell unpleasant etc.
 We're aware of health problems that can develop as a result of poor personal hygiene

Body Image
Body image influences self-esteem, confidence and motivation. Those who already have
low self-esteem and especially those with depression often neglect personal hygiene which
perpetuates the problem of poor body image. Many forms of modern media including magazines,
fashion, TV, film and the internet present a certain body image as being "acceptable" or
"expected". Young children and teenagers are especially influenced by this; physical appearance
being the ultimate factor by which to judge and be judged (Sudhakar, 2017).

To youngsters, teenagers and those who care for them, there are 3 things to remember
(Sudhakar, 2017):

45
  The first thing to accept is that you will probably never look like those perfect specimens
in the media - but you can, and WILL look good to most people if you follow basic personal
hygiene principles
 Secondly, your actions and the way you behave are more important to most people than
the way you look
 Thirdly, good hygiene practices will help to keep you healthy, give you confidence and be
pleasant for those around you

Social Reasons
Most people hate to be talked about, especially in a negative manner. By ensuring that
our body is clean and well presented, we are more assured of projecting a positive body image
that reflects our personalities. Children should be taught the importance of hygiene and how to
achieve good hygiene very early to keep themselves and others healthy and to reduce the risk of
being bullied at school (Sudhakar, 2017).

Psychological Issues
By being well presented, clean and tidy, people can feel more confident, especially in
social situations. Our chances of succeeding either in work or social settings, or even with the
opposite sex can be altered by maintenance of good hygiene (Sudhakar, 2017).

Maintaining hygiene practices helps to reduce the risks of ill health, but equally important
affects how we and others perceive ourselves and can influence our levels of confidence and self-
esteem which can affect many aspects of our lives (Sudhakar, 2017).

Which Bits to Focus on and How?

Think about each area individually and why hygiene is important (for health reasons as
well as appearance). Hair and teeth are good places to start, together with those areas of the
body that might smell or which are more prone to fungal/bacterial infections (Sudhakar, 2017).

46
1. Hair (Sudhakar, 2017)
 Dirty head hair does not actually cause many health problems; it's mostly for appearance
factor that keeping hair clean is a good idea.
 Greasy hair - At some points of your life - especially in teenage years and at times of
hormonal change, hair can become greasy more easily. There's really only one solution
to greasy hair and that is to wash it, although some people find dry shampoo or talc helps
to absorb some of the grease. If you're lucky enough to have hair long enough to tie up
then you can miss a wash occasionally - those with natural blonde hair will find grease
shows up more than on brunettes - it has to have some draw backs!
 Dandruff - If you suffer from dandruff, try the various shampoos available. If it's serious
there are some medical treatments available that are not harmful to the skin - those
containing zinc pyritheone or selenium sulphide are said to be the most effective.
 Head lice - Head lice are highly contagious. If left unattended, the lice grow large enough
that you can actually see them moving and the white eggs (nits) are also sometimes
visible. You may also - but not always - experience itching. The best way to avoid
persistent head lice is to wash your hair, leave a conditioner in and comb through with a
fine tooth comb. Do this at least once a week, then even if a couple of lice manage to find
their way to your lovely locks, they will not be given the chance to lay eggs and multiply!

2. Teeth and Mouth (Sudhakar, 2017)

 Teeth - A beautiful smile can make a person's day - but if teeth are grubby or breath is
smelly, it has an entirely different result. Brush your teeth twice daily with a decent
toothbrush (powered ones are best), a fluoride based toothpaste and an antibacterial
mouthwash and you can't go far wrong. If you think your teeth are not white enough, try
wearing different colors to make them seem brighter, avoid drinks such as tea, coffee and
red wine, which are thought to stain them. If you're still convinced, they're not white enough
ask your dentist about treatments.
 Smelly breath - Sometimes, despite good brushing a tooth will succumb to decay - if left
untreated this can spread and infect your gums. Bad breath can be the sign of a gum
infection. Make sure you visit your dentist regularly to keep a check on it. Halitosis (bad

47
 breath) can also be a result of dehydration or an empty stomach, so eat and drink
regularly.

3. Areas Prone to odor and Fungal Infection (Sudhakar, 2017)

 Unpleasant smells and fungal infections are most commonly experienced in areas of the
body that are warm and not often exposed to fresh air: the feet; the genitals and some of
our sweat glands.
 Smelly Feet - The feet contain lots of sweat glands. If feet are confined in socks and shoes
the sweat has nowhere to 'evaporate' and the skin bacteria will in effect attack to, causing
that pungent ‘cheesy' aroma. There's a variety of reasons why some people suffer more
than others.

Here are some measures you can take to minimize smelly feet (Sudhakar, 2017):

 Wash regularly and dry thoroughly with a soft towel and an anti-bacterial foot powder or a
baby talc
 Allow feet to air when feasible and wear open shoes as much as possible
 Change socks more than once a day if needed and make sure they are cotton or other
breathable fabric
 Athlete's foot - Athlete's foot is a fungal infection that causes itching, flaky skin and
sometimes a sore, red rash. It's highly contagious and can be unsightly. There are plenty
of products available to combat athlete's foot, but you should check with your pharmacist
or GP if you are taking any other medicines, have certain medical conditions, or are buying
for a child as some of the treatments contain steroids.

4. Genital Areas - Genital areas can be prone to bacterial infections and unpleasant aromas if not
kept clean. Conversely though, too much cleaning with scented products or soaps can cause
thrush - a yeast infection. The best hygiene for all the genital areas is to clean once or twice a day
using mild soap and water (Sudhakar, 2017).

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Grooming Standard
Skills, experience and qualifications are important, but so is our grooming. Our
appearance is a statement of who we are. Our grooming should create a professional image at
work and we have to be attentive to our appearance and posture. Grooming is the combination
of style and discipline. It is to project an image of organization’s culture and ethics to our esteemed
costumers which is our guests. It also enhances the personality of employee, character of an
organization and value of the company (Sudhakar, 2017).

Why Is It Important?
First impression that will create lasting impression. It is also essential to make ourselves
feel good and confident. If we feel good about ourselves, everything goes better (Sudhakar,
2017).

How Can We Do It?

We can keep ourselves looking fresh and professional by paying a good attention to (Sudhakar,
2017):
a) Our dress and/or uniform
b) Our hair
c) Make-up
d) Nails
e) Breath
f) Body Fragrance
g) Expression and Body Language

Proper grooming and professional appearance are important to gain not just positive
impression but also respect in the workplace. First impressions matter and the way you look and
carry yourself create impact on people you get along with in the work setting. Proper grooming
and professional appearance is important to both men and women. Lack of these may lead to
poor image and may interfere with your chance of getting good impression and positive feedbacks
from your workmates and superiors (Sudhakar, 2017).

49
 As an individual living and working in a highly complex and competitive society, you must
recognize and understand the impact of your appearance as it communicates first to you and then
to others. While it is important to like what you wear and the way you look, it is more important to
understand why or why not and specifically how this affects you, others and your life and the
achievement of your goals (Sudhakar, 2017).

 Your clothing and grooming affect the way you think: When you appear authentic,
attractive and appropriate, you think more positively about yourself, your situation and
others (Sudhakar, 2017).
 Your clothing and grooming affect the way you feel: A positive personal appearance is a
fast, effective way to boost self-confidence and overcome anxiety regarding ability or
acceptance (Sudhakar, 2017).
 Your clothing and grooming affect the way you act or behave: A positive personal
appearance is one of the most effective ways to improve behavior and enhance
performance level or productivity (Sudhakar, 2017).
 Your clothing and grooming affect the way others react and respond to you: Your
appearance makes a strong statement about your personality, values, attitudes, interests,
knowledge, abilities, roles, and goal (Sudhakar, 2017).

As a professional you should always ensure your makeup is conservative. Tattoos are to
be avoided as much as possible especially on parts of the body that are exposed. In the workplace
setting, as you meet clients, bosses, team members, always wear a smile. Everyone has their
own share of problems but the best thing you can do is to appear like you have no issues. No one
ever wants to stick around gloomy people. Maintain a good body posture. Avoid slouching. When
sitting, ensure that your back is straight. Women should sit with crossed legs. These are some of
the tips that will help you a lot in your professional world (Sudhakar, 2017).

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Lesson 3. Uniform
The Importance of a Proper Medical Uniform

Appearance can be a huge determining factor in how much we trust a person upon first
sight. While it's true that many medical workers will likely (or at least hopefully) look well put
together and professional, if they didn't have proper attire you might give a second thought to
trusting them with your health. As a medical professional, it's important to have patients trust you
fully (Chesapeake Uniform, 2021).

Wherever you may work that requires a medical uniform as your professional wear, that
place is guaranteed to hold cleanliness and order in the highest regard. If your scrubs or lab coat
look anything less than perfectly clean, it might indicate to patients that the cleanliness of your
facilities could be less than stellar. As was mentioned above, appearance is huge factor in judging
trust, and your medical uniform should display the same attention to detail as the building you're
in (Chesapeake Uniform, 2021).

Scrubs are a common uniform for nurses and medical professionals in the healthcare
setting. In fact, they offer several benefits beyond simply making it easier for patients to identify
them. They help medical providers to identify bodily fluids and contaminants, are fairly cheap to
replace, are cleaner than regular clothing and allow for easily accessibility of tools since they often
come with large pockets (Ong, 2017).

Scrubs are very comfortable, designed for long hours of working. They are relatively more
durable as compared to other forms of clothing because they have to go through much daily. They
are made to hold up well even after multiple cleanings and are stain resistant as well. This is
because they have to be resistant enough to withstand thorough washing to get rid of bacteria
and contaminants. Usually, high temperatures and specialized cleaning chemicals are used to
clean the scrubs. They are harsher than normal cleaning methods for regular clothing, and scrubs
are strong enough to withstand that without being ruined in the process (Ong, 2017).

Nurses, in particular, come into contact with many different kinds of diseases. Clothing
has been found to transmit bacteria easily simply by encountering someone else. It would be a
disaster to wear infectious clothing to a hospital with tons of sick patients. Whether a person is
sick or not, it is important to be sanitary as long as work requires coming into contact with others.

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Scrubs are cleaned very thoroughly to ensure that they are sanitary and prevent the spread of
diseases. Certain manufacturers also produce scrubs that can fight bacteria and other forms of
infections to shield both healthcare professionals and patients (Ong, 2017).

Scrubs are fantastic for aiding in the identification of harmful contaminants and fluids. They
can include stool, urine, blood, vomit and other types of chemicals or fluids. It is important to do
so to minimize contamination and reduce bacteria from spreading (Ong, 2017).

Any healthcare practitioner who wears his/her own regular clothes to work would likely
ruin them whilst trying to remove bacteria. Scrubs are an inexpensive option that prevents their
own clothing from being damaged. It is more effective and cost-friendly for healthcare
professionals to wear scrubs at work rather than wear their own clothing (Ong, 2017).

In a hospital, it can be messy and confusing during peak periods and rush hours. Similar
to doctors’ coats, scrubs are a fool proof way for patients and colleagues to identify healthcare
professionals. Some places require different-coloured scrubs to differentiate nurses from other
medical personnel such as doctors to easily identify them with a glance.
Scrubs also offer a professional appearance. Similar to a police officer or army regular, they can
provide identification on the same level. They can also instil greater confidence and trust from
patients and respect from co-workers (Ong, 2017).

Scrubs have lots of pocket space for putting things in. Healthcare professionals can easily
slot in their tools and equipment, such as pens, pen lights, smartphones, gloves, scissors –
anything that they might need. Instead of having to scurry back and take their things one by one
or stuffing their medical tools into bursting pockets, scrubs offer the luxury of space and
convenience (Ong, 2017).

Uniform Policy for Nurses and Midwives

The personal appearance and attire of the Nursing and Midwifery professionals can impact
on the safety provided to clients as well as as well as the public perception of the quality of
services provided and professionalism at large. Therefore all nursing and midwifery personnel
working with patients/clients and/or patients’/clients’ families or/and in public areas are expected
to dress in a professional manner (Nursing Service Directorate, 2018).

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The Objectives (Nursing Service Directorate, 2018):

 Client and Staff Safety: To ensure that nurses’ and midwives’ uniforms and work
attire facilitate good practice and minimize any risk to clients and staff. Nothing
should be worn that could impede effective hand hygiene or /and compromise
clients or staff safety.
 Professional Image and Public Confidence: To ensure a professional image which
projects competency, inspires confidence and communicates respect to
patients/clients, coworkers and the public.
 Identification: To provide “security through an employee identification system
and/or a cue for recognition of staff members’ name and designation”.
 Staff Comfort: To ensure nursing and midwifery personnel comfort and safety at
place of work.
 Equality and Diversity: To ensure that each and every nursing and midwifery
personnel is treated equally and that religious and cultural practices are respected
as long as the safety of patients/clients, staff and general public are not
compromised.
 Uniformity Across all Entities: To put forward a standardized policy that is agreed
upon and followed across all entities within the Public Health Sector.

Personal Hygiene and Professional Appearance (Nursing Service Directorate, 2018)

 All nursing and midwifery personnel should reflect a high standard of cleanliness
and hygiene at all times.
 The uniform should be neatly pressed.
 If a nursing or midwifery personnel accidentally damages or permanently stains
any item of uniform during their course of work, they must inform their managers
so that arrangements can be made for a replacement.
 Chewing gum is not permitted while on duty.
 Language used during the course of work should be polite and professional in
nature. No profanity or vulgar slang is permitted.

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  Nursing and Midwifery personnel should appear the same within their uniform
group and therefore uniforms should not be personalized.
 Nursing and Midwifery personnel should not socialize outside the workplace or
undertake social activities such as shopping, personal festivities or errands
unrelated to work while wearing the uniform.

Hair

Hair must be clean and neat in appearance and worn in a professional manner to respect
infection control and safe work practices. Nursing and midwifery personnel with direct patient/
client contact must secure their hair off the shoulder and away from the face so it does not contact
the client and interfere with client care. With the exception of theatre staff, headwear should not
be worn unless it forms part of religious attire (Nursing Service Directorate, 2018).

Facial hair such as beards and sideburns must be neat, clean and well-trimmed and must
not present a bushy or uncombed appearance (Nursing Service Directorate, 2018).

Nails

Fingernails should be clean and in length that does not interfere with work (not protruding
beyond fingertip) and in line with infection control and safe work practices. Nail polish, artificial/
gellish nails are not acceptable in the clinical area as they harbor bacteria, especially if they
contain artificial materials (Nursing Service Directorate, 2018).

Cosmetics and Perfume/Cologne

All nursing and midwifery personnel may use moderate make-up, perfume, colognes
and/or shaving lotions (Nursing Service Directorate, 2018).

Jewelry (Nursing Service Directorate, 2018)

 In the clinical setting only a plain ring is allowed on the hands.

 Earrings should be small and studs. Only one pair of earrings is permitted.
 Body piercing jewelry is not appropriate to the work setting; hence it should not be
visible.

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Body Art - Nursing and midwifery personnel should take into consideration the public’s
expectations and aesthetic impact with it regards to professional image in the workplace when
considering getting a tattoo (Nursing Service Directorate, 2018).

Lesson 4. Health
Health Reasons
Poor hygiene can lead to poor health. If you have cut yourself, the wound should be
cleaned and dressed suitably, this can help reduced the risk of infection and pain. Conditions
such as head lice, athlete’s foot etc. should be treated immediately to prevent further infections
and spread to others (Sudhakar, 2017).

Hand washing cannot be emphasized enough as this simple action can prevent a plethora
of illnesses and disorders developing. Many people ‘forget’ to wash their hands after using the
toilet or before handling foods; this can cause a great deal of illness and even death (Sudhakar,
2017).

When it comes to your professional growth and career development, a majority of us focus
on mastering our strengths and extending our skill sets, to create an impressive personal profile.
Not many of us realize the significance of health and are unaware of how a healthy body and
lifestyle can contribute to your personal development. Jobs, in the present age, have become
ever more demanding and organizations are expecting a lot from their employees in terms of
work, performance, and efficiency. Aside from that, the increasing competition among the
workforce has propelled the employees into a rat race, to excel ahead of the rest and add a
competitive advantage to their professional profile. All these efforts combined, in the pursuit of
personal development will require some strenuous work on your part. To be able to stay a step
ahead of the competition, you need to maintain your mind and body in an optimally healthy state
(Delgado, 2017).

As the adage goes, “A healthy body possesses a healthy mind”. Therefore, you cannot
expect yourself to perform your best and pursue career growth while depriving your body of its

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essential needs. Maintaining a healthy lifestyle is the first step to personality development
(Delgado, 2017).

Here are some good practices to implement in your daily routine to foster a healthy lifestyle
and achieve personal development and career growth (Delgado, 2017).

 Adopt a Routine
A disorganized routine and ill-maintained lifestyle will make you lose your sense of
direction rather than taking you closer to your career goals. Routine brings order to your
life and makes it convenient for you make the most of your hours of the day. It improves
your time management skills and creates a balance between the various aspects of
your life.

 Eat Healthy
You are what you eat. This is true since what you eat eventually reflects in your physical
and mental performance. If you are habitual of eating junk food, rich in harmful fats and
bad cholesterol, you will become lazy, sluggish and lethargic, eventually becoming
unable to perform to your utmost potential.

 Move Out of Your Comfort Zone

Your comfort zone might seem as a serene place, but, it is the very restriction that
prevents you from aiming for higher pursuits. No matter how contented you are with
your career accomplishments, do not let them make you settle for less, while you have
it in you to grow and achieve more.

 Do More of What Makes You Happy

Staying optimistic in all circumstances and possessing a positive outlook on life is
essential for personal development. Engage yourself in some constructive activities
that not only make you happy but also help you learn something new. This will boost
your self-esteem and motivation and will inspire you to keep going and achieve more.

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  Additionally, it will eliminate the negative consequences of stress and brain function
that might be affected due to excessive workload.

 Make a Wise Use of Your Time

How you utilize your free time says a lot about how successful you will be in future. You
might be tempted to spend your leisure hours, sitting idly and binge-watching TV shows
and series. However, spending that time in healthy activities such as swimming or
working out at the gym will be more beneficial for you.

Lesson 5. Voice
“Voice” refers to the ability to engage in meaningful conversation, and to make a
difference or impact upon key decisions. According to John Paul Lederach as cited in Euphony,
2017 voice centers upon inclusive conversations that are grounded in “mutuality, understanding
and accessibility”. When individuals have a voice, their views, thoughts, and feelings receive a
“fair hearing” that is readily recognized by others. They possess the ability to influence outcomes
and manipulate contexts with words they speak (Euphony, 2017).

Why voice matters?

The moment we open our mouths to speak we are judged. As words are spoken
assumptions are made about who we are — presumptions about our intelligence, desires,
determination, confidence and influence are all inferred from how we use our voices (Euphony,
2017).

For instance (Euphony, 2017):

 Our tone, pitch, quality of articulation and inflection deliver subtle messages about the
kind of person we are. They convey our mood and our feelings at a particular time.
 Having the capacity to project appropriate sounds can make a critical difference in the
way we are perceived and treated. When used effectively, our voice can work in our
favor and enhance our personal and professional relationships.

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  It can be said that our voice is the primary link between our mind and body. Therefore,
with the appropriate mindset and awareness of how to use our voice properly, we can
exercise control over how we speak, improve effectiveness and do so with confidence.

Nine Pillars of Your Voice Personality

Your voice personality is a result of these nine components which I call as voice personality
pillars (Verma, n.d.).

1. Pace- Some of us speak too fast where as some very slow. Speaking too fast can show you
anxious and make it difficult for others to understand. Solution is, take a deep breath before
you speak and natural pauses can work wonders. If you speak slowly, you appear fully in
control, calm, and confident. However, this style of talking can backfire as you can appear
absent minded and put others to sleep. On the contrary, some of the Psychologists have found
that delivery at a rate of 190 words per minute makes a speaker credible, objective,
knowledgeable, and persuasive as compared to slow speakers (Verma, n.d.).

2. Pitch- One clear difference between various human voices is how loud people are. Technically,
pitch is the frequency of the sound waves you produce. Those who speak in high pitch,
generally sound unpleasant and arrogant. After a few minutes, your listener may even think of
ways or excuses to end your conversation. A low but powerful voice reflects authority because
a deep voice correlates with high testosterone. It is understood that deeper voices have more
credibility than higher-pitched voices. Pitch is measured in hertz which helps in defining
different sounds heard by human ear. When you make variation in your voice, it establishes
and reinforces your message (Verma, n.d.).

3. Pause- Pauses are one of the most precious elements in your voice. In any conversation, it is
not only important what you say, but equally important is how you say. Mark Twain rightly said,
“No word is ever as effective as the well placed pause”. If you take a pause before
emphasizing an important word or concept, it will make you reflect what comes next is
important for the audience (Verma, n.d.).

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4. Pronunciation- Pronunciation is also very important component in your voice personality.
Incorrect pronunciation can crash your sharpness into uneducated and an intelligent person.
You must master the correct pronunciation of jargon or unfamiliar words, including
complicated, technical, and other terminology. Always pay attention to the way authorities of
language are pronouncing a word on Radio or Television. Talking dictionaries are also helpful
asset (Verma, n.d.).

5. Punctuation- When a script is well punctuated, it is like a piece of music with natural flows,
stops and an inherent rhythm. Understanding and reading punctuation is essential for a better
performance which allow for smooth moderation of pace, rhythm and breathing like a musician
for quality performance (Verma, n.d.).

6. Practice- Some people are born with capacities that enable them to excel, while others lack
these traits, are destined for mediocrity. When we look at our voice personality, our talent
continues to grow implicitly or explicitly only through practice. Aptitude, skill and knowledge are
the three elements in giving direction to any talent. Practice is such a key that if you want to
achieve anything you have to work, work and then work some more (Verma, n.d.).

7. Posture- Posture plays a significant role in your voice personality. Slouching as you speak,
moving from one foot to the other, or leaning on the dice bring down your audience’s
confidence in you and your message. You may not be aware of your bad posture, but whenever
you are the focus of the audience’s attention on T.V or Radio, poor and uncertain posture will
be obvious to your listeners. There are many aspects of delivering a speech which you cannot
control, but proper posture is certainly one variable you can control very easily. Easy way to
begin your speech is by standing with your feet 7 to 12 inches apart and if seating, keep your
back straight. This will give you balance for the rest of the body and will help you to be more
confident (Verma, n.d.).

8. Passion- Passion is a burning desire to achieve something or reach some goal. Someone has
rightly said, “Every great dream begins with a dreamer. Passion is one great force that

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 unleashes creativity.” If you're passionate, then you're able to add more colors in your voice
(Verma, n.d.).

9. Positivity- Positive attitude gives you pleasant and happy feelings. This brings brightness to
your eyes, more energy, and comfort. You walk tall, your voice is more powerful and your body
language shows the way you feel. Positive thinking is a mental and emotional attitude that
focuses on the bright side of life and gives positive results. Maintaining your positive attitude
is critical when you want to improve the quality of your voice (Verma, n.d.).

Tips to Enhance Your Voice Personality (Verma, n.d.)

 Keep your posture straight and let the air from the depths of your diaphragm rise to
modulate your voice.
 Take a deep breath and then close your ears and eyes with both thumb and figures of
your hands and hum “OM” for sixty seconds.
 Take a newspaper and read headlines like a newsreader taking pause after every news
headline.
 Speak confidently and aim for the lowest comfortable pitch of your voice.
 Never abuse your vocal chords by smoking or drinking too much caffeine. Drink
lukewarm water before a speech.
 Whenever you are using a microphone, test it first and while speaking, stay at a proper
distance so that it does not cause distractions.
 In order to increase your throat stamina and its lubrication, keep in your mouth
something like Mishri or green cardamom etc.
 And, last but not the least, breathe comfortably, rhythmically and steadily while speaking.
Here pranayama, yoga and meditation can be very helpful.

Lesson 6. Poise
Having poise is being balanced, graceful, and elegant in social situations. If you want to
become poised, you need to increase your self-confidence, become a great communicator, and
learn how to keep your composure in difficult situations (Chernyak, 2019).

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Methods to Improve Pose (Chernyak, 2019):

1. Increasing Self-Confidence
a. Practice self-acceptance.
If you have self-confidence, then you will have poise; the two dovetail. Accepting yourself
increases your self-esteem and can help you develop confidence and poise. Make a list
of your strengths and things you want to improve, including personality characteristics and
appearance. Go down the list and verbally accept each part of yourself. Say, “I accept that
I am talkative. I accept that I sometimes have a temper.” In general, you can use a self-
affirmation such as saying to yourself, “I accept everything about myself. I accept who I
am, what I look like, my past, present, and future.”
b. Believe in yourself.
 How you think about yourself affects your actions and your ability to be poised. To
develop self-confidence, learn to believe in yourself. This means believing that you
are a positive person who has interesting things to share. This also means doing
things that make you feel confident about yourself.
 Visualization is a helpful way to believe in yourself. Close your eyes and imagine
yourself as completely confident and poised. Where are you? What does it feel
like? What are you thinking about? What are you doing?
 Think positive thoughts about yourself. If you find yourself worrying or thinking
negatively, re-frame the situation. You could practice by purposefully thinking, "I
can do this. I can accomplish anything I put my mind to. I believe in myself."
 Try power poses. Our body language can actually shape how we feel about
ourselves. Power poses generally involve making your body bigger (taking up
more space) instead of smaller (which indicates a lack of confidence). Try
spreading your legs slightly apart and putting your hands on your hips. You can
find more power poses online.
c. Focus on your strengths.
Paying attention to the positive aspects of yourself can heighten your ability to have
confidence and poise in social situations, which can increase the likelihood that you are
accepted by others. Make a list of your accomplishments. Did you get an A on a paper?

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 Are you great at swimming and you once won a medal? Think about how you can use
your strengths to increase your poise.
d. Trust that it will work out.
Whatever the situation you are in, the way you think about it can influence the outcome
(for better or worse). Those who believe that something negative will happen may actually
influence that outcome to occur. For example, if you are worried that you will say
something silly or wrong in a meeting, this thought can increase your nervousness, which
may cause you to stumble over your words. Thus, you create the outcome that you are
fearful of.
Instead of thinking about what might happen or the worst case scenario, focus instead on
what you actually want to happen. Instead of thinking, "Oh no, I hope I don't stumble over
my words," consciously think positive thoughts such as, "I want to speak clearly and
effectively. I will focus on being poised and feeling confident. I can do this." These positive
thoughts are much more likely to reduce negative feelings and increase the likelihood of
a positive outcome.
e. Get social support. Supportive relationships can help to empower you and increase your
overall self-confidence. Through others, we can develop a sense of connection, belonging,
and acceptance.
 If you are feeling low or not confident in yourself, talk to a friend or family member
about it. Chances are, they will help you identify the good things about you and
turn your mood and thoughts around. This can be very validating and can increase
your self-confidence if you know that others support and believe in you.
 Take a look at your relationships and ask yourself if those who you spend time with
are supportive of you. Our social connections should bring us positivity and lift us
up in times of stress. If people are putting you down or making you feel worse
about yourself, these connection are not likely to help you become more confident.
Consider distancing yourself from damaging relationships and focus on connecting
with supportive individuals.

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2. Becoming a Skilled Conversationalist
a. Become educated in a variety of topics. Interacting comfortably with others shows
confidence and poise. It is much easier to come up with subjects to discuss if you are
educated in a variety of skills and topics.
 Go to the library and read a variety of books. Read up about history, science,
sociology, psychology, or anything else that you are interested in.
 Scan the internet, and read reputable websites to keep up with current events.
 Read a newspaper (either online or in print) and be educated about current
events in your community as well as the world. This way, you can start a
conversation by asking, "Did you hear about ____? What do you think about
it?"
 Learn new hobbies and activities. Some examples include learning how to:
play an instrument, dance, do yoga, rock-climb, skydive, surf, snowboard, ski,
scuba-dive, paint, draw, or sing. This way, when you meet a new person you
have plenty of activities to discuss. Chances are, the other person will have
some similar interests.
b. Listen. When attending social gatherings, be a "listener" rather than always driving the
conversation. People love being listened to and gravitate to people who take the time
to listen to them.
 Relax, breathe and pretend you're talking to someone you've know all your
life.
 Ask questions and be interested. Focus solely on the person and his or her
experience rather than on what you are going to say next. Be present in the
moment.
 Ask open-ended questions rather than closed-ended "yes" or "no" questions.
This will help increase the likelihood that you have a positive and continued
conversation.
 Use active listening skills, which help to build understanding and trust. One
way to show that you are listening is to restate what the person has just said.
You can do this by saying, "I am hearing that you are upset at your brother. Is
that right?"

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  You can also give feedback and validate the person. Say something like, "That
sounds really tough. It sounds like you are hurt, and that makes sense given
the situation."
c. Focus on the positive.
If you talk about negative things too much you may seem like a complainer and
someone who lacks poise. However, if you focus on positive subjects people may
notice your elegance and charm.
 Ask positive questions such as, “What's going well for you? What have you
been doing that's fun lately?”
 Generally avoid conversations about politics and religion unless you share the
same mentality and openness toward these subjects.
d. Use assertive communication. Assertiveness is generally being respectful and open
about your feelings and thoughts while maintaining tact and composure. Assertive
communication is warm, welcoming, and friendly.
 One way to be assertive is to be understanding of others and their situations,
while still respecting and communicating your own needs and desires. For
example, you might say, "That is a great idea. How about we also do this?"
 Show you are assertive through your body language. Give appropriate eye
contact (not staring, but not avoiding, look around every once in a while). Be
relaxed in your body; Do not make your body too small (hunched shoulders) or
too large (hands on hips).
 Do not use aggressive forms of communication such as putting people down,
calling them names, or raising your voice.
 Saying how you feel or think when you know it might hurt other people can also
be a form of aggressive communication; some things are better left unsaid
(negative comments about how someone looks or acts, for example). These
types of speech and actions may show that you are aggressive, and can
indicate to others that you are losing your cool.
 Some cities offer "finishing schools" where social skills are taught.
3. Maintaining Your Composure
a. Stop and take deep breaths.

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 Part of being poised is maintaining your composure in difficult or irritating situations.
Instead of reacting automatically in a negative way such as storming out of the room
or yelling at someone, maintain your poise by stopping and take a breath or removing
yourself from the situation in an elegant way (i.e. excusing yourself to go to the
restroom)
 If you are alone, you can try a deep breathing exercise to calm yourself down.
Breathe in through your nose deeply and out through your mouth slowly. Focus
on your breathing and your experience of it. Your body should begin to relax
and once you feel calm you can stop the breathing exercise.
b. Observe.
Being mindful of what you are reacting to is an important component of keeping your
composure. If you observe what is happening, you can begin to change how you react
to the situation and be more poised.
 Ask yourself, “What am I reacting to? What am I thinking and feeling about this
situation? Is this something that is a pattern from my past? Am I upset about
this situation or does it remind me of something else that happened and struck
a chord with me?”
 Look at the bigger picture. Observe the situation from afar as if you were in a
helicopter viewing it from the sky. What is the bigger picture? Will this situation
matter in 1 month, 6 months, or a year? You may find that you react to
situations that do not affect your life in the long-term.
c. Practice what works.
Having a plan on how to deal with difficult emotions is one surefire way to maintain
your composure in difficult situations. Identify ways to cope with difficult emotions that
work for you.
 For example, if you notice that you tend to get angry when people do not agree
with you on a topic, you may develop specific coping mechanisms for dealing
with this situation. This might include taking deep breaths, counting to ten, or
reminding yourself that others can have different opinions and it doesn't mean
that they think you are dumb or don't like you.

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Lesson 7. Conduct, Manners and Behaviors
Conduct is the manner in which a person behaves, especially on a particular occasion or
in a particular context (Oxford Dictionary, n.d.).

Factors in Personality Development

Our personality cannot only be identified on the basis of our physique, intellectual level or
character. It is the combination of our behavior, conduct, and the way we respond and adjust to
our environment (Grace, 2014).

Here are the primary factors that start young and cut a deep influence in our personality
development (Grace, 2014):

1. Self-assessment

From infancy on, children should be motivated to develop their confidence and self-esteem in
achieving their dreams and aspirations. This will help them put things in perspective, brush aside
bullying and being calm in the face of adversities. Having faith in themselves is crucial to help
them overcome personal challenges, including physical and mental hurdles (Grace, 2014).

2. Parents

How well our children are reared can presage their type of personality later in life. Children who
grew up with loving parents and siblings will develop a stable personality. Parents can seek help
or tap resources (e.g. tutoring, summer class, etc.) to build up their skills and self-confidence at
home and school. This will help them cope with the challenges of growing up, such as sports and
making good grades at school. (Grace, 2014)

3. Home environment

Home is the foundation of a child’s education and personality. A home with a close bond between
parents and siblings will develop a stable personality in adolescence and adulthood. A troubled
home may have a negative influence, causing a child to adopt a fierce, unstable or reckless
personality. Personality wields power and influence. It will make people listen to what you say, it
influences decisions and even get your superior to act on your wishes. A developed personality

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will manifest an image of confidence, influence and authority. It will make you go places (Grace,
2014).

Human personality is like an onion. It consists of multiple layers that become denser as
you go deeper within. Manners are a thin veneer on the surface, a set of formalized patterns of
action and response demanded of each of us by the society we live in, regardless of how we
actually feel inside, which is often very different from the outward manners we exhibit. Though
manners are superficial, perfect conduct even at this level is extremely difficult. We may exhibit
good manners on important occasions or with important people, but few are capable of
maintaining perfect conduct all the waking hours with close friends, intimate family members, work
colleagues, casual acquaintances, servants, etc. The world worships appearances and gives
utmost value to good manners, even when they conceal the very opposite inner disposition. Self-
restraint, soft speech, humble considerate behavior towards all, thoughtful gestures are extremely
difficult to maintain as unvarying conduct. One who is a perfect master of good manners can by
virtue of that endowment alone secure international fame and recognition (Jacobs, 2006).

Manners are on the surface. Behavior is on the depth of the surface. Whereas manners
reflect conduct that the world expects or demands of us, behavior is conduct expressive of our
inner attitudes and beliefs. What the society demands as manners develops into genuine behavior
in the individual. Friendly manners may disguise inner anger or anguish because society frowns
on their expression, whereas cheerful, warm behavior expresses genuine happy, positive
attitudes towards oneself and others (Jacobs, 2006).

Character is behavior that one has accepted in the very depths of his being, in the
substance, and allowed to take root there. The attitudes that express outwardly as behavior can
change in an instant or over time, but the formed traits that constitute our character are lasting
and extremely resistant to change, regardless of the circumstance. A fair weather friend behaves
well in good circumstances, but a person of good character is incapable of conduct that is contrary
to his deep-seated convictions. As manners can disguise our real attitudes, outer behavior can
either reflect or veil our true character, i.e. what we really are inside. Character expresses most
clearly in times of crisis or opportunity, when the surface veneer of manners and superficial
behavior is swept aside by an external pressure or lure (Jacobs, 2006).

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 Character is largely inherited from family, community and the nation. It is worthwhile
examining oneself in terms of our national character to see to what extent one’s own nature is
representative of the collective. The American character is one that seeks a larger rhythm, rises
to meet any challenge and perseveres until the work is done. In India, character is generally
misunderstood to mean honesty or in a narrower sense reliability in conduct with women. It is
used to refer to a person’s social or individual value, rather than to the entire layer of human
nature that is deeply rooted and fixed behind our behavior (Jacobs, 2006).

Character is associated with capacity. One who accomplishes at any level or in any field
relies on a stable capacity for effective action that is an expression of character. Character may
express as professional ability in a given field, in which case the endowment is narrowly limited
or fixed so that it cannot be transferred to any other field of accomplishment. But the skills and
capacities that constitute the essence of character lie at a deeper level in the plane of personality.
Endowments at the level of personality are not fixed and can be transferred from one field to
another. The IAS officer exhibits an administrative personality capable of managing any type of
assignment given to him. The able politician who rises to rule a nation often exhibits the political
personality of administration (Jacobs, 2006).

Manners, behavior, character and personality are attributes one acquires from society, the
external environment, what is philosophically referred to as Nature (Jacobs, 2006).

Assessment Task 3-1

Assess your own personality. Have a reflection and based on this module, how can
you improve and develop your own personality. Have a minimum of 500 – word essay
as your answer.

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 Summary

Personality development is defined as a process of developing and enhancing

one’s personality. Personality development helps an individual to gain confidence and high self-
esteem. Personality development also is said to have a positive impact on one’s communication
skills and the way he sees the world. Individuals tend to develop a positive attitude as a result of
personality development. Personality refers to individual differences in characteristic patterns of
thinking, feeling and behaving. Heredity, environment and situation are factors affecting in
shaping one’s personality. Our grooming should create a professional image at work and we have
to be attentive to our appearance and posture. Grooming is the combination of style and discipline.
Maintaining personal hygiene is necessary for many reasons; personal, social, health,
psychological or simply as a way of life. Keeping a good standard of hygiene helps to prevent the
development and spread of infections, illnesses and bad odors. Body image influences self-
esteem, confidence and motivation. Scrubs are a common uniform for nurses and medical
professionals in the healthcare setting. In fact, they offer several benefits beyond simply making
it easier for patients to identify them. They help medical providers to identify bodily fluids and
contaminants, are fairly cheap to replace, are cleaner than regular clothing and allow for easily
accessibility of tools since they often come with large pockets. When it comes to your professional
growth and career development, a majority of us focus on mastering our strengths and extending
our skill sets, to create an impressive personal profile. Not many of us realize the significance of
health and are unaware of how a healthy body and lifestyle can contribute to your personal
development. Voice refers to the ability to engage in meaningful conversation, and to make a
difference or impact upon key decisions. Having poise is being balanced, graceful, and elegant
in social situations. If you want to become poised, you need to increase your self-confidence,
become a great communicator, and learn how to keep your composure in difficult situations.
Conduct is the manner in which a person behaves, especially on a particular occasion or in a
particular context. Manners are a thin veneer on the surface, a set of formalized patterns of action
and response demanded of each of us by the society we live in, regardless of how we actually
feel inside, which is often very different from the outward manners we exhibit.

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 References

American Psychological Association (2019, November 17). Personality.

https://www.apa.org/topics/personality#:~:text=Personality%20refers%20to%20individu
al%20differences,such%20as%20sociability%20or%20irritability.
Chesapeake Unifrom (2021). The importance of a proper medical uniform.
http://www.chesapeakeuniform.com/importanceofpropermedicaluniform
Chernyak, P. (2019, September 06). How to develop poise. https://www.wikihow.com/Develop-
Poise
Delgado, R. (2017). How to adopt a healthy lifestyle for personal development.
https://tech.co/news/healthy-lifestyle-personal-development-2017-08
Euphony. (2017, February 22). The truth about the importance of voice.
https://medium.com/@EuphonyInc/the-truth-about-the-importance-of-voice-
5f6b3dd5a97d
Grace, J. (2014, November 01). Why personality development is important to you .
https://www.linkedin.com/pulse/20141101014334-111288788-why-personality-
development-is-important-to-you.
Jacob, G. (2016, August 19). Manners — behavior — character — personality — individuality.
https://www.motherservice.org/content/manners-%E2%80%94-behavior-%E2%80%94-
character-%E2%80%94-personality-%E2%80%94-individuality
Juneja, P. (2015). Personality and personality development - an overview.
https://www.managementstudyguide.com/personality-development.htm
Ong, W. 17, 2017. The Importance of Scrubs. https://today.mims.com/the-importance-of-scrubs
Oxford Dictionary (n.d.). Conduct. https://www.lexico.com/en/definition/conduct
Sia, M. (2008). Midwifery law and ethics (2nd ed). RMSIA Publishing Quezon City, Philippines
Sudhakar, J. (2017 December 17). "Grooming is the secret of real elegance and success" .
https://www.linkedin.com/pulse/grooming-secret-real-elegance-success-ms-jemi-
sudhakar
Verma, S. (n.d.) Improve your personality.
http://employmentnews.gov.in/NewEmp/MoreContentNew.aspx?n=SpecialContent&k=
68

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 MODULE 4
THE MIDWIFERY PROFESSION

Introduction

A professional is a person who after completing the required training and preparation of a
profession has passed the required licensure examination to practice the profession. a
professional person uses high level intellectual and moral judgment in the practice of his
profession, is committed to serve society and takes responsibility in improving himself as a person
and professional in order to better his services to the people he/she serves (Sia, 20008).

To a layman, a Midwife is a person who assists woman in childbirth. A more proper

definition would be: A midwife is a person who has undergone and completed the required training
and academic preparation in a duly recognized school of midwifery and has passed the Midwifery
licensure Examination and a holder of a valid certificate of registration or professional license as
a midwife (Sia, 2008).

Midwifery is a profession whose members have undergone intensive preparation and

passed the required qualifying examination before being allowed to render midwifery services to
the public. From time of antiquity, midwifery has evolved and developed its own specialized body
of knowledge which is the basis of education and training of its members. It continues to seek
new information according to scientific principles. The functions that midwives perform are
indispensable to the people they serve. Midwives possess skills and knowledge that are required
through years of training and experience and which they continue to enhance through research
and continuing education in order to improve their services. Midwives adapt their services
according to the changing needs of the people who require their services while at the same time
maintain a set of ethical values and principles that guide them in both their professional practice
and personal life (Sia, 2008).

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 Learning Outcomes

At the end of this module, students should be able to:

1. Demonstrate awareness on the qualifications of a midwife.
2. Explaining the qualifications of a midwife in the Philippines.
3. Synthesize the practice of Midwifery in the Philippines.

Lesson 1. Sphere of Midwifery Practice in the Philippines

Republic Act 7392 – The Midwifery Act of 1992

Is the performance or offer to perform or render for a fee, salary, or other reward or
compensation of service recurring an understanding of the principles and application of
procedures and techniques in the supervision of and care of women during pregnancy, delivery
and puerperium (Sia, 2008).
1. Management of Normal Delivery
2. Performance of Internal examination during Labor, except when patient has antenatal
bleeding.
3. Health education of patient family and community, including nutrition and family
Planning
4. Carrying out the written order of the physician with regards to ante-natal, intra natal and
post natal care of the normal pregnant women
5. Giving Immunization
6. Oral and parenteral dispensing of oxytocic after the delivery of the placenta
7. Suturing perineal laceration to control bleeding
8. Giving intravenous fluid during obstetrical emergencies provided they were trained for
that purpose
9. May inject vitamin K to new born

Provided that this provision does not apply to students of midwifery schools that perform
midwifery services under the supervision of their instructors, nor to emergency cases (Sia, 2008).
Functions of Midwife (Sia, 2008):
1. Traditional Function of the Midwife (R.A No. 7392). The Philippine Midwifery Act of 1992
provides the midwife:

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 a. Gives supervision care and advice to women during pregnancy, labor and post-
partum period.
b. Conduct deliveries on her own responsibility
c. Cares of the newborn including the detection of abnormalities and counseling of
parents or couple.
d. Gives health Education
e. Executive emergencies measures
f. Procures medical supplies

2. Expanded Function of the Midwifes

a. Oral and parenteral dispensing of oxytocic drugs after delivery of the placenta
b. Suturing perineal lacerations to control bleeding
c. Giving of intravenous fluids during obstetrical emergencies
d. Injecting of vitamin K. to the Newborn

Different Fields of Midwifery

The registered midwife can practice in whatever field of midwifery she prefers and
considers most fitting to her preparation, experience and personality. A midwife will become
happy, satisfied and successful in her midwifery career if she chooses to practice in the field of
midwifery suited to her training, knowledge and skills (Sia, 2008).

 Private Practice – a midwife can engage in private practice by operating her own lying-in
clinic or day-care center. She can advertise her services by posting a sign in a
conspicuous place outside her house or by running an advertisement in newspapers. A
midwife engage in private practice is responsible for her own actions and is allowed to
handle normal cases only.
 Institutional Midwifery – Midwives in midwifery education have agrat responsibility of
educating and training student midwives to become future competent professional
midwives. The midwife can fill the following positions if she has the required qualifications
(Sai, 2008):
1. Clinical Instructor – A registered midwife can follow-up students in the community or
ward provided she has at least 2 years’ experience in the area of assignment and has
undergone training in the supervision of students.

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 2. Classroom Instructor – A midwife can teach in the classroom if she has BS degree or
if she is a registered nurse-midwife, and have at least one year satisfactory teaching
experience or one year efficient performance in the ward or community.
3. Principal – a midwife can occupy this position if she is a registered nurse-midwife, or
a registered midwife with a bachelor’s degree, with a t least 3 years’ experience in
maternity ward, one year of which in supervisory position and 2 years with teaching
experience in a school of midwifery (Sia, 2008).
 Community or Public Health Midwifery – These are midwives employed in puericulture
centers, rural health units and health centers. In public health midwifery, the midwife
renders services to individuals, families and communities in the implementation of the
health programs of the government (Sia, 2008)

Lesson 2. Skills and Abilities of Professional Midwife

Graduates of the Diploma in Midwifery Program are expected to be able to (CMO No.
33, Series of 2007):

1. Provide the necessary supervision, care and advise to low-risk women during pregnancy, labor
and puerperium. Specifically, they should be able to:

 Obtain pertinent history;

 Perform physical assessment including vital signs taking;
 Do simple laboratory examinations such as haemoglobin determination and urine test for
sugar and albumin;
 Assess the progress of labor;
 Perform relevant midwifery procedures;
 Provide appropriate care to the mother and the newborn;
 Provide life-saving measures during obstetrical emergencies such as administering IV
fluids and cardiopulmonary resuscitation;
 Detect abnormal conditions of the mother and/or newborn; and
 Facilitate referrals as necessary.

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2. Perform primary health care services within the community. Specifically, they should be able
to:

 Implement government health programs following proper protocols;

 Administer first aid measures as needed;
 Give appropriate health teachings to individuals, families and the community;
 Supervise barangay health workers; and
 Manage a barangay health station.

Lesson 3. Qualifications of Applicants for Licensure

In order to be admitted to the licensure, an applicant must, at the time of filling

his/her application, establish to the satisfaction of the Board that the applicant is (Sia,
2008):

1. A citizen of the Philippines

The Citizen of the Philippine are:
 Those who are citizens of the Philippines at the time of adoption of the
1987 Constitution.
 Those who elect citizen pursuant to the provisions of the Constitution of
1935.
 Those whose fathers and mothers are Filipino citizens.
 Those who are naturalized in accordance with the law.
 A Filipino citizen who marries an alien retains his/her citizenship unless by
her act or omission he/she is deemed under the law to have renounced
his/her citizenship.
 A natural born citizen who is a citizen of the country from birth without
having to perform any act to perfect or acquire his Philippine citizenship.
2. At least 18 years old. Provided, that any underage applicant who successfully
passes the examination shall be permitted or licensed to practice midwifery until
he or she shall have reached the age of majority.

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 3. He/she is of good health and good moral character
4. He/she is graduate from a college or university that complies with the standards
of midwifery education duly recognized by the proper government agency.

Lesson 4. The Midwifery Licensure Examination

Examination Requirements

Pass a written examination given by the Board of Midwifery (Gandul, 2010).

Section 18: License Contains / Certificate of Registration (Gandul, 2010)

1. Full name of registrant

2. Serial number
3. Official seal of commission
4. Signature of Chairperson of Commission
5. Members of the Board

Scope of Examination (Gandul, 2010)

a. Infant care and feeding

b. Obstetrical Anatomy and physiology
c. Principles of Bacteriology
d. Obstetrics
e. Midwifery Procedures
f. Domicilliary midwifery
g. Domicilliary Hygiene and first aid
h. Nutrition
i. Ethics of midwifery practice
j. Primary Health Care
k. Professional Growth and Development
l. Family Planning
m. others That Board may seem necessary

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Graduate Midwife Forms (Professional Regulation Commission, n.d.):
An applicant for examination must file at least 20 days before the first day of examination
if filed in the central office in Manila and 30 days before the first day of examination if filed at the
PRC regional offices. An applicant who files after the 30 days deadline in the PRC regional offices
will no longer be accepted but shall be directed to file in the central office (Sia, 2008).

1. NSO / PSA Birth Certificate

- NSO / PSA Marriage Contract (for married female applicants)
2. School of Midwifery
- Transcript of Records with scanned picture and Remarks "For Board
Examination Purposes"
3. Payment: P600.00
4. Graduate Midwife
- Record of twenty (20) deliveries actually handled and signed by
Supervisor/Tutor.
Signatory of cases should have undergone the training on Expanded Functions
under RA 7392 (see IRR Resolution No. 100)
Signed by Principal or Dean duly notarized
- Five (5) sutures and Five (5) IVF insertion
- repeater: case requirements done more than 5 years ago shall be repeated (new
cases shall be submitted)
5. (4) Passport sizes colored pictures in white background with complete name tag.
6. Current Community Tax Certificate (Cedula)
7. One window mailing envelope with metered postage stamps

Registered Nurse

- PRC ID Card / TOR / Board Certificate

- Record of twenty (20) deliveries actually handled with records of five (5) sutures and five
(5) intravenous injections signed by Hospital Director or Municipal Health Officer and
duly notarized.
- Certificate of Consent (from the hospital where cases were performed)

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 - Certificate of Trainings on Expanded Function on RA 7392 accredited by PRC CPD
Council for Midwifery of Registered Midwife who supervised (Graduate Midwife & RN)
- PRC ID License and Employee's ID of the Supervising Registered Midwife.
- PRC ID license & Employee's ID of the Certifying Officer (must be a registered
physician) **First Timer (FTB) Graduate Midwife & RN

What to Bring on the Examination (Sia, 2008):

1. Notice of Admission
2. Application stub
3. PRC official receipt
4. Two or more pencils
5. Ballpens with black ink only
6. One (1) piece Metered-Stamp Window Envelope
7. One (1) piece Long Brown Envelope
8. One (1) piece Long Transparent (non-colored) plastic envelope (to keep above items)

Guidelines during the Examination (Sia, 2008)

1. An examinee should report to the test center before 6:30 am on the first day of examination
to verify your room and seat numbers.
2. Late examines will not be admitted.
3. Before the start of each examination, always put the answer sheet on top of the desk of
the chair.
4. While taking the examination, always put the answer sheet on top of the desk of the chair.
5. Candidates taking the examination are prohibited from communicating with each other by
means of codes, signs, gestures, words or other acts that allows them to transmit and
acquire information about the answers to the examination questions.
6. Stop answering the questions at the end of the time allotted for the subject. Arrange test
papers as follows:
- Notice of Admission
- Answer Sheet
- Test Questionnaire
7. Do not leave room until:

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 - Your answer sheet and test question set are received by the room watchers
- You have signed, indicated the time and set (A or B) on the Examinees Record of
Attendance, and
- The lower portion of your Notice of Admission (Certification on the Receipt of Test
Papers) is signed by the Room Watchers and returned to you.
8. Prohibited Acts Inside the Examination Room
- Accepting or receiving anything, including food from any person while the
examination in in progress.
- Giving money, food or any favour and other consideration to the Room watchers
and other examination personnel.
- Loitering, talking or discussing your answers inside the room or along the corridor
while the examination is in progress.
- Putting any of the following markings on your answer sheets: name, seat number,
unnecessary words or phrases, strokes, dots or any other marks not called for in
the test questions.
Penalties
- Placing of name in the space provided for the subject of the examination shall be,
aside from the cancellation of the examination papers, suspension from taking the
examination for one (1) year.
- Multiple markings shall be cancellation of the examinees examination and
suspension from taking the examination for two (2) years.
- Taking out of the examination room of test questions used or pages thereof,
copying and/or divulging or making known the nature of content of any examination
to any individual or entity.
- Copying or referring to any solution, answer or work of another examinee or
allowing anyone to copy , or refer to tour work, helping or asking help from any
person or communication with anyone by means or words, signs, gestures,, codes
and other similar acts which enable you to exchange, impart or acquire relevant
information.
- Being inside the examination rooms, the following: books, notes, review materials and
other printed materials containing principles or excerpts thereof, coded data/ information/
formula which are relevant to or connected with the examination subject. Programmable
Calculators, Cellular Phones, portable personal computers and/or similar

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 gadgets/devices. This act shall be considered cheating and/or act of dishonesty and shall
be a ground for the cancellation of your examinations (Sia, 2008)

Failure to Take the Examination

Examination fee paid by examines shall be forfeited if an examinee:
- Fails to arrive at test center on time and was not allowed to take the examination.
- Fails to take the examination for whatever reason.

These rules are made for reason that the Commission has already incurred operational
expenses such as manpower services, cost of supplies and dorms during the filling period and
has also allotted the necessary supplies and forms for examination purposes. If in the future the
examinee reapplies to take the examination, he or she will be required to pay the examination
fees again (Sia, 2008).

Passing the Examination

In order to pass the examination, an examinee must obtain a general average of at least
seventy-five percent (75%) with a rating of not below sixty percent (50%) in any subject (Sia,
2008).

Examinees Report of Ratings

The Report of Ratings of successful examinees in the various licensure examinations are
distributed during the oath taking ceremonies. If the examinee failed to get his or her Report of
Rating, such can be claimed at the PRC. The board certificates and professional identification
cards are also issued to the successful examinee on oath taking day if they register with the
Commission at least 3-5 days before the dates of the oath taking ceremonies (Sia, 2008).

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 Assessment Task 4-1

1. Discuss RA 7392.
2. Who are the qualified applicants for the Midwifery Licensure Examination?
3. What are the requirements for the Midwifery Licensure Examination?
4. Enumerate the scope of Midwifery Exam.
5. Are you prepared for the Midwifery Licensure Examination? What are your
preparations in mind for you to be successful in taking the board examination?

Summary

The sphere of midwifery practice is governed by RA 7392 as the midwifery Act of 1992.
Functions of Midwifery Practice are Traditional function and Expanded Functions. Private
practice, Institutional Midwifery and Community Health Midwifery are the fields of midwifery
profession. Provision of the necessary supervision, care and advise to low-risk women during
pregnancy, labor and puerperium and performance of primary health care services within the
community are the skills and abilities of a professional midwife. Being a Filipino citizen, at least
18 years old, in good health and with good moral character and a graduate of a recognized college
or university of midwifery are the qualifications for the Midwifery licensure Examination.
Examination requirements are: PSA Birth Certificate, TOR, required cases, passport sized
pictures, Community Tax Certificate and window mailing envelope with metered postage stamps.

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 References

Gandul, E. (2010, August 26). Professional growth and development.

https://www.scribd.com/doc/36450514/Professional-Growth-and-
Development#download
Philippine Regulation Commission (n.d.). Midwife. https://www.prc.gov.ph/requirements/midwife
Sia, M. (2008). Midwifery law and ethics (2nd Ed). RMSIA Publishing Quezon City, Philippines

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