Table 5 Summary of a review of the code of ethics presented in the selected organizations and countries

International Midwifery Confederation ICM [31]

2020

4 sections with 23 items

The purpose of this confederation is to improve the standards of midwifery care for the mother, infant, and family. The code of ethics is a guideline for midwifery education, research, and practice. Four sections including Midwifery Relationships, Practice of Midwifery, The Professional Responsibilities of Midwives, and Advancement of Midwifery Knowledge and Practice are expressed in the form of 23 items. The appearance of these items considers a woman as a person with human rights who seeks justice and equality in access to health care and emphasizes the two-way relationship of respect and trust along with the preservation of all members of society. Since The ICM is a valid midwifery institution, the midwifery code of ethics provided by this confederation was used and emphasized as the main basis for developing a code of ethics using the available texts in this study

American College of Nursing and Midwifery ACNM [32]

2015

3 ethical mandates and 11 ethical items

ACNM presents 3 ethical mandates to achieve the mission of midwifery to promote the health and well-being of women and newborns within their families and communities. The first mandate is directed toward the individual women and their families, the second mandate is to a broader audience for the public good for the benefit of all women and their families, and the third mandate is to the profession of midwifery to assure its integrity and in turn, its ability to fulfill the mission of midwifery. Considering these 3 ethical mandates ACNM introduced 11 ethical items including; Midwives in all aspects of professional relationships and practice will 1- respect basic human rights and the dignity of all persons; 2- respect their own self-worth, dignity, and professional integrity; 3- develop a partnership with the woman in which each shares relevant information that leads to informed decision-making, consent to an evolving plan of care, and acceptance of responsibility for the outcome of their choices; 4-Act without discrimination based on factors such as age, gender, race, ethnicity,religion, lifestyle, sexual orientation, socioeconomic status, disability, or nature of the health problem; 5-Provide an environment where privacy is protected and in which all pertinent information is shared without bias, coercion, or deception; 6-Maintain confidentiality except where disclosure is mandated by law.7-Maintain the necessary knowledge, skills, and behaviors needed for competence; 8- Protect women, their families and colleagues from harmful, unethical, and incompetent practices by taking appropriate action that may include reporting mandated by law; 9- promote, advocate for, and strive to protect the rights, health, and well-being of women, families, and communities; 10- Promote just distribution of resources and equity in access to quality health services; 11- Promote and support the education of midwifery students and peers, standards of practice, research, and policies that enhance the health of women, families, and communities

UK Nursing and Midwifery Council UKNMC [33]

2018

25 sections with 95 items

Treat people as individuals and uphold their dignity; 2. Listen to people and respond to their preferences and concerns; 3. Make sure that people’s physical, social and psychological needs are assessed and responded to; 4. Act in the best interests of people at all times; 5. Respect people’s right to privacy and confidentiality; 6. Always practice in line with the best available evidence; 7. Communicate clearly; 8. Work co-operatively; 9. Share your skills, knowledge, and experience for the benefit of people receiving care and your colleagues; 10. Keep clear and accurate records relevant to your practice; 11. Be accountable for your decisions to delegate tasks and duties to other people; 12. Have in place an indemnity arrangement that provides appropriate cover for any practice you take on as a nurse, midwife, or nursing associate in the United Kingdom; 13. Recognize and work within the limits of your competence; 14. Be open and candid with all service users about all aspects of care and treatment, including when any mistakes or harm have taken place; 15. Always offer help if an emergency arises in your practice setting or anywhere else; 16. Act without delay if you believe that there is a risk to patient safety or public protection; 17. Raise concerns immediately if you believe a person is vulnerable or at risk and needs extra support and protection; 18. Advise on, prescribe, supply, dispense or administer medicines within the limits of your training and competence, the law, our guidance, and other relevant policies, guidance, and regulations; 19. Be aware of, and reduce as far as possible, any potential for harm associated with your practice; 20. Uphold the reputation of your profession at all times; 21. Uphold your position as a registered nurse, midwife, or nursing associate; 22. Fulfill all registration requirements; 23. Cooperate with all investigations and audits; 24. Respond to any complaints made against you professionally; 25. Provide leadership to make sure people's well-being is protected and to improve their experiences of the health and care system

The British Columbia College of Nurses and Midwives BCCNM [34]

2020

4 sections with 36 items

BCCNM articulates 36 ethical items in 4 sections including 1-professional practice, with 9 items that explain the midwifery's primary responsibilities for safeguarding the well-being of the client and their newborn; 2-relationships and accountability, with 12 items about developing the midwife’s relationship of trust and partnership with the client; 3- knowledge, competency and learning with 4 items about maintaining and facilitating safe and competent midwifery practice in all environment and cultures; and 4-conduct with 11 items including midwives’ act as effective role models by maintaining both professional and ethical conduct. Midwives should not engage in any activity that would adversely affect the honor, dignity, or credibility of the profession

Nursing and Midwifery Board Australia NMBA [35]

2018

.4 sections with 23 items

The International items of ethics are now in effect for Australian nurses and midwives International Council of Nurses (ICN) Code of ethics for nurses and the International Confederation of Midwives (ICM) Code of ethics for midwives took effect as the guiding documents for ethical decision-making for nurses and midwives in Australia on 1 March 2018

New Zealand College of Midwives NZCM [36]

2023

3 sections with 28 items

The sections are 1-responsibilities to the women with 12 items; 2-responsibilities to the wider community with 5 items and 3- responsibilities to colleagues and the profession with 11 items

Turkey Midwifery National Code of Ethics [37]

2019

21 Items

The items refer to that a midwife should:

1-not expect personal interests and should not have any conflict of interests; 2- take the necessary precautions to protect the privacy of her patients; 3- protect honesty and reliability in her records 4- consider the unborn baby, the mother, and the newborn as separate beings; 5- prevent harm to the baby and/or the mother due to sloppy and inexperienced interventions and neglect; 6- considers the mother’s and the baby’s utmost benefits more than anything else; 7-believe that every individual has equal rights; 8-care for the breastfeeding relationship between the mother and the baby 9-never shares information about her patients with anyone, unless there is a life-threatening situation or a law that requires it; 10-care for women’s physical, emotional and spiritual values 11-improves her professional knowledge and is responsible for compliance with ethical standards and she acts in line with professional values and displays professional competence;12-protects her dignity and her professional dignity; 13-value natural birth; 14- ensure that women take advantage of all available medical resources and avoid potential hazards; 15-improve and maintain women's health and contribute to the prevention of illness; 16-fairly allocate resources and midwifery services;17-inform women about midwifery practices willingly 18-try to protect, improve and defend the rights of women and their families; 19-listen to her inner voice to judge herself; 20- improve the quality of care,21-Encoure women to make informed decisions

Nursing and Midwifery Board of Ireland [38]

2021

38 items in 5 sections

The Sections are:

1-Respect for the dignity of the person (16 items)

2- Professional, responsibility, and accountability)15 items)

3- Quality of practice (7 items)

4- Trust and confidentiality (7 items)

5- Collaboration with others (9 items)