I. Midwife and Client Responsibilities and Rights

The Informed Choice and Disclosure (ICD) Agreement

The Midwife is required to have on file a signed statement verifying that each client has read and understood the Midwife’s Informed Choice and Disclosure (ICD) agreement. The ICD should be written or translated in language understandable to the client. There must be a place on the form for the client to sign attesting that she understands the content by signing her full name. The ICD discloses to a prospective client information regarding the Midwife’s practice. The ICD includes information regarding the Midwife’s responsibilities and rights as well as the client’s responsibilities and rights. Each Midwife may broaden the agreement to include additional information reflecting details of the Midwife’s practice.

The ICD shares information regarding the responsibilities and rights of the Midwife. It includes information including, but not limited to:

A.     a description of the Midwife’s education, training, and experience level in midwifery, continuing education, participation in peer review, and grievance process;

B.     the Midwife’s philosophy of practice;

C.     antepartum, intrapartum, and postpartum conditions requiring consult, transfer of care and transport to a hospital;

D.     a plan for a physician consult/collaboration plan;

E.     the services provided to the client by the Midwife;

F.     the Midwife's current legal status;

G.    treatments and procedures, possible alternative procedures and treatments, risks and expected benefits of  home birth;

H.     documentation of any refusal by the client of any procedure required by law;

I.      the client's and Midwife's signatures and date of signing.

 

The Midwife will give a copy of the ICD to the client and keep a copy of the ICD Agreement Statement in the client’s records.