Is the Concept of Midwifery Abdication Evident in Australian Case Law? A Systematic Review of Legal Literature, Court/Tribunal Decisions, and Coronial Findings

Abstract

BACKGROUNDThis review builds upon previous work exploring the concept of Midwifery Abdication, within the national midwifery literature. This article focuses on Australian legal literature, court/tribunal decisions and coronial or coroner's court findings.OBJECTIVETo explore Midwifery Abdication and whether it is evident within Australian caselaw.DATA SOURCESAustralian Legal literature, coronial findings, and court/tribunal decisions reported by the Australian Health Practitioner Regulation Agency, during 2005–2020.ELIGIBILITY CRITERIA1,246 cases were located using the presented search terms. Use of exclusion criteria resulted in the inclusion of 41 cases.METHODSWhile there are no validated tools to appraise caselaw, this review followed a robust protocol that guides the preparation and reporting of systematic reviews. Midwifery Abdication was identified using previously validated, interrelated constructs.RESULTSMidwifery Abdication occurred in 41 cases; that included one or more previously identified constructs. In line with the associated integrative review, a midwife's professional identity, environmental hierarchy and associated culture of social obedience are all shown to act as influencing factors in Midwifery Abdication.LIMITATIONSRigorous and reproducible processes were used; however, limited search functionality of some data sources may have resulted in inadvertent omission of cases. While this review relates to case law in one high-income country it provides a platform for further international research.CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGSAcknowledging Midwifery Abdication in Australian caselaw may serve to strengthen the midwifery voice and encourage an enhanced educational and reflective focus on midwifery philosophy and decision-making. Midwifery education must empower midwives to embrace their autonomous status while enhancing their abilities to optimize informed decision-making within a woman-centered midwifery philosophy.