Our responsibility to our clients is to support bodily autonomy and personal needs, values, and preferences for each individual and family that engages our support. These values guide our practice and our interactions with our clients, and are framed by our respect and humility for individual, geographic, religious, cultural, ethnic, political, educational, and personal backgrounds.
The Family Ways statement of ethics our personal guideline for our practice, and includes the following six principles: 1) autonomy, 2) beneficence, 3) non-maleficence, 4) veracity, 5) confidentiality, and 6) justice.
We emphasize the role of the individual as the owner and director of their own medical and personal care, and we are guided by our responsibility to develop relationships with our clients that uplift the client’s values, goals, and preferences in the full course of the support we provide. Decision making is the client's ultimate responsibility, with the support of their care team and with the mutual goal of healthy birthing people and health babies. We acknowledge that “healthy” means mental and emotional health and wellness as well as physical health and wellness. We honor and respect the decisions that pregnant and birthing people make about their pregnancies and births based on their knowledge and belief about what is best for themselves and their babies.
Our intentional work in the perinatal healthcare landscape is to benefit the birthing people and babies whom we support. Mutual trust and respect are the foundation for decision making at every step of the perinatal care process, and are established through positive, affirming care for all parties. We take seriously and at all times strive to uphold, to the best of our ability, positive benefits such as good health and holistic wellness, and to prevent and remove harmful conditions and barriers to meaningful, humble, and appropriate client-directed care and support.
We attest that “primum, non nocere," or “first, do no harm” [often wrongly attributed to the Hippocratic Oath] is an insufficient starting point for the care of birthing families. To uphold the principles of non-maleficence, we honor and acknowledge that individual moral integrity and recognition of the complexity of life events require flexibility in identifying the best possible course of action for each situation. Pregnancy and birth are broad events with unknown and unknowable outcomes, and in some circumstances affirmative intentions and best decisions may lead to consequences we could not foresee.
We vehemently uphold the principle of veracity, or truth telling, according to which all healthcare providers are bound to be honest in all interactions with patients. In its most fundamental application, the principle of veracity relates to informed decision-making and the client’s autonomy to consent or decline based on all available information. Additionally, we acknowledge and support that it is an ethical violation to withhold information or willfully mislead people, even if it is expedient to do so, and even if it is believed that a subjectively or objectively better outcome would come from the lie. Our clients can trust that we will be forthright, honest, and thorough in all communications, even when such communication would be uncomfortable or inconvenient, and we ask that our clients be forthright, honest, and thorough in all communication to our team and their care providers. Veracity is integral to the development of a trusting relationship with our clients.
In keeping with basic human rights to privacy, and upheld by the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides privacy protections and patient rights regarding the use and disclosure of Protected Health Information (PHI), we support our clients’ right to receive meaningful support and ready access to their own medical records and those of any children for whom they are responsible. All clients have the right to care and support that is provided in a prompt, courteous, and respectful manner, and that is culturally humble and respectful of cultural and ethnic identity, religion, disability, gender identity, age, marital status, and sexual orientation. We will at all times protect privacy and confidentiality in support discussions, treatment services, communications, and records pertaining to our support.
We acknowledge that we are living and working with gratitude on unceded Piscataway territory of the First Nation. We encourage our clients to learn about the Native Land we occupy and the significance of acknowledgement.
We acknowledge that, though we are active in dismantling oppressive structures, we remain participants in a white supremacist, patriarchal society. We acknowledge that our support and decisions may be impacted by the oppressive rules and practices of a society that is often hostile to out-of-hospital birth, doulas, midwives, and doula/midwifery clients. We acknowledge that our choices may be limited by the medical, legal, political, economic, cultural, and social climate in which we function, and that ethical conflicts with the dominant culture may pose a threat to the integrity of our values and a risk that our actions may lead to professional repercussions or legal reprisal. In spite of barriers, we remain committed to dismantling oppressive structures and to creating a safe space for all clients to receive meaningful, appropriate care.
Reproductive Justice Acknowledgement
Our ethos uplifts our clients’ human right to maintain personal bodily autonomy, have children or not have children, and parent the children they have, in safe and sustainable communities. We support the expansive, intersectional, and holistic physical, mental, spiritual, political, social, and economic well-being of those seeking our support, based on the full achievement and protection of fundamental human rights.
[Last updated December 7, 2023.]