M1 T1.2 -Midwifery Law & Legislative Framework – Detailed Study Notes

Nature and Functions of Law

Law = formal set of rules everyone must follow 🡪 breaching them brings consequences.
- Protects citizens, up-holds shared norms/values, sanctions offenders.
- Fluid: statutes evolve as social values shift (e.g. legalisation of marriage for same-sex couples).
- Context–specific: differs between countries; travelling midwives must stay alert to jurisdictional changes.
Practical significance for midwives
- Provides the right to use the protected title “Midwife.”
- Imposes duties of safe, competent, culturally appropriate care.
- Gives health-care consumers enforceable rights; failure to honour these is a frequent basis for complaints.

Law
- Codified by legislature/government.
- Enforceable by courts, police, regulatory authorities.
- Can feel narrow or “limiting.”
Lore (knowledge/tradition)
- Collective wisdom, cultural narratives, practices passed inter-generationally.
- Often broader, more holistic than statutory law, embedding equity, spirituality, community priorities.
- Vital to respect in maternity care: listen, negotiate, seek mid-points between statute and family/whānau custom.

Hearing “law” can trigger anxiety for midwives → investigations are lengthy; practitioners must live with the process.
Key coping principle: you do NOT need to memorise every Act—just know:
- The key points relevant to maternity.
- Where and how to locate current versions quickly.

Be familiar with the overarching legislative framework so you can fulfil legal & professional obligations.
Capabilities required:
1. Identify relevant Acts/Regulations/Codes.
2. Retrieve the latest text (websites, internal policies, legal advisors).
3. Interpret how provisions apply to specific clinical contexts.
4. Communicate requirements clearly to parents/whānau.

Online statute repository: legislation.govt.nz (searchable by keyword or Act name).
Health & Disability Commissioner (HDC) site – Code of Rights, case notes.
NZ College of Midwives (NZCOM) legal team (Carla Humphreys + advisers) – especially for self-employed practitioners.
Employer chains (Charge Midwife, Quality/Safety units) – primary support point for employed staff.
Keep textbooks in perspective: useful background, but may lag behind amendments—always cross-check dates.

Formerly Section 88 contract; now situated within the Pae Ora (Healthy Futures) Act 2022.
Governs funding & service obligations for community Lead Maternity Carers (LMCs).
- Self-employed midwives generally know the PMN intimately because they negotiate it directly with Te Whatu Ora/Ministry of Health.
- Employed midwives need awareness, particularly if providing continuity-of-care models within facilities.

Recent reforms removed previous criminal framework ➔ health-service model.
Midwives may deliver medical abortion care after additional training.
- Facility-based midwives in dedicated units likely possess deeper day-to-day knowledge.
- Self-employed midwives’ knowledge varies with service provision; still must understand referral pathways and conscientious-objection rules.

Allegations are evaluated from the very beginning of the care episode ⇒ reviewers trace every preceding factor, not just the final event.
Breaches of the HDC Code of Rights are common triggers.

1901 – Nursing Council established.
1990 – Nurses Amendment Act enabled midwives to practise autonomously.
- Took 60 years of advocacy to achieve independent antibiotic prescribing.
- Sparked enhanced education → direct-entry midwifery programmes (no prior nursing compulsory).
Health Practitioners Competence Assurance Act (HPCAA) 2003
- Created the Midwifery Council of NZ (MCNZ).
- Purpose: protect public health & safety by ensuring practitioners are fit & competent.
- MCNZ ≠ NZCOM:
- MCNZ = regulator (recertification, competence reviews, scopes of practice).
- NZCOM = professional body (advocacy, education, indemnity, collegial support).

HPCAA 2003 – registration, competence, recertification.
Pae Ora (Healthy Futures) Act 2022 – Section 94 PMN contract & Referral Guidelines.
Health & Disability Commissioner Act 1994 + HDC Code of Rights.
Abortion Legislation Act 2020 – scope for midwife provision, conscientious objection.
Medicines Act 1981 & Misuse of Drugs Regulations – prescribing, storage of controlled drugs.
Privacy Act 2020 – personal health information handling.
ACC Act – treatment injury coverage.
Human Rights Act 1993 – non-discrimination obligations.

Schedule periodic self-audits: review the Acts most relevant to your practice context every 6–12 months.
Subscribe to MCNZ & NZCOM bulletins for amendment alerts.
Maintain a quick-reference folder (digital or hard copy) with:
- Hyperlinks to Acts/Codes.
- Unit/organisation policies mapping statutory duties into local procedure.
- Contact list for legal advice.
Integrate legislative checkpoints into clinical documentation templates (e.g. informed consent prompts aligned with HDC Rights 1–7).

Legislation sets the floor; culturally-centred care (reflecting lore) often aspires to a higher ceiling.
Continuous dialogue with whānau about customary practices ensures statutory compliance and respect for tradition.
Midwives act as translators between statutory language and lived cultural realities.

You are NOT examined on rote statute wording; you are evaluated on ability to:
1. Recognise when a legal obligation is engaged.
2. Locate and interpret the correct provision.
3. Apply it to protect consumer rights & your professional standing.
Remember the key numbers:
- Section 94 (Primary Maternity Notice).
- HPCAA 2003 (foundation of MCNZ authority).
- HDC Code (Rights 1–10).

"SAFE":
- Scope – stay within HPCAA scope.
- Access – know where Acts/Codes live online.
- Fundamentals – consumer rights always foregrounded.
- Escalate – seek expert/legal advice early when unsure.

Legal literacy is a dynamic competency—update it as actively as clinical skills.
View statutes as protective partners: they keep whānau safe and safeguard your practice when adhered to.