Midwife Licensure Exam Midwifery Law, Scope & Community Role (RA 7392) — Scope & Legal Boundaries of Midwifery PracticeConcept Map

Concept

Independent Scope of Practice

Sub Concepts

• Normal Spontaneous Delivery
• Prenatal/Antenatal Care
• Postnatal/Postpartum Care
• Newborn Essential Care (EINC/Unang Yakap)
• Family Planning Services
• Community MCH Education & Health Teaching

Relationship To Central

What a midwife may do alone, without physician supervision, within normal/low-risk care

Concept

Grey Zone: Emergency & Conditional Functions

Sub Concepts

• Internal Vaginal Examination
• Life-Saving Emergency Measures
• Oxytocic Administration (postpartum hemorrhage)
• Basic Newborn Resuscitation
• Suturing 1st-2nd Degree Perineal Lacerations
• BEmONC-Level Interventions

Relationship To Central

Acts permitted only in defined emergencies, absence of physician, or with specific certified training

Concept

Mandatory Referral & High-Risk Conditions

Sub Concepts

• Hypertensive Disorders (Pre-eclampsia/Eclampsia)
• Antepartum & Postpartum Hemorrhage
• Abnormal Presentation (Breech, Transverse Lie)
• Prolonged/Obstructed Labor
• Fetal Distress & Abnormal FHR
• Medical Co-morbidities
• Complications Requiring Surgery
• Sick Newborn (Asphyxia, LBW, Sepsis)

Relationship To Central

Conditions that cross the boundary and require physician/hospital referral

Concept

The Recognise-and-Refer Principle

Sub Concepts

• Early Detection & Risk Screening
• Timely Decision to Refer
• Stabilization Before Transfer
• Clear Referral Documentation
• Safe Transport & Communication

Relationship To Central

Core doctrine governing all midwifery clinical decision-making and scope application

Concept

Legal & Regulatory Framework

Sub Concepts

• RA 7392 (Midwifery Act of 1992)
• RA 9288 (Newborn Screening Act 2004)
• RA 10354 (Responsible Parenthood & RH Act 2012)
• RA 8344 / RA 10932 (Anti-Hospital Deposit Law)
• DOH EINC / Unang Yakap Protocol
• BEmONC Standards & Training

Relationship To Central

Philippine laws and DOH policies that define and protect midwifery scope

Concept

Professional & Ethical Responsibilities

Sub Concepts

• Informed Consent
• Confidentiality & Privacy
• Cultural Sensitivity & Dignity
• Complete Documentation & Records
• Code of Ethics (PRC Board)
• FHSIS Reporting & Target Client List

Relationship To Central

Duties that accompany every act within or at the boundary of scope

Concept

Liability & Professional Consequences

Sub Concepts

• Violation of RA 7392
• Administrative Liability
• Criminal Liability
• Loss of License/Suspension
• Civil/Tort Liability
• Documentation as Legal Protection

Relationship To Central

Legal and administrative outcomes of practicing beyond scope or misapplying scope

To

Independent Scope of Practice

From

RA 7392

Strength

strong

Relationship

RA 7392 legally defines and authorizes the independent scope; all independent acts derive their legality from this Act

To

Mandatory Referral & High-Risk Conditions

From

RA 7392

Strength

strong

Relationship

RA 7392 defines the boundary of scope by specifying what is NOT within scope; high-risk/abnormal falls outside scope and triggers referral

To

Normal Spontaneous Delivery

From

Independent Scope of Practice

Strength

strong

Relationship

Normal vaginal delivery is the signature independent act; it is the centerpiece of midwifery scope under RA 7392

To

Prenatal Care

From

Independent Scope of Practice

Strength

strong

Relationship

Comprehensive prenatal care including risk screening is an independent function that forms the foundation for early detection and referral decisions

To

Newborn Essential Care (EINC/Unang Yakap)

From

Independent Scope of Practice

Strength

strong

Relationship

EINC is a DOH-mandated protocol within independent scope; midwife leads immediate newborn care (drying, skin-to-skin, cord clamping, breastfeeding)

To

Family Planning Services

From

Independent Scope of Practice

Strength

strong

Relationship

RA 10354 (RH Act) positions midwife as primary family-planning provider in community; FP is core independent scope

To

Life-Saving Emergency Measures

From

Grey Zone: Emergency & Conditional Functions

Strength

strong

Relationship

Emergency measures (oxytocic for hemorrhage, newborn resuscitation) are permitted in the grey zone when no physician is immediately available

To

Internal Vaginal Examination

From

Grey Zone: Emergency & Conditional Functions

Strength

strong

Relationship

Internal exam is a grey-zone act: permitted for labour assessment when no physician is available, but not routine independent practice

To

Early Detection & Risk Screening

From

Recognise-and-Refer Principle

Strength

strong

Relationship

Early detection is the first step of recognise-and-refer; screening at every contact is the mechanism for catching danger signs in time

To

Mandatory Referral & High-Risk Conditions

From

Recognise-and-Refer Principle

Strength

strong

Relationship

When a danger sign is recognised (early detection), the midwife refers the case; the two concepts form a decision chain

To

Stabilization Before Transfer

From

Recognise-and-Refer Principle

Strength

strong

Relationship

After referral decision, the midwife stabilizes the case (life-saving measures) before and during transfer to hospital

To

Independent Scope of Practice

From

Legal Framework

Strength

strong

Relationship

RA 7392, RA 9288, RA 10354 are the statutory foundations that authorize and define the scope boundaries

To

Recognise-and-Refer Principle

From

Legal Framework

Strength

moderate

Relationship

RA 8344/RA 10932 (Anti-Deposit Law) protects referral by ensuring no facility delays emergency care for lack of deposit

To

Documentation & Records

From

Professional Duties

Strength

strong

Relationship

Complete documentation is both an ethical duty and a legal protection; records prove scope adherence and clinical judgment

To

Informed Consent

From

Professional Duties

Strength

strong

Relationship

Informed consent is required before any examination or procedure, even within scope; it is an ethical boundary alongside scope

To

Practising Beyond Scope

From

Liability & Professional Consequences

Strength

strong

Relationship

Practising beyond scope (managing a case that should be referred) is a direct violation of RA 7392 with administrative and criminal liability

To

Newborn Essential Care (EINC/Unang Yakap)

From

Newborn Screening Act (RA 9288)

Strength

moderate

Relationship

RA 9288 mandates newborn screening; midwife ensures screening referral as part of independent newborn care under EINC

To

Family Planning Services

From

Responsible Parenthood RH Act (RA 10354)

Strength

strong

Relationship

RA 10354 explicitly positions midwife as frontline FP provider; it reinforces and expands the family-planning component of scope

To

Grey Zone: Emergency & Conditional Functions

From

BEmONC Standards & Training

Strength

strong

Relationship

BEmONC training authorizes midwife to perform certain emergency-level interventions (e.g. oxytocic, resuscitation) in the grey zone

To

Newborn Essential Care (EINC/Unang Yakap)

From

DOH EINC / Unang Yakap Protocol

Strength

strong

Relationship

EINC is the DOH protocol that defines the sequence and standard of essential newborn care within midwife's independent scope

To

Professional Duties

From

FHSIS Reporting & Target Client List

Strength

moderate

Relationship

FHSIS and Target Client List reporting are public-health documentation duties that accompany all midwifery care

To

Life-Saving Emergency Measures

From

Stabilization Before Transfer

Strength

strong

Relationship

Stabilization is the practical application of life-saving measures (oxytocic, resuscitation, fluids) before and during referral transfer

To

Documentation & Records

From

Clear Referral Documentation

Strength

strong

Relationship

A clear referral note (findings, interventions, timing) is part of complete documentation and ensures safe handoff to physician

To

Recognise-and-Refer Principle

From

Safe Transport & Communication

Strength

moderate

Relationship

Communication with receiving facility and arrangement of safe transport are the final steps of the recognise-and-refer process

To

Safe Transport & Communication

From

Anti-Hospital Deposit Law (RA 8344/RA 10932)

Strength

moderate

Relationship

The Anti-Deposit Law protects referral by prohibiting facilities from demanding deposit before emergency care; midwife should know this when referring