Home Midwives Professional Practice Guidance for practice

Guidance for practice

The College consensus statements and the multi-disciplinary guidelines provide women, midwives and maternity services with the profession’s position on any given situation. The following consensus statements are currently available to download or a full set can be purchased through the shop. The College works closely with health professionals from various disciplines and also has a number of multi-disciplinary guidelines also available below.

Consensus statements

Alcohol and Pregnancy There is no known safe level of alcohol consumption at any stage of pregnancy. Therefore parents planning a pregnancy and women who are pregnant should be advised not to drink alcohol.
Anti-D prophylaxis administration during pregnancy and early postpartum The provision of anti-D prophylaxis following birth reduces the risk of haemolytic disease for the subsequent newborn. The provision of anti-D prophylaxis during pregnancy may reduce the incidence further but more high quality evidence is required to confirm this.
Antimicrobial Resistance Antimicrobial resistance (AMR) is a serious and growing threat to public health including the health of childbearing women and their babies. Midwives have a role in antimicrobial stewardship to reduce antimicrobial resistance.
Artificial Rupture of Membranes The College does not support the artificial rupture of membranes (ARM) in an uncomplicated physiological labour and birth.
Breastfeeding The College is committed to the protection, promotion and support of breastfeeding.
Climate Change, midwifery and environmental sustainability  Rapid and effective action is necessary to reduce greenhouse gas emissions (GHG) and to achieve net-zero GHG emissions. The College and its members are committed to health-centred climate action and supporting national and global initiatives which reduce the negative impacts of climate change.
Complementary and Alternative Therapies Complementary therapies such as homoeopathy, rongoa, herbal therapy, aromatherapy, naturopathy and acupuncture may have important effects on the progress of pregnancy, labour and birth, and the postnatal period for both the woman and her baby.
Covid-19 vaccination for midwives – position statement Vaccination against Covid-19 is the best form of protection for ourselves, our whānau/families, our colleagues and importantly, the women and people we provide care to. The College therefore encourages midwives to choose to be vaccinated against Covid-19.
Donor Human Milk and Milk Sharing Breastfeeding is the biologically normal way to feed infants. In situations where mothers’ own milk is not available, human milk from a donor mother is considered to be an appropriate substitute when both the donor and recipient mother/guardian give informed consent. The College supports informed decision making regarding ethical and safe human milk sharing practices.
Family Violence Abuse against women and children is unacceptable and should be eliminated within all societies. During pregnancy family violence should be considered a risk factor that leads to adverse health outcomes.
HIV Screening in Pregnancy The pregnant woman determines her risk factors following discussion with her midwife, and decides whether to undertake HIV screening based on full and culturally appropriate information.
Infant Feeding in Emergencies and Disasters The College is committed to supporting women and safeguarding the health, well-being and development of infants during emergency and disaster situations.
Informed Consent and Decision Making The College believes midwifery care takes place in partnership with women. It is the midwife’s professional responsibility to uphold each woman’s right to informed decision making throughout the childbirth experience.
Laboratory Testing and Screening A registered midwife has the educational background and knowledge to appropriately order and correctly interpret laboratory tests in relation to pregnancy, birth and the postnatal period for women and their newborn.
Long Acting Reversible Contraception The Long Acting Reversible Contraception consensus statement was withdrawn in November 2022. For guidance on contraception please refer to New Zealand Aotearoa’s guidance on contraception, which the College has endorsed.
Mentoring The mentoring relationship is one of negotiated partnership between two registered midwives. Its purpose is to enable and develop professional confidence.
Midwife Prescribing Midwives prescribe within their scope of practice and are competent to prescribe for conditions commonly associated with uncomplicated pregnancy, labour, birth and postnatal period.
Midwives Using Ultrasound The Colleges’ position on midwives performing ultrasound for diagnostic purposes is that it is not a core competency required of a registered midwife in New Zealand.
Normal Birth Normal birth should be protected, promoted and supported.
Oral Health Guidelines The College supports the primary health strategy in relation to oral health for women and their families.
Placental birth: Facilitating the Birth of the Placenta Women can expect physiological placental birth when they have had a physiological labour and birth.
Prescribing and Administering Opioid Analgesia in Labour The College does not advocate the use of the routine opioid analgesia for intrapartum pain relief.
Prescribing Drugs Unapproved for use in Maternity Care or for the Newborn Drugs that are unapproved for use in maternity care or for the newborn should not be promoted or prescribed by a midwife on her own responsibility.
Roles and Responsibilities in the Hospital Setting Self employed and employed midwives will respect each other’s right to autonomous practice and their accountability for that practice.
Safe Sleeping for Baby The College supports current public health messages about safe sleeping recommendations to ensure every New Zealand baby has a safe sleep, in every place, at every sleep.
Sexually Transmitted Infections The College promotes discussion between midwives and women on the risks associated with Sexually Transmitted Infections (STIs) during pregnancy and the options available for screening.
Social Media All midwives and midwifery students should maintain professional standards and ensure professionalism in all on-line postings, sharing and other on-line activity. 
The Role of Non-regulated Support People Midwives are the appropriately qualified and responsible health professionals to provide safe, effective and quality care to mothers and babies. The College believes that doulas, health care assistants and maternity assistants are not a substitute for midwives.
The Use of Water for Labour and Birth The College supports warm water immersion for women during labour as a method of pain management.
Tongue-tie (Ankyloglossia) The College believes in the importance of free, equitable, accessible and timely service along with consistent assessment and referral pathways for the release of tongue tie when it is having an impact on breastfeeding.
Umbilical Cord Blood Banking Any potential benefit for routine private cord blood collection needs to be explained to prospective parents in an unbiased manner.
Vaginal Birth after Caesarean Section Vaginal birth after caesarean section (VBAC) as a safe option for the majority of women, and does not support routine elective repeat caesarean section.
Vitamin K Prophylaxis for the Newborn The administration of Vitamin K as a prophylactic intervention in the prevention of Vitamin K Deficiency Bleeding (VKDB) in the newborn.

Multi-disciplinary and general guidance

Anti-D Blood Services Expert Panel Consensus Position Statement regarding the Use of Rh(D) Immunoglobulin in women with a Body Mass Index >30
Booking and transfer guidelines Booking guidelines 

Transfer guidelines

Contraception New Zealand Aotearoa’s guidance on contraception
Diet and activity Eating and Activity Guidelines for New Zealand Adults
Fetal wellbeing during pregnancy Assessment and promotion of fetal wellbeing during pregnancy
Gestational Diabetes Screening, Diagnosis and Management of Gestational Diabetes in New Zealand MOH 2014
Group B Streptococcus Prevention of Early-Onset Neonatal Group B Streptococcus Infection
Healthy weight gain Guidance for Healthy Weight Gain in Pregnancy
Hypertension and Pre-eclampsia Diagnosis and Treatment of Hypertension and Pre-eclampsia in Pregnancy in New Zealand. A clinical practice guideline
Induction of Labour Induction of Labour in Aotearoa New Zealand Guideline
Intermittent Auscultation guide for practice Practice guidance document

Practice guidance videos

Low dose aspirin Diagnosis and Treatment of Hypertension and Pre-eclampsia in Pregnancy in New Zealand. A clinical practice guideline.
Periviable gestations New Zealand consensus statement on the care of mother and baby(ies) at periviable gestations
Postpartum Haemorrhage National Consensus Guideline for Treatment of Postpartum Haemorrhage Treating Postpartum Haemorrhage poster
Postpartum observation Observation of Mother and Baby in the Immediate Postnatal Period: Consensus Statements Guiding Practice
Record keeping Record Keeping Keteparaha/Toolkit
Red eye reflex Red reflex screening assessment in newborns and infants (starship.org.nz)
Referral Guidelines Guidelines for Consultation with Obstetric and Related Medical Services (Referral Guidelines)
Syphilis Syphilis in Pregnancy: Antenatal Management Guidelines for maternal and congenital syphilis
Tongue-tie National Guidance for the Assessment, Diagnosis and Surgical Treatment of Tongue-tie in Breastfeeding Babies
Vitamin D Companion Statement on Vitamin D and Sun Exposure in Pregnancy and Infancy in New Zealand: A supplement to the Consensus Statement on Vitamin D and Sun Exposure in New ZealandWebinar: Vitamin D during pregnancy, breastfeeding and infancy