Assessment of Observance of Ethics Codes in Midwifery and Underlying Factors Among a Group of Midwives Participated in Continuing Education Programs at Avicenna Fertility Center

Original Article | Pages: 72 - 80
  • Shadab Shah Ali - Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
  • Shima Seddighinia - Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR,Tehran, Iran
  • Arash Mohazzab - Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR,Tehran, Iran []


Background: Following the compilation of ethical codes of midwifery in the health system of Iran, the knowledge about compliance with these codes in different groups of midwives working in the health system, both public and private, can provide an appropriate feedback on the status of compliance of such codes and in a more general attitude, undertaking implementation of professional ethics and the underlying factors can be scrutinized more rigorously.

Methods: In a descriptive-analytic study based on self-reported observance of professional ethics, 70 midwives participating in continuous medical education programs at Avicenna Fertility Center completed a Likert scale researcher-designed questionnaire including 65 questions in different fields of ethics codes. Data were analyzed by SPSS software using Kendall Rank Correlation Coefficient, independent t-test and variance analysis.

Results: The mean age of the participants was 44 years. 82% of the participants had a bachelor's degree and the rate of observance of professional ethics codes in this study in the range of -2 to 2 times was 0.12±1.68. There was no significant relationship between observing ethical codes with educational level, income level, professional ethics training, participation in professional ethics training workshops and activities in different parts of the health system. The only significant correlation was the interest rate to midwifery with observing ethical codes in the area of providing services to the client (r=0.257 with p=0.048).

Conclusion: It seems that self-report assessment in professional ethics is based on extrapolation of professional ethics observance by the hierarchy. Also, in the current assessment, there was no meaningful relationship between professional ethics education and knowledge with observance of midwifery ethics codes, which indicates the necessity of implementing assessments as well as more effective teaching in the field of ethics observance.


  1. Ministry of health and medical education. Ethical codes of the midwifery profession in Iran. 2013.
  2. Farajkhoda T, Nejhad RL, Abbasi M. The necessity of developing professional codes of ethics in Reproductive Health in Iran. Med Ethics J. 2013;7(22):35-53.
  3. Shariati M. History ethics rules and forensic medicine in midwifery. 2nd ed. Tehran: Shahre Firozeh Publisher. 2013. 163 p.
  4. Rahimparvar V, Fatemeh S, Nasiriani L, Khoda TF, Bahrani N. [Compliance rate of midwives with the professional codes of ethics in maternal child health centers in Tehran]. J Med Ethics History Med. 2014;7(2):36-46. Persian.
  5. Thompson JB, King TL. Resources for clinicians: a code of ethics for midwives. J Midwifery Women Health. 2004;49(3):263-5.
  6. Tefag M, Nikbakht Nasrabadi A, Mehran A, Dinmohammadi N. [Investigation of the ethical practice in medication process among nurses]. Hayat. 2005;10(4):77-85. Persian.
  7. Jonson AR, Singler M, Winslade WJ. Clinical ethics: a practical approach to ethical decision in clinical medicine. 7th ed. New York: Mc-Graw-Hill; 2002. p. 163-80.
  8. Masumi SZ, Bibalan FG, Roshanaei G. [Ob-servance of midwifery code of ethics among midwifery students and its related factors]. Med Ethics J. 2016;10(35):11-30.
  9. Baghany R, Faramarzi F, Baghjari M, Zare F, Tabaraei Y. [Observance of midwives’ code of ethics by midwifery students during vaginal ex-aminations in labor and its influencing factors in 2012]. J Mazandaran Univ Med Sci. 2013;23 (107):90-4. Persian.
  10. Shaali M, Shahriari M, Abdi SM. [Evaluation of compliance rate of midwives with the codes of professional ethics in maternity and gyne-cology wards of hospitals affiliated with Is-fahan university of medical sciences in 2016]. Iran J Obstet Gynecol Infertil. 2018;21(3):54-63. Persian.
  11. Mossadegh Rad AM, Esna Ashari P. [Patients and physicians awareness of patients’ rights and its implementation at Beheshti hospital in Isfahan]. Iran J Med Edu. 2004;4(1):45-54. Persian.
  12. Khodakarami N, Jan Nesari S. [Evaluating mothers' awareness about pregnant women’s rights]. Iran,Med J Ethics. 2009;2(1):51-58. Persian.
  13. Psaila K, Schmied V, Fowler C, Kruske S. Discontinuities between maternity and child and family health services: health profess-sionals’ perceptions. BMC Health Serv Res. 2014;14:4.
  14. Mudaly P, Nkozi ZZ. Factors influencing nurse absenteeism in a general hospital in Durban, South Africa. J Nurse Manag. 2013; 23(5):623-31.
  15. Yousefzadeh S, Kordi M, Mazloum SR, Tara F. [The survey of midwives’ knowledge, attitude and practice about professional ethics codes in the maternity of Mashhad educational hospitals in 2014]. Iran J Obstet. 2015;18(173):23-31. Persian.

XML Format

XML in HBI Format


Shah Ali Sh, Seddighinia Sh, Mohazzab A. Assessment of Observance of Ethics Codes in Midwifery and Underlying Factors Among a Group of Midwives Participated in Continuing Education Programs at Avicenna Fertility Center. Iran J Biomed Law Ethics. 2019;1(1):72-80.