Introduction <p>Midwives are frequently confronted with ethical dilemmas and require guidance in addressing them. This study investigates Lebanese midwives’ recognition of and perception of ethical dilemmas in clinical practice, examines influencing factors and explores the role of internal policies and ethics committees.</p> Methods <p>Lebanese midwives who graduated between 2017 and 2021 and were registered in the Lebanese Order of Midwives participated in this qualitative and quantitative survey. In September 2022, three online focus groups were held via Zoom with sixteen participants answering validated questions. A quantitative survey was carried out Between October and December 2022.</p> Results <p>A total of 147 midwives completed the questionnaire. The most frequently reported ethical dilemmas involved disagreements within the team and with patients or families, followed by challenges related to patient autonomy. Among the ethical dilemmas studied, disagreement with patient or family, patient autonomy, and restrictive and hierarchical institutional regulations were found to be significantly associated with the support person sought by the midwives (p = 0.015, p = 0.037, and p = 0.045, respectively). The presence of an ethics committee was significantly associated with reliance on “moral perception and judgement” as a means of coping with ethical challenges (p &lt; 0.001).</p> Conclusion <p>Lebanese midwives regularly face ethical dilemmas, notably disagreements and patient autonomy issues. The presence of an ethics committee significantly aids their moral judgement, highlighting the need for institutional structures that guide ethical practice.</p>