Note: This article was originally published in our Autumn 2019 edition of our On Call newsletter, and has not been updated.
The practice of midwifery in Ontario consists of the scope of practice statement, the controlled acts authorized to midwives, and all other activities that are in the public domain.
The scope of practice statement is set out in the Midwifery Act, 1991 as:
The assessment and monitoring of women during pregnancy, labour and the post-partum period and of their newborn babies, the provision of care during normal pregnancy, labour and post-partum period and the conducting of spontaneous normal vaginal deliveries (section 3 of the Midwifery Act, 1991).
The practice of midwifery also includes the controlled acts authorized to midwives in the Midwifery Act, 1991 (section 4), as well as many other types of care or activities that are in the public domain and can be performed by both regulated and unregulated individuals. While not prohibited under the legislation governing the midwifery profession, these activities fall within the scope of midwifery practice and therefore cannot be performed by a member in the Inactive class.
The following are examples of activities that are considered in the scope of practice of midwifery and therefore cannot be performed by a member in the Inactive class:
- performing any of the controlled acts authorized to midwives under the Midwifery Act, 1991
- providing labour support
- providing breastfeeding support
- acting as a second birth attendant
- providing well baby care to newborns
- providing contraceptive counselling and advice to postpartum individuals
Is a member in the Inactive class permitted to do anything midwifery-related?
A member in the Inactive class is permitted to engage in activities that do not fall within the scope of midwifery practice such as teaching academic and clinical midwifery (not precepting), researching midwifery care, working as staff at the Association of Ontario Midwives or the College, managing the administrative aspects of a midwifery practice or working as a hospital administrator.
In addition, a member in the Inactive class is permitted to provide health services that are not in the midwifery scope of practice because the legislation does not prohibit this. For example, a member in the Inactive class may administer a vaccine to a school-aged child under the delegation of a physician, as this is not within the midwifery scope of practice and the authority to perform the controlled act is provided via delegation. A member in the Inactive class may conduct blood pressure checks on seniors as this is not within the midwifery scope of practice and is not a controlled act (i.e. is in the public domain).
What options does a member in the Inactive class have if they want to provide components of midwifery care?
A member in the Inactive class who wishes to provide care that is in the scope of midwifery practice has two options:
Option 1 – Obtain a General certificate of registration
Once a member in the Inactive class switches to the General class, they can practise midwifery by providing care that is in the scope of midwifery practice as set out in the Midwifery Act, 1991.
Option 2 – Resign from the College
Once resigned and no longer a member of the College, a former College member may provide services that any member of the public can provide without being a regulated health professional, for example providing breastfeeding support or working under delegation administering vaccines to newborns. While they can now perform activities in the midwifery scope, they cannot use the title “midwife” because they are no longer College members.
If a member in the Inactive class resigns and later wishes to resume practise in Ontario, they must submit a new application for a certificate of registration, pay all applicable fees, and meet all registration requirements in force at the time of application.
To learn more please refer to the Inactive Class Information found on our website here.