Scope of Practice Changes

Midwives are now authorized to both order and apply soundwaves for pregnancy diagnostic ultrasound or pelvic diagnostic ultrasound to their clients.

The College has worked closely with the Ministry of Health and Long-Term Care to make amendments to the Controlled Acts Regulation under the Regulated Health Professions Act, 1991. The changes to the regulation clarify that midwives are now authorized to both order and apply soundwaves for pregnancy diagnostic ultrasound or pelvic diagnostic ultrasound to their clients.

When applying ultrasound, all midwives must meet the following requirements:

Be accountable for your professional decisions and actions
Have the appropriate knowledge, skills, and judgement to perform the procedure
Always work within the limits of your competence
Consult with another care provider when the required care exceeds your knowledge and skills
Ensure appropriate maintenance of the equipment

What has changed in the Regulation?

On January 1, 2018, the Controlled Acts Regulation (O. Reg. 107/96: CONTROLLED ACTS) was revised allowing midwives to apply soundwaves for pregnancy diagnostic ultrasound or pelvic diagnostic ultrasound. This means that now midwives are able to perform all diagnostic ultrasounds they are authorized to order.

What has not changed in the Regulation?

Midwives are not authorized to order or perform diagnostic ultrasounds on newborns or on women who are not pregnant or postpartum. Midwives are not authorized to order or perform diagnostic ultrasound for conditions that are not related to a pregnancy, birth or postpartum.

Are midwives required to perform ultrasounds?

No – midwives are not required to perform diagnostic ultrasounds.

Midwives are required to order ultrasounds as part of the routine screening and diagnostic testing done during the course of midwifery care but performing ultrasounds involves a set of skills that midwives are not required to have.

What kind of training do midwives need to be able to perform ultrasounds?

A midwife who wants to perform pregnancy and pelvic diagnostic ultrasounds must participate in education and training to gain the knowledge and skills required to perform them. The College does not specify the education and training programs that midwives must take but requires midwives to be competent.

What responsibilities do midwives have if they perform ultrasounds?

As with any test, a midwife performing a pelvic or obstetric diagnostic ultrasound is responsible for interpreting the results; recognizing any abnormal conditions; recommending and initiating treatment; consulting with another care provider, or referring to another health care provider as appropriate.