The College of Midwives of Ontario takes our public-interest mandate seriously. While we have been committing to serving midwifery clients and their families since our inception, our 2018 Scope of Practice Changes submission is in the interest of all Ontarians accessing health care. Our proposal is safe, provides cost-savings, will benefit midwifery clients and their families, and reduces the burden on Ontario’s health care system as a whole.
Health Care Access
According to Health Quality Ontario (HQO), access can be measured as the percent of patients who report that they were able to get a same or next-day appointment when they were sick or needed medical attention. In 2019, HQO reported that only 40.6% of adults were able to access care when they needed it even though 93.3% had primary care physicians.
The government’s new health plan, Your Health: A Plan for Connected and Convenient Care, includes welcome and needed initiatives to address the tremendous pressure on Ontario’s health care system.
In this context, we believe it is essential that midwives are able to practise to their full scope. Not only would this provide optimal care for midwifery clients, but it would lessen the burden on the health care system overall, allowing more Ontarians to access the care they need when they need it. We were pleased to see the Your Health document include mention of possible changes to midwives’ scope of practice.
Scope of Practice Changes Submission
The College has been recommending changes to the ways midwives can administer and prescribe drugs and order laboratory tests for some time. In our 2018 submission, the College requested the Ministry rescind the current list of laboratory tests midwives are authorized to order in Appendix B of the Laboratories Regulation under the Laboratory and Specimen Collection Centre Licensing Act, 2015 (now found in Schedule 2 of the Act). Instead, we proposed the Ministry grant midwives the authority to order laboratory tests within their scope of practice as defined by the Midwifery Act, 1991 and the controlled acts authorized to midwives.
The College also requested the Ministry rescind the list in the Designated Drugs Regulation made under the Midwifery Act, 1991 and allow midwives access to any drug or substance approved by Health Canada, within the scope of midwifery practice.
Benefit to Ontarians
Our submission demonstrates that authority to order tests and prescribe within scope will:
- Ensure clients have access to the tests and treatments required during pregnancy, birth, and postpartum.
- Allow midwives to respond to emerging health situations that pose increased risks to their clients.
- Decrease the number of consultations with physicians for routine tests and treatments.
- Ensure healthy, pregnant people can receive the care they need without unnecessary hospital visits.
The government’s Your Health plan speaks to maximizing expertise of health care workers. The plan states “Delivering convenient care to people in their communities will help keep Ontario healthier by diagnosing illnesses earlier, starting treatment as soon as possible, and keeping emergency room wait times down when you and your family need urgent care.” Midwives ordering lab tests and prescribing in scope is an important part of delivering convenient care for clients because it prevents unnecessary physician visits, reduces duplication of services, and lessens the burden on Ontario’s health care system.
The College of Midwives of Ontario’s role is to set the standard of professional practice for registered midwives and to ensure midwives work within evidence-based practice guidelines to deliver safe and effective care.
We regulate midwifery in the public interest to make sure that the Ontario public and families who choose to work with a midwife can trust and feel confident in that choice.
For more information contact:
Communications and Stakeholder Relations Officer
College of Midwives of Ontario