About this consultation
The College’s commitment to risk-based regulation requires a rigorous approach to policy development. This means revisions to the College’s policies and standards must be based on numerous factors including an evaluation of risks of harm, research evidence, and an analysis of options and impacts. This process ensures that our regulatory tools are not adopted as the default solution but are introduced to mitigate risk when other non-regulatory options are unable to deliver the desired results.
Consultation with midwives, midwifery and regulatory organizations, and the public is an essential part of our policy development process, and in keeping with our guiding principles of accountability and transparency.
The Professional Standards for Midwives requires that all births must be attended by a midwife and a second birth attendant defined as an individual, other than a midwife registered with the College of Midwives of Ontario, who works with a midwife to provide care during labour, birth and the immediate postpartum, not in a subsequent postpartum visit. The Second Birth Attendant Standard sets out the minimum requirements for midwives working with second birth attendants and requires, among other things, that second birth attendants h0ld certificates of completion in neonatal resuscitation (NRP), cardiopulmonary resuscitation (CPR) and obstetric emergency skills (ES).
College standards should be achievable by all midwives and this standard is not achievable by midwives practising in some rural practices that are unable to reliably find second birth attendants who can certify in NRP. The reason they are unable to find second birth attendants with NRP certification is because only a small number of licensed or regulated health professions are eligible to participate in NRP courses and these care providers are difficult to recruit and retain in areas with shortages in health human resources.
This standard was revised so it is achievable by all midwives by requiring midwives work with second birth attendants who are competent in NRP rather than certified in NRP.
Addition – A line has been added to the definition of second birth attendant to specify that second birth attendants may be care providers who are regulated or who are not regulated. This means that midwives will be permitted to work with second attendants who are not licensed or regulated health professions or students of a licensed or regulated health profession.
Revision – The requirement that midwives must work with second birth attendants who are certified in NRP has been replaced with the requirement that midwives must work with second birth attendants who are competent to assist in the provision of care to clients during neonatal resuscitation.
The proposed Second Birth Attendant Standard
- Are the proposed requirements clear?
- Are risks of harm to the public addressed?
- Is the standard achievable for all midwives?
- Is there anything missing?
This consultation is open until May 11, 2022