Registration Currency Policy Consultation (Feedback from midwives)

Background

Since 2020, the College has been working on updating the Registration Regulation to better align its requirements with the evolving landscape of the midwifery profession.

The primary goal of the proposed changes is to provide greater flexibility in order to meet the diverse needs and practices within the profession.

Why now?

The current regulation does not fully reflect how midwifery care has grown, as its main focus is on requiring midwives to provide full scope of midwifery care and attend a set number of births. The existing regulation even specifies the number of births that must be attended in hospital and out-of-hospital. According to the regulation, these requirements are the only way for midwives to demonstrate that they are current and apply to both midwives in the general class and midwives wishing to move from the inactive to general class.  

The College knows that registered midwives contribute to the profession in many other meaningful ways. As a result of the existing regulation:

• Many registrants are referred to the Registration Committee for review, which may cause disruption or delay in providing midwifery care;
• Due to their limited authority, Registration Committee orders may not align with the registrant’s scope of practice, to the possible detriment of the client, the midwife, and their practice.

The proposed changes to the regulation directly address these issues by removing the prescriptive nature of the definition of currency. Instead, the College’s Board will be empowered to set minimum requirements for the profession, ensuring the public is protected while reflecting the evolving nature of the profession.

Purpose of the consultation

In anticipation of the changes to our Registration Regulation, we are working to develop a policy on currency that will enable registrants to demonstrate the necessary knowledge, skills, and judgment required to practise midwifery safely and ethically. The College’s primary mandate is to regulate in the public interest and the policy will aim to achieve this by including all types of midwifery activities.

We are seeking your input in this consultation process to help shape the following key objectives:

• Define the minimum requirements that demonstrate midwives have the judgment, skills, and knowledge necessary for safe practice;
• Highlight midwifery activities that are directly connected to and support safe practice;
• Establish an effective framework for reporting on these requirements when needed.

We are particularly focused on identifying any gaps in our proposed approach and areas requiring further clarification. Your feedback is crucial in helping us refine these regulatory provisions to ensure they effectively serve the public while reflecting the realities of midwifery practice.

Why do registrants need to demonstrate currency?

As the body mandated to oversee the midwifery profession, the College is responsible for ensuring the public is protected. Without any assurances that a framework exists to hold registered midwives accountable, the profession risks its ability to self-regulate.

Professional currency demonstrates that a registered midwife possesses the up-to-date knowledge, skills, and judgment required to practice the profession competently and safely.

We are committed to working with registrants to find a fair and proportional way to develop this framework. Our focus is to implement a policy that ensures that:

• The public is safeguarded, ensuring that midwifery care and practices meet the College’s high standards.
• The public is assured that there is a framework in place to regulate registered midwives.
• Only registered midwives who have the necessary skills and knowledge can provide care to clients.
• The policy reflects the evolving nature of the profession and inclusive of all types of midwifery practice.
• The policy is continuously assessed to ensure its effectiveness and can be adjusted as appropriate.
• The policy does not create undue burden for registrants to report to the College.

It is important to note that all holders of a general, supervised, or transitional certificate of registration are already required to report to the College, and this proposed policy does not alter that expectation. What it does is expand the range of activities that can be reported, offering more flexibility.

For registrants in the inactive class who remain in that class, there will be no change—they will not be required to report.

This proposed policy primarily benefits those who are unable to meet the currency requirement in place today. Broadening the definition of currency will enable these individuals to be registered in the general class without restrictions.

Current requirement

Active Practice Requirement

2 years following registration	Provide midwifery care to 40 women Attend birth: 20 in the role of primary 10 in hospital 10 out-of-hospital
Every subsequent 5 years	Provide midwifery care to 100 women Attend birth: 50 in the role of primary 25 in hospital 25 out-of-hospital

Registered midwives who do not meet this requirement are referred to a panel of the Registration Committee.

Proposed Policy

Unlike the existing requirements whereby currency can only be demonstrated based on birth attendance, registered midwives will now be able to demonstrate currency using both clinical or non-clinical midwifery activities.

These will be measured in terms of units, or Midwifery Care Units (MCU).

To demonstrate currency, a registrant must complete a minimum number* of Midwifery Care Units (MCU) every two years to demonstrate that they practise midwifery.

How are activities measured?

• Clinical activities are measured in terms of client interactions and follow the reporting model used by the Better Outcomes Registry & Network (“BORN” or BORN Information System, BIS).
• Non-clinical activities are measured in terms of hours due to their diverse nature, with one MCU equating to 48 hours of non-clinical activities.

Examples of eligible activities

Clinical activities Full scope/base course of care Client encounters (an interaction between a client and the registrant for the purpose of providing midwifery service(s) or assessing the health status of the client) Intrapartum care (primary and second)

Non-Clinical activities Academic/teaching Administrative or leadership activities in the field Advocacy or governance activities in the field Research and education Workshop, courses, training EDI-related activities

 *the public consultation will assist with the compilation of this list