Read our digital newsletter for information on the new Designated Drugs and Substances Regulation, three open public consultations, new practice advice, Council highlights, 30 years of regulated midwifery, and more!
*new* Designated Drugs and Substances Regulation
The Designated Drugs Regulation has been expanded, effective Friday, May 3, 2024 to improve client care through more direct access to necessary drugs and substances.
The new Designated Drugs and Substances Regulation adds drugs and substances to the list of drugs that midwives may prescribe and/or administer on their own authority. These new drugs and substances will reduce the need for midwifery clients to seek care from a physician for treatment that is within the midwifery scope of practice, improving the quality and timeliness of care for clients.
Practice Advice: Identification and Management of Hypertensive Disorders of Pregnancy
Case Scenario: You receive a late-to-care client who is booked for their initial intake appointment at 28 weeks gestational age. As you conduct the appointment, you review their prior medical records, which indicate a history of preeclampsia in a previous pregnancy.
You assess the client in your office, and their blood pressure (BP) on your clinic’s automatic sphygmomanometer is 152/88. You retake their BP and again, it’s high, with a reading of 158/92. Their urine tests negative for protein. You ask your client if they’ve experienced swelling, epigastric pain, or any feelings of being unwell, and they say no, but tell you over the past few weeks, they have had a few BP readings on their “old monitor left over from the last pregnancy,” of over 150/90.
You know that this could be serious, but you aren’t yet sure if it’s actually a hypertensive disorder of pregnancy (HDP), as your client seems well, has no other symptoms, and really doesn’t fit the profile of previous clients you’ve had with HDP.
You consider your options: sending this client into emergency will probably result in a long wait for your client, and they have their four- and eight-year-old children with them. Deep down, you’re worried about over-reacting. The last time you had an assessment like this in the hospital, you had an uncomfortable interaction with the on-call doctor who seemed frustrated with you for “wasting time and resources.” You’re also nervous, and ask yourself, “what if this really is preeclampsia?” You are undecided about next steps, and feel under pressure to take the correct course of action.
Laboratory and Specimen Collection Centre Licensing Act, 1990 Consultation
We are pleased to share that the Ministry of Health is now consulting on proposed changes to the General Regulation under the Laboratory and Specimen Collection Centre Licensing Act, 1990.
Expanding the list of laboratory tests that midwives are able to order will ensure clients have access to necessary tests during pregnancy, birth, and postpartum, and decrease the number of unnecessary consultations with other health care providers for routine tests.
There are many new additions to the list of laboratory tests that midwives may be able to order, including point of care tests like the Group B Strep rapid screen, and genetic screening tests like Non-invasive Prenatal Testing (NIPT).
General By-law Consultation
The General By-law has been reviewed by Council and the College is consulting on several proposed changes.
A comparison table on our website outlines the current provisions in the by-law, along with proposed changes and their respective rationales. A summary of proposed changes follows.
In reviewing the by-laws, the following changes were applied throughout to update:
Language and definitions
- ‘Council’ to ‘Board’
- ‘Member’ to ‘Registrant’
- ‘Council Member’ to ‘Board Director’ (elected and appointed)
- ‘Inactive’ to ‘inactive/non-practising’ – to include the wording in the proposed Registration Regulation that was submitted to the Ministry of Health in May 2023.
- Accessible and inclusive language – the By-law had already been reviewed to use gender-inclusive language in 2018.
Aligning with current best practice
- Removing sections that no longer apply.
- Simplifying and aligning with other governing legislation, such as the Regulated Health Professions Act, 1991 and the Health Professions Procedural Code, by removing duplicate language and/or adding references for clarity.
- Building in flexibility where possible to enable governance modernization, procedural fairness, and equitable practices.
The proposed changes to the by-law are open to a 60-day public consultation from Thursday, April 4, 2024 to Monday, June 3, 2024. Following the 60-day consultation, the General By-law and feedback will be brought to Council for final review and approval at its June 2024 meeting.
Fees and Remuneration By-law Consultation
The Fees and Remuneration By-law has been reviewed by Council and the College is consulting on several proposed changes.
To provide greater clarity on the proposed changes to the Fees and Remuneration By-law, we would like to highlight three substantial areas of change for consideration. Please refer to the full consultation table to learn of all proposed changes and give your feedback after reading the document.
- Changing the automatic annual increase in fees: This would allow for the College to decide to freeze fees in a given year, as is being proposed for the 2024 renewal period.
- Elimination of installment payments: Council is proposing the removal of installments. Registrants facing financial challenges will still have the option to request a modified payment plan.
- Changes to administrative fees in some areas: The College is proposing to increase administrative fees in some instances and remove administrative fees in other areas.
The proposed changes to the by-law are open to a 60-day public consultation from Thursday, April 4, 2024 to Monday, June 3, 2024. Following the 60-day consultation, the Fees and Remuneration By-law will be brought to Council for final review and approval at its June 2024 meeting.
Welcome New Council Members
We are pleased to advise that Alexia Singh, RM and Lynne-Marie Culliton, RM have been acclaimed to fill the two open professional member positions for Council.
The new Council term will begin in October, 2024.
Alexia Singh, RM
Alexia Singh is a Black identified, registered midwife. Alexia has been registered since 2015 and is pursuing her Master’s degree in Midwifery at McMaster University. She has also worked as sessional instructor for the Midwifery Education Program and continues to mentor racialized midwifery students in the community.
Alexia has recently started a new adventure as the Clinical Lead at Ancestral Hands Midwives, a newly funded expanded midwifery care model that will be exclusively providing midwifery and reproductive care to people within the African, Caribbean, Black diaspora who reside in the GTA. This collaborative, interdisciplinary program will allow equity-deserving populations to access midwifery in a non-traditional way.
A community midwife working with Oak Valley Health’s Alongside Midwifery Unit since its inception, Alexia is also happy to continue to contribute to her community as a casual hospitalist.
Alexia is excited to be moving into her second term as a Council member and looks forward to continued learning and collaboration for the midwifery community in the public interest.
Welcome back, Alexia!
Lynne-Marie Culliton, RM
Bringing a wide range of experiences and a deep commitment to advancing midwifery care, Lynne-Marie Culliton, a registered midwife since 2002, is excited to join the Council for the College of Midwives of Ontario.
As a person with a disability, she brings a unique perspective to her work, advocating for accessibility and equity in maternal health services.
Her invaluable contributions extend to rural areas, where she tirelessly champions maternal health initiatives, ensuring that people in underserved regions receive the highest standard of care.
As a recent graduate with a Masters in Midwifery and a career marked by dedication to inclusivity and innovation, she specializes in the expanded model of midwifery, offering comprehensive sexual and reproductive health care to diverse communities.
Welcome, Lynne-Marie!
Thank you Hardeep Fervaha
We would also like to thank outgoing Council member Hardeep Fervaha, RM, for her service over the last three years and for all her contributions to the Council and committees.
March Council Highlights
At the March Council meeting, Council members approved the 2024-25 budget (a balanced budget that includes a planned freeze on registrant fees), received an update on our Operational Plan, approved public consultations on two College by-laws, and more. Our quarterly Council meetings are open to the public. We post the Council package publicly in advance of each meeting.
30 Years of Regulating in the Public Interest
For 30 years, we have worked to ensure that midwives in Ontario are qualified, skilled, and competent to practise so all Ontarians can be confident in the care they receive from registered midwives. We have supported midwives in providing their best care to clients – and we’ve been there for clients when they need us.
Since the Regulated Health Professions Act, 1991 and the Midwifery Act, 1991, were enacted on January 1, 1994, Ontario’s midwives have been fully integrated within the public health care system and care for parents and babies through pregnancy, childbirth, and into infancy.
We’ve put together a timeline celebrating milestones from the last 30+ years of regulated midwifery in Ontario.
Unauthorized or Illegal Practice Webpage
The College of Midwives of Ontario is increasingly aware of individuals who are providing care they are not authorized by law to provide. Only midwives registered with the College of Midwives of Ontario and Indigenous midwives are able to provide midwifery care in Ontario.
The College takes the unauthorized and illegal practice of midwifery very seriously and works to address these instances to ensure the public remains confident in receiving safe and ethical care from qualified midwives. We’ve updated our website to provide more information on unauthorized or illegal midwifery practice in Ontario.
Professional Development Portfolio
Thank you to everyone who joined us for our webinars about the College’s Quality Assurance Program, including the Professional Development Portfolio. If you missed the webinar, or if you’d like to revisit part of the presentation, please take a look at the uploaded recording.
Neonatal Resuscitation Program, CPR, and Emergency Skills Requirements
All practising midwives renewing their registration with the College in 2024 are expected to have completed full training in neonatal resuscitation (NRP), cardiopulmonary resuscitation (CPR), and emergency skills (ES). NRP certification must be completed every 12 months. CPR and ES certification must be completed every two years.
NRP, CPR, and ES must be current on October 1, 2024, to meet the College’s registration renewal requirements. Midwives can review their documents now and make any necessary arrangements to ensure they will have current NRP, CPR, and ES on October 1, 2024.
College Performance Measurement Framework (CPMF)
The Ministry of Health introduced the College Performance Measurement Framework (CPMF) in 2020. The CPMF was developed by the Ministry in collaboration with health regulatory colleges, members of the public, and subject matter experts. The CPMF sets standards against which all Colleges are measured related to performance in executing our public interest mandate and highlighting practices related to regulatory excellence.
Our 2023 CPMF report is posted publicly to our website. We’re proud of this year’s report where we once again demonstrated compliance with the standards and reported on our continuous improvement efforts.