Guiding Documents
Guides for Midwives
These documents outline procedures and define or describe standards related to legislation or regulation. Guides assist midwives with their understanding of College requirements or legal obligations imposed by other authorities.
Professional Misconduct Guide
Gives an overview of actions and behaviours that constitute professional misconduct.
Mediating Risk in Caring for Related Persons & Others Close to Midwives
Provides guidance to midwives who are asked to provide treatment to their family members or people with whom they share a close relationship.
Guide on Removing & Withholding Information Under s. 23 of the Code
Describes situations in which registrant information can be deemed obsolete or irrelevant and be removed from the College’s website.
Guide on Mandatory and Permissive Reporting
Outlines circumstances where midwives, employers, and operators of facilities are required to file a mandatory report with the College.
Guide to the Health Care Consent Act
Lays out the obligations of midwives in obtaining consent from clients for treatment.
Guide on Compliance with Personal Health Information Protection Act (PHIPA)
Provides an overview of the responsibilities of midwives in handling personal health information.
Guides for Clients and Members of the Public
Guide on Funding Therapy and Counselling
Information on obtaining funding for therapy and counselling for individuals who were, or may have been, sexually abused while being treated by a midwife.
Sexual Abuse Complaints Guide
The midwife-client relationship is based on trust. Sexual abuse by a midwife violates that trust and is never acceptable. This guide is intended to help a client understand why it is important to report sexual abuse and what to expect when a report is made.
Guide to Filing a Complaint
A step-by-step guide for clients and other members of the public who wish to file a complaint with the College.
College Guidelines
The guidelines below are best practice suggestions for midwives. They do not establish a minimum standard and are not mandatory.
Guideline for Reporting Sexual Abuse
This guideline assists midwives who believe that another regulated health professional has sexually abused a client in making a report, and defines when reporting is mandatory.
Guideline for Midwives Using Social Media & Electronic Communications
This guideline provides suggestions for midwives to consider when using social media or communicating through email and other electronic means.
Guideline on Managing Personal & Practice Health
This guideline assists midwives in recognizing sources of stress, mental illness, and addiction. It provides suggestions on how to manage personal health and wellness.
Guideline on Ending the Midwife-Client Relationship
This guideline describes situations where it’s appropriate for a midwife-client relationship to end and the obligations of a midwife when this occurs.
Guideline on Appropriate Professional Behaviour with Clients
This guideline has been developed to assist midwives in understanding how to maintain appropriate professional boundaries with clients.
Resources
À quoi vous attendre de votre sage-femme (français)
Cette brochure décrit ce à quoi les clientes peuvent s’attendre de leur sage-femme.
What to Expect from Your Midwife (English)
This brochure outlines what midwifery clients can expect when receiving treatment from a registered midwife.
Transitional Certificate of Registration Information
Overview of the transitional certificate of registration and requirements of midwives who are granted registration in this class.
Inactive Class Information
Detailed information about transitioning from active practice to the inactive class of registration and the ongoing requirements for inactive registrants.
Complaints Process for Midwives
Overview of the complaints process and resources available to midwives if they are the subject of a complaint.
Active Practice Requirements Information
Detailed information about the active practice requirements for midwives in the general class of registration.
Jurisprudence Course Handbook
This handbook provides information on the ethical and legal framework for midwives Ontario.
Mandatory Reporting Reference Tool for Midwives
When must midwives make mandatory reports? This chart outlines common reporting scenarios, and provides information about when, how, and what information to include when making a report.
Strategic Documents
Decision-Making Tools
The College is committed to fairness and transparency. This commitment is why we post our decision-making tools online.
Our Regulatory Policy Development Process is our tool for policy development.
Setting and promoting regulations, standards, and policies are some of the College’s core regulatory functions. We are committed to adhering to a rigorous approach to policymaking to ensure that policy decisions are based on a proper evaluation of risk, solid evidence, and a thorough analysis of options and impacts. This process ensures that regulatory tools are not adopted as the default solution but rather introduced to mitigate risk when other non-regulatory options are unable to deliver the desired results.
Our policy development process is based on the principles of good regulation and ensures that:
- Regulation is proportionate to the risk of harm being managed.
- Regulation is evidence-based and reflects current best practice.
- Regular and purposeful engagement is undertaken with partner organizations, midwives, and the public throughout the policymaking process.
- Equity has been adequately considered.
Every policy proposal designed to introduce or revise a regulatory tool (i.e., a statute, regulation, relevant by-law provision, a standard of practice, or regulatory policy) must be accompanied by a regulatory impact assessment (RIA) statement.
Regulatory Impact Assessment
A regulatory impact assessment is an assessment of the expected impact of each regulatory policy initiative that must be done before any regulatory measure is introduced or revised. The results of this analysis are, in effect, a justification of the need for regulation. A regulatory impact assessment is designed to help Board and committee members understand the impact of decisions, structure ideas, test assumptions; and think beyond a regulation-based solution as the default.
The RIA statement addresses the following:
- Problem Definition and Public Interest rationale
- Options to Consider
- Assessment of Impacts of Proposed Change, including:
- Cost-Benefit Analysis
- Equity Analysis
- Data Analysis (including feedback from public consultations)
- Final recommendation
- Implementation and Evaluation Plans
The College of Midwives of Ontario’s Inquiries, Complaints, and Reports Committee (ICRC) investigates public complaints and information the College receives through reports regarding concerns related to professional misconduct, incompetence, or incapacity. Based on this, the Committee decides whether the concerns warrant a referral to the Discipline or Fitness to Practise committee or if some other action would better serve the public interest.
The College’s commitment to fairness and transparency led us to develop the ICRC Risk Assessment Framework.
The framework is designed to guide panels in their assessment of complaints and reports by providing:
- Guidance to panel members in making fair, consistent and transparent decisions,
- Aid in considering clinical and/or practice issues that may be raised in complaints and reports, and
- Context to assess risk of harm posed to clients and the public interest.
Risk is categorized into one of four categories:
- No or minimal risk
- Low risk
- Moderate risk
- High risk
By categorizing all actions into risk categories, decision-makers on the panel can uniformly assess each complaint and report, enabling transparent, consistent and fair decision-making.
For each complaint and report, the ICRC panel will assess the concerns using the following categories:
- Demonstrating Professional Knowledge & Practice
- Providing Person-Centred Care
- Demonstrating Leadership and Collaboration
- Acting with Integrity
- Being Committed to Self-Regulation
In each situation there can be aggravating factors and mitigating factors, each of which will be considered by the panel. Some examples of aggravating factors include prior history, intent, and harm to the client. Some examples of mitigating factors include willingness to address the issue(s), cooperation, remorse, and no harm to the client.
Read the full ICRC Risk Assessment Tool. Get more information on the College’s complaints process.
When information about a registrant’s conduct or actions (that is not a formal complaint) comes to the attention of the College, the Registrar has a responsibility and obligation to take the steps necessary to address the alleged conduct or actions of the registrant.
This decision-making tool assists the Registrar in determining an appropriate outcome relative to risk to the public.
The tool demonstrates a consistent, and transparent formula that informs the Registrar’s decision-making when they consider information and decides on whether a regulatory outcome or further actions are required in the public interest.
The College may decide to conduct preliminary and informal inquiries as part of the process. Preliminary inquiries are not always required but may include obtaining additional information from the source and/or the registrant, or obtaining a copy of the midwifery record relevant to the alleged conduct. The nature of the preliminary inquiries will vary from case to case, depending on the alleged conduct and potential risk to the public.
Review the Registrar’s Investigation Decision Making Tool.
This framework guides decision-making regarding Quality Assurance Program (QAP) non-compliance, enabling a transparent, consistent, and fair process.
This tool guides Quality Assurance Committee panels in their evaluation of a registered midwife’s demonstrated accountability to the QAP.
Review the QAP Non-compliance Decision Making Tool.
All midwives and applicants re-entering active practice are required to demonstrate clinical competence in accordance with the requirements set out in the Registration Regulation, made under the Midwifery Act, 1991.
Where a registered midwife or an applicant has a clinical experience shortfall or deficiency, a requirement for clinical experience may be met by successfully completing a requalification program that has been approved by a panel of Registration Committee for that purpose.
This tool is designed to support consistent decision-making by the
Registration Panel when:
- Assessing the extent to which deficiencies identified in a midwife’s or an applicant’s clinical experience affect their ability to provide competent midwifery care, and
- Identifying what measures should be taken to satisfactorily address the deficiencies in the applicant’s or the registrant’s clinical experience.
Review the Registration Panel Risk Assessment Tool for Determining Requalification Programs.
To maintain a general certificate of registration, all midwives in the general class are required to actively practise the profession in accordance with s.12 of the Registration Regulation, made under the Midwifery Act, 1991.
Where a registered midwife has a shortfall in birth numbers and does not meet the active practice requirements (APR), the registrant is referred to a panel of the Registration Committee for consideration of a shortfall plan, the existence of extenuating circumstances or the need for a term, condition, or limitation to be imposed on the certificate of registration.
This tool is designed to support consistent decision-making by the registration panel when:
- Assessing the extent to which shortfalls in registrants’ active practice affect their ability to provide competent midwifery care, and
- Identifying what measures should be taken to satisfactorily address the deficiencies in the registrant’s active practice.
On Call Newsletters
On Call Summer 2024
On Call is the College’s digital newsletter offering quick and easy-to-read information about midwifery standards and regulation in Ontario, including practice advice, updates to practice standards, changes to regulation and legislation, and other news affecting midwifery practice.
Videos
Consent in Midwifery Care
This video was created to help midwives understand their professional and legal obligation to obtain informed consent when providing treatment to clients.
Let’s Talk Privacy with Kate Dewhirst
The College of Midwives of Ontario and the College of Physiotherapists of Ontario welcomed privacy expert and health lawyer Kate Dewhirst to provide privacy information for regulated health professionals.
Mandatory Reporting Webinar
This webinar, produced in collaboration with the Association of Ontario Midwives, discusses mandatory reporting requirements for midwives.
Professional Development Portfolio Webinar
Information on what the College’s Quality Assurance Program requires of midwives (including those in the inactive class of registration).
Presentations
Deanna Williams on the role of regulatory colleges
Dr. Zubin Austin on professionalism and competency