On December 15, 2025, the General Regulation under the Laboratory and Specimen Collection Centre Licensing Act, 1990 was expanded to improve access to laboratory and point of care tests (POCTs) for midwifery clients.
Midwives collect specimens and order and perform laboratory investigations for their clients as part of their midwifery practice. The College of Midwives of Ontario worked with the Ministry of Health to update this regulation to improve access to care for midwifery clients. We are happy to see this expansion to the list of essential lab tests and point of care tests (POCTs) that midwives can order and provide to their clients on their own authority.
The updated regulation adds new laboratory tests to the current schedule, and also adds an additional category of POCTs to the list that midwives may order or perform on their own authority. Access to this expanded list of tests improves the quality and timeliness of care for clients.
As with all elements of midwifery care, midwives must use their knowledge, skill, and judgement to order or perform all items on the list safely and effectively.
The changes to the list include the addition of investigations for hypertensive disorders of pregnancy, infectious disease, and non-invasive prenatal testing (NIPT).
The College understands that these changes will provide improved access to tests and investigations within the midwifery scope of practice. While we are pleased with this expansion to the list, we recognize that specified lists of tests are at risk of becoming outdated as clinical guidance and practice standards change. We will continue to work with the Ministry to find a sustainable solution for clients to continue to receive optimal care by midwives.
Frequently Asked Questions
We have collected some common questions and answered them below. If you have any further questions about changes to your routine practice in light of the new regulation, please contact practiceadvice@cmo.on.ca.
Twenty-nine additional tests have been added to the Schedule 2 of the General Regulation of the LSCCLA.
Five point of care tests can now be found under Section 25.1 (3).
Midwives must be competent in all areas of their practice including ordering, performing and interpreting results of laboratory and point of care tests. As such, prior to providing any midwifery care, midwives must have sufficient knowledge, skill, and judgement to justify ordering or performing tests. Anything less may constitute professional misconduct. Midwives are expected to seek out the resources, courses, and training they need to be competent at ordering and providing tests that they may not have routinely included in their practice prior to this change. This is consistent across midwifery care.
While cord blood gases are routinely ordered by midwives in hospital as per newborn admission protocols, the Ministry did not add them to the list at this time. You can continue to order these in accordance with your hospital policies (i.e., under medical directive).
Midwives who hold leadership roles within the hospital, such as lead midwives or head midwives, are primarily responsible for notifying hospital administration of changes to the Schedule 2 of the General Regulation under the Lab and Specimen Collection Centre Licensing Act (1990). Lead midwives should be open to collaboration with hospital leaders such as the Chief of Medicine, the Medical Advisory Committee, and the Chief of Obstetrics to adapt any current processes that would need to change considering the new regulation. The College of Midwives of Ontario has prepared a letter notifying hospitals to the changes contained within the LSSCA, which can be provided to midwives for them to communicate with their hospitals about these updates.
The College of Midwives of Ontario has also sent a letter to other health regulatory colleges, including the College of Physicians and Surgeons of Ontario and the College of Medical Laboratory Technologists of Ontario, advising these regulators of changes to the LSSCA, with a request for them to share this information with their registrants.
If you have any questions about changes to your routine practice in light of the new regulation, please contact practiceadvice@cmo.on.ca.
The Association of Ontario Midwives has prepared a FAQ document for midwives to provide an overview of each of the new tests added to the regulation.