November 22, 2017

Postpartum Ultrasounds in Independent Health Facilities

Earlier this year, we wrote to the Ministry of Health and Long-Term Care seeking additional clarification regarding the ordering of a postpartum ultrasound by a midwife.

Midwives have the authority to order pregnancy diagnostic ultrasounds and pelvic diagnostic ultrasounds under the Controlled Acts Regulation of the RHPA. However, the Schedule of Facility Fees for Independent Health Facilities (IHF Schedule) states “Ultrasound for normal, complicated or high risk pregnancy (but not for the postpartum period) rendered in an Independent Health Facility is insured when referred by a midwife who is a member of the College of Midwives of Ontario.”

We had heard that this had been interpreted by IHFs to mean that postpartum ultrasounds are uninsured. A restriction on payment in the IHF setting presents a barrier to optimal care, and would be arbitrary, as midwives can order these ultrasounds in the hospital setting.

In our mandate of protecting the public, and ensuring quality midwifery care, we wrote to the Ministry for some clarification on this matter, and the Ministry has now sent a bulletin to all Independent Health Facilities regarding the ordering of postpartum ultrasounds by a midwives. From the bulletin: “In the postpartum period, midwives have the scope of practice to order insured pelvic ultrasounds, and IHFs can be paid the facility fee to provide a pelvic ultrasound, which is the appropriate service. ”

Click here to read the full bulletin for further clarity.