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Alternate Practice Arrangement (APA)

Alternate Practice Arrangement (APA)

The Alternate Practice Arrangement (APA) program is in place to support inter-professional care models and was developed in response to requests from midwives for flexibility in the delivery of midwifery care. It is currently under review. Read below for more information, and if you have further questions, please contact College staff at

APA Type 1 Extension for Members

This update is for all members of the College with a current Alternate Practice Arrangement (APAs) Type 1.  A proposal to eliminate the APA Type 1 (Modified Primary Care) program is going forward to the College of Midwives of Ontario Council on June 13th.

If you are a midwife that currently has an APA Type 1 with the College, note that you are not required to renew your agreement.  

We do not anticipate that the way you practise will change as a result of eliminating this program. Some members will be able to continue practising without requiring the College’s approval, and some members may have to change the way they request exemptions from Active Practice Reporting and Quality Assurance Program requirements. In exceptional circumstances, some members will be able to request a waiver from the Registrar to exempt them from certain standards.

You can review the full proposal in the Council’s meeting materials on our website here.

Following the Council meeting, we will be in touch to let you know Council’s decision, and provide detailed information for members who currently have APA Type 1s.