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 intended to support midwives who have innovative proposals to contribute to health care needs in their community, or who require flexible work options to remain in the profession.

The College of Midwives has identified two alternate practice arrangements whereby:

Type 1 – A midwife or midwifery practice works within a modified primary care model with other health care professionals and/or,

Type 2 – A midwife or midwifery practice that works with a second birth attendant who is not a registered midwife (formerly TAPA.)
Midwives applying for an Alternate Practice Arrangement must complete the required application form. Applications for Type 1 will be reviewed by College staff to determine if the APA meets the criteria, and notice of decision will be issued within 45 days. New applications for Type 2 will be reviewed by CMO staff and a response will be issued within 30 days.


A one-time fee of $100 is due at the time of application for an APA and the fee is $50 at time of renewal.

There is no fee to make changes to the APA between renewal periods. Changes may include the addition or reduction of Second Birth Attendants between renewal periods, or changes to scope in an APA1.

Renewal of APA:

APAs must be renewed annually by March 1st for the period starting April 1st to March 31st. Note that these renewal timelines do not apply to an Emergency Preparedness APA (Type 2).

At renewal, APA Type 1 applications will be assessed to determine if the APA continues to fit College criteria and to make recommendations or requirements regarding the evaluation component.