APA Type 2 – Second Birth Attendant

APA Type 2 – Second Birth Attendant

The standard of the College of Midwives of Ontario is that two midwives attend each birth, unless a practice has been approved for an Alternate Practice Arrangement – Type 2 (APA2). The approved APA allows the practice to use one midwife and a Second Birth Attendant.

In 2016 the College is making some changes to the APA2 program. The most significant change is that the names and professional designation, if applicable, of each Second Birth Attendant will be available on the public register. Moving forward, the College will be collecting this information as part of renewal for the update to the register on April 1, 2016.

Application Types:

  1. Sole Practitioner – a sole practitioner must have an APA–Type 2 in place in order to practice
  2. Group Practice Application
  3. Emergency Preparedness

Period Covered:

April 1st to March 31
*For an Emergency Preparedness APA, the period covered is the duration of the emergency.

Initial Application:

One-time submission of documents. Re-submission of documents is only required if changes to the agreement are required.

If adding a Second Birth Attendant, supporting documentation for each new attendant is required with the renewal application as follows:

2nd birth attendant for home births only

  1. A copy of the contract between the practice and the 2nd birth attendant
  2. A revised Informed Choice Document, if the additions require it.

2nd birth attendant for hospital births (non-hospital staff)

  1. A copy of the contract between the practice and the 2nd birth attendant
  2. A letter from the hospital agreeing to the use of non-hospital staff as 2nd birth attendants
  3. A revised Informed Choice Document, if the additions require it

2nd birth attendant for hospital births (hospital staff)

  1. A letter from the hospital agreeing to the use of hospital labour and delivery staff as 2nd birth attendants
  2. A revised Informed Choice Document, if the additions require it

Processing Time:

A practice may apply for an APA type 2 at any time. A new and complete application will take two to four weeks for processing. Renewals will take 2 weeks for processing.

More Information

Marina Solakhyan
Director of Policy & Quality Assurance
m.solakhyan@cmo.on.ca or 416-640-2252/1-844-640-2252 ext 231