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.
UPDATE: Changes are coming to the Alternate Practice Arrangement (Type 2).
All practices with an APA type 2 should have received an email from the College of Midwives of Ontario in January of this year, advising that renewal of APA type 2s was extended to December 31st, 2017. This update is to let you know that if you currently have an APA type 2 with the College of Midwives of Ontario, you are not required to renew.
New Professional Standards for Midwives
Our current Midwifery Model of Care Standard states “Two midwives attend each birth regardless of setting except in circumstances permitted by the College of Midwives under approved Alternate Practice Arrangements.” Because so many practices cannot meet the standard of having two midwives at each birth, we plan to rescind this standard completely, as part of the implementation our Professional Standards.
The proposed new standard will require midwives to “ensure that every birth you attend as the most responsible provider is also attended by a second midwife or another individual competent to perform the role of second attendant.” With this in place, there would be no need for the APA type 2 program, and it could be eliminated completely. We anticipate that the Professional Standards will come into force on June 1, 2018, and that the APA type 2 program will end at that time.
What does this mean for practices that currently have an APA type 2?
Your practice is able to continue with your APA type 2 until the Professional Standards come into force, and you will not have to renew this agreement with the College again. If you have any change to your arrangement, whether someone is leaving or you need to add a second birth attendant to your practice, you are still required to advise the College.
With the implementation of the Professional Standards, all midwives would be able to work with a second birth attendant, provided they have the competencies as defined by the Second Birth Attendant Standard. We will also be revising the Second Birth Attendant Standard to define what is required of an individual competent to perform of role of second attendant, and the revised standard will be brought to Council for approval in March 2018.
APA Type 2 – Second Birth Attendant
April 1st to March 31
*For an Emergency Preparedness APA, the period covered is the duration of the emergency.
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
2nd birth attendant for hospital births (non-hospital staff)
2nd birth attendant for hospital births (hospital staff)
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.
Director of Policy & Quality Assurance
firstname.lastname@example.org or 416-640-2252/1-844-640-2252 ext 231