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Second Birth Attendant Standard

October 1, 2018

The College of Midwives of Ontario’s revised Second Birth Attendant Standard  came into effect on October 1, 2018. All members are now required to follow the revised standard and should be familiar with the changes.

As midwives are aware, the College rescinded the standard requiring two midwives at every birth, as there is no evidence to support the need for two primary care providers at a birth. There are, however, recommendations that every birth be attended by a primary care provider and a second individual who has primary responsibility for the newborn, including the skills to perform neonatal resuscitation.

The College has a duty to the public to set a minimum standard of required performance for midwives. Our Second Birth Attendant Standard assures that midwifery managed home births, where there are fewer human resources to rely on, are attended by a skilled second individual.

That is why College Council made a decision to require that all second birth attendants who provide care in homes or other out-of-hospital locations hold a certificate of completion in NRP. This brings Ontario in line with other midwifery regulators in Canada such as British Columbia, Alberta, Saskatchewan, Manitoba and Nova Scotia.

Council also decided to require second birth attendants who provide care in homes or other out-of-hospital locations to hold a certificate of completion in an obstetrical emergency skills program.  The revised standard requiring all second birth attendants hold certificates of completion is the College’s way of assuring the public that their care providers have demonstrated the knowledge and skills required to participate in an obstetrical emergency.

Over the past few months, some members shared concerns that the Second Birth Attendant Standard is too high for a layperson to meet, as currently the Canadian Paediatric Society’s NRP course will only certify regulated health professionals. Similarly, we have heard that second attendants should not be required to complete the same courses as midwives with regard to the training in obstetric emergency skills.

The College has introduced a new waiver policy,  to acknowledge that in exceptional circumstances, midwives may not be able to meet certain College standards. In these rare cases, standards may be waived.

Midwives who are confident that they will be able to demonstrate to the College that exceptional circumstances exist and that granting a waiver is in the public interest are able to submit their application. More information can be found here.