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APA Type 2 and Second Birth Attendant Standard

April 5, 2018

Note: This article was originally posted in our April 2018 newsletter, and has not been updated.

The Second Birth Attendant standard sets out the College’s expectations for non-midwife attendants who provide intrapartum and postpartum care in the role of a second midwife.

Currently, the College’s Second Birth Attendant standard applies only to midwifery practices in Alternate Practice Arrangements (APA 2) that grants “permission” to work below the College’s Model of Care standard that requires the attendance of two midwives at every birth.

The new Professional Standards for Midwives 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 new standard, we have eliminated the need for midwives to work in APA 2s, effective June 1st.

With the implementation of the Professional Standards, the Model of Care standard will be rescinded in the summer of 2018, and the requirement for two midwives at a birth will be replaced by the requirement of either two midwives or one midwife and a second birth attendant.   For this reason, we revised the second birth attendant standard to better define the expectations for midwives who work with second birth attendants.

The College has established a minimum standard that is in the best interest of midwifery clients and their newborns. The new standard will come into effect on October 1st and the major changes to the second birth attendant standard are as follows:

  • The new standard has been revised to address the midwife’s responsibilities rather than the second birth attendant’s accountabilities because the College’s standards are setting minimum requirements for midwives.
  • The details about clinical care and descriptions about acceptable and unacceptable tasks in the current second birth attendant standard have been removed because the midwife working with the second birth attendant is responsible for ensuring the competence of the second birth attendant and can assign tasks and delegate accordingly.
  • Certain second birth attendants will be required to obtain a certificate of completion from the Neonatal Resuscitation Program (NRP) every 12 months.

This new standard will come into effect on October 1 2018, and midwives are encouraged to review it well in advance in order to make any necessary changes. You can see the new standard here.

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