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Clarification re: COVID-19 tests midwives are authorized to perform

December 22, 2020

On April 1, 2020, the College sent midwives frequently asked questions (FAQs) with guidance relating to COVID-19. One of the FAQs stated that midwives were able to order and perform COVID-19 testing. However, the FAQ did not state that midwives require a delegation to perform nasopharyngeal swabs. 
The information provided in the April FAQ was updated on December 21, 2020, to clarify the authority of midwives to perform COVID-19 tests. This updated FAQ (also provided below) replaces the content in the April FAQ relating to COVID-19 testing, and midwives should use it as guidance for their practice decisions relating to COVID-19 testing.
Midwives are permitted to perform some, but not all, tests for COVID-19.

Midwives are not permitted to perform nasopharyngeal swabs (NP swabs) and deep nasal swabs on their own authority as they require the performance of the controlled act of “putting an instrument, hand or finger beyond the point in the nasal passages where they normally narrow.” Under the Midwifery Act, 1991, midwives do not have the authority to perform this controlled act. Midwives are only permitted to perform these tests under delegation if they have the knowledge, skills, and judgment to safely do so.

Midwives are permitted to perform anterior nasal swabs and throat swabs, as they do not require the performance of a controlled act. Midwives must only perform these tests if they have the appropriate training to do so and must follow Public Health recommendations for testing.While NPS is the optimal specimen collection method for COVID-19 testing, as per the current Public Health Ontario guidance, when NP swabbing cannot be performed, including in remote and low resource communities where there is not a health professional with the requisite or delegated authority, combined swabbing of the throat AND both nostrils (anterior nares) is a preferred alternative method. 
Access the College’s COVID-19 FAQs for midwives by clicking here