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Midwives may be redeployed to provide hospital-based care outside of scope

April 22, 2021

The College has just received a memo from the Ministry of Health providing information on new directives in effect in Ontario. The new regulation is available to read here: Ontario Regulation 305/21 Regulated Health Professionals, made under the Emergency Management and Civil Protection Act, 1990.
A new order under the Emergency Management and Civil Protection Act, 1990 (EMCPA) authorizes health care professionals including midwives to provide patient care services outside their regular scope of practice and enables hospitals to employ, contract, appoint or otherwise engage regulated health professionals from out-of-province.
Under this new order, health professionals, including midwives, from Ontario or out-of-province are authorized to engage outside of their regular scope of practice provided it is necessary for the health care professional to provide such services to respond to, prevent, or alleviate the effects of the COVID-19 outbreak. The services provided must also be consistent with the duties that have been assigned or the privileges that have been granted by the hospital.
The College interprets this new order to apply only to practising midwives providing care within a hospital (who are either employees of or hold privileges in that hospital).  It does not permit midwives to practise outside of scope while they are working in a clinic or home setting.
This is a change from recent orders as it allows regulated health professionals with hospital privileges to provide care outside of scope, not just under delegation but under their own authority, as long as the services are consistent with the duties that have been assigned or the privileges that have been granted by the hospital.
While this order allows midwives to work outside of scope and care for individuals who are not pregnant, recently postpartum, or newborns, midwives are still required to work within their abilities and only deliver services they are reasonably qualified to provide. A member of the College continues to be subject to the jurisdiction of the College for incompetence that occurs while the member provides services under this new order.
Registered midwives who are authorized to practise in other Canadian jurisdictions may be employed by Ontario hospitals under this new order. These midwives do not have to register with the College of Midwives of Ontario and are not permitted to work as midwives in the community setting with midwifery practice groups or at birth centres.
The College has just become aware of these changes and will continue to monitor the situation. Should we have any additional guidance we will be in touch in the coming days. In the meantime, we are asking midwives to let us know if you have any questions about experiences you have working in hospitals under this new regulation.
I know that this is a very hard time to provide health care in Ontario. I want to let you know how much we appreciate all that you are doing to keep your clients, communities, and families safe during this extraordinary time.


Kelly Dobbin
College of Midwives of Ontario

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