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Complaints

If you have a concern or complaint about the care you received from your midwife, you have a right to complain to the College. Anyone can file a complaint about a midwife, including a client, a family member or friend of the client, or a general member of the public. There is no time limit on filing a complaint.

The College works to protect the public interest to ensure Ontarians have access to safe, effective, and ethical care. As part of its mandate, it must deal with all complaints received about a midwife’s practice or behaviour. The process is set out in the Regulated Health Professions Act, 1991 (RHPA), and the Health Professions Procedural Code.

If you are comfortable doing so, you can discuss your concerns with the midwife or midwifery practice before filing a complaint. In some cases, you may be able to resolve any concerns you have before filing a complaint. 

If you have questions with respect to the care you received and want to speak to a Professional Practice Advisor before filing a complaint, you may do so. While the advisor cannot help you make a decision about a particular clinical situation, understanding how the standards, legislation, and regulations relate to that situation may inform your decision on whether to file a complaint. To contact our Professional Practice Advisor, please email practiceadvice@cmo.on.ca or telephone 416.640.2252 ext. 230.

Professional Conduct staff at the College assists in the administration of the complaint, but are not involved in the decision making. You can contact the Professional Conduct Department if you have questions about the complaints process or are unsure if you would like to file a formal complaint. If you are unsure of the name of the midwife you want to complain about, Professional Conduct staff can help you. Contact the Professional Conduct department by email at conduct@cmo.on.ca, or by telephone at 416.640.2252 ext. 224.

1. File a Complaint
2. The Complaints Process
3. Alternative Dispute Resolution
4. The Inquires, Complaints, and Reports Committee
5. Overview of the ICRC Complaints Process
6. The Complaints Process Flowchart
7. Frequently Asked Questions

File a Complaint

To initiate a complaint against a midwife, please provide the following information in a written or recorded form, such as a letter, or audio or video recording:

  • Your full name, mailing address, and/or email, and phone number
  • A clear statement indicating that you are filing a formal complaint including the name of midwife you are complaining about
  • Description of events, and the details of the complaint in your own words. Include the date(s) of the incident(s) and the specific issues you would like to complain about (this can be point-form)
  • Name of the midwifery practice, hospital(s) or other health clinics related to your complaint, if applicable
  • Any supporting documentation you wish to include
  • Optional: Your expectation of outcome(s)

There are three ways to submit your complaint:

  • Recommended: Submit your complaint through our secure online submission form. Please include the information listed above, as well as any additional supporting evidence relevant to your complaint. You can submit your complaint on our secure online submission form by clicking here.
  • Alternatively, you may submit your complaint by email: conduct@cmo.on.ca. If you are sharing personal health information, note that regular email is not a secure method of transmission. 
  • Or, submit your complaint by mail to the attention of the
    Professional Conduct Department
    College of Midwives of Ontario,
    21 St. Clair Ave E, Suite 303,
    Toronto, ON M4T 1L9

For additional support, please email conduct@cmo.on.ca, or phone 416.640.2252 ext. 224.

The Complaints Process

After your complaint is received, a College staff member will contact you, usually within two business days, to explain the complaints process and confirm the main issues of your complaint. The College will confirm receipt of your complaint in writing within 14 days. The midwife will be provided with notice of your complaint, along with a copy of your complaint, within 14 days.

The College has two complaint process streams: an alternative dispute resolution process and the ICRC investigative process .

Information about the Complaints processes at the College are also described in College’s Guide to Filing a Complaint.

Alternative Dispute Resolution

Alternative Dispute Resolution (ADR) is an alternative to the College’s complaint process. It allows for the complainant, the midwife, and a third-party mediator to work together to create a resolution that satisfies all parties. With ADR, there is no formal investigation of the complaint. The ADR process will only take place if both the complainant and the midwife agree to resolve the complaint through this process.

Many complaints are eligible for ADR, but the Health Professions Procedural Code states that complaints involving alleged sexual abuse or matters that have already been referred to the Discipline Committee cannot be referred to ADR. The College’s ADR Policy further describes the ADR process and the criteria that must be met to process a complaint in this matter.

Resolutions are unique to each complaint so it is difficult to predict what a resolution may look like. Some resolutions may include one or more of the following:

  • Acknowledgment regarding the incident and the impact it had on the complainant, and/or an apology by the midwife
  • Changes or initiatives set forth by the midwife that will improve future care
  • An agreement by the midwife  to take a remedial course or obtain additional educational relating to an issue(s) identified in the complaint
  • An understanding or acknowledgment by the complainant that the midwife acted appropriately

Complaints that go through ADR are often completed sooner than those that go through the formal complaints process. Resolutions must be reached within 60 days, with a possibility of an extension to 120 days.

Additional information about the ADR process at the College can be found in College’s Guide to Filing a Complaint.

The Inquires, Complaints, and Reports Committee

The Inquiries, Complaints, and Reports Committee (ICRC) is responsible for investigating complaints and determining what action, if any, should be taken to protect the public. The ICRC deliberates on complaints in panels. These panels are comprised of both midwives and members of the public who are appointed by the provincial government to represent the views of the public. In coming to a decision, the ICRC will consider the conduct, the College standards, and the legislation and regulations that govern midwifery practice in Ontario as well as the risk to the public.

Each step of the complaints process is designed to ensure fairness to both the person filing the complaint, and the midwife who is named in the complaint.

The ICRC also has the power to make an interim order at any time following the receipt of a complaint. The ICRC can make an order if it believes a midwife’s conduct exposes or is likely to expose clients to harm or injury.

Overview of the ICRC Complaints Process

In this process, the Inquiries, Complaints and Reports Committee (ICRC) investigates and makes decisions on complaints. The investigation will include obtaining a copy of the relevant midwifery record. Other investigative steps could include obtaining hospital or EMS records, witness statements, etc. if they are deemed relevant to the complaint. Occasionally, the ICRC may decide an expert opinion is required. Sometimes, the ICRC may engage a third-party investigator to conduct aspects of the investigation.

The midwife is asked to respond to the complaint within 30 days. Sometimes extensions are granted. Examples of extensions can include time to obtain relevant medical records, and requests for extensions to respond.

The midwife’s response to the complaint is generally shared with the complainant, particularly if it raises new information and the ICRC requires the complainant’s further comment.

The midwife is provided an opportunity to provide a further written submission on all information gathered in the investigation before the ICRC meets to deliberate and decide on the complaint.
After a thorough review of the materials gathered in the investigation, a panel of the ICRC will then meet to deliberate and decide on an appropriate outcome.

The ICRC panel will use the College’s Risk Assessment Framework to make a fair, consistent and transparent decision on the complaint. The panel could decide to do one or more of the following:

  1. Take no further action, should the panel decide that the midwife met the standards of the profession
  2. Provide advice and recommendations to the midwife
  3. Require the midwife to complete a Specified Continuing Education or Remediation Program (SCERP) which can include courses, papers or chart audits
  4. Administer an oral caution, where the midwife appears before the panel
  5. Require the midwife to sign an acknowledgment and undertaking, which is a voluntary agreement between the midwife and the College to place certain restrictions on the midwife’s practise
  6. Refer specified allegations of professional misconduct and/or incompetence in the complaint to the Discipline Committee
  7. Refer the matter to the Fitness to Practise Committee, should the matter involve an allegation regarding the physical or mental capacity of the midwife.

The panel has no authority to assess injury or award compensation to the complainant. That is the subject of civil court proceedings.

The ICRC will prepare written reasons for their decision. Both the complainant and the midwife will receive a copy of the panel’s written decision in the mail.

The complainant and the midwife have the right to request a review of the decision to the Health Professions Appeal and Review Board (HPARB) within 30 days of the decision being issued. Information about this process will be provided to the complainant and midwife with the decision.

The infographic provides a high-level overview of the College’s ICRC complaints process.
For more information about complaints, please review the Frequently Asked Questions, College’s Guide to Filing a Complaint, and ADR Policy. Alternatively, you can contact a Professional Conduct staff member by email conduct@cmo.on.ca or by telephone 416.640.2252 ext. 224.

To submit a complaint, please complete the Online Submission Form.

This image is an infographic that outlines the College of Midwives of Ontario's Complaints Process. There are five steps in this process with five potential outcomes.

Complaints Process Overview Infographic (LINK to PDF version)

Frequently Asked Questions

Who can make a complaint to the College?

Anyone can make a complaint, including former clients, family members, and other health professionals.

Can I make an anonymous complaint?

You can report your concerns to the College anonymously, but you will not be a party to the process and will not receive a copy of the decision. If you wish to proceed with a formal complaint, we require your information in order to investigate the matter fully.

Can I make a complaint about a Midwifery Practice?

No, you can only make a complaint about individually named members, however, the College can help you identify the Practice Partners and your complaint can be made against them.

Is there a time limit to complain?

There are no time limitations on filing a complaint with the College, but it is recommended that it is filed as soon as possible so the College can investigate your concerns in a timely way.

Will my information be kept confidential?

Health regulatory college investigation procedures are designed to keep information about the complaint confidential. However, it is important to note that your personal information will be released to the health care provider that is the subject of the complaint. You should also be aware that if your complaint is appealed to the Health Professions Appeal and Review Board, or if the complaint is referred to the Discipline Committee, the case will be heard in a hearing which is open to the public.

Will the midwife know I made a complaint?

As a part of the process, the midwife is notified once we receive your letter of complaint. They will also have an opportunity to provide a written response to the College once all of the investigation materials are received.

What happens after a complaint is submitted to the College?

College staff will review the complaint. The College may contact the complainant to introduce themselves, confirm the issues in the complaint if needed, explain the complaints process, and answer any questions the complainant may have about the process.

The complainant will receive a formal acknowledgment of complaint within 14 days of receipt of complaint. 

If the complaint is eligible for Alternative Dispute Resolution, this acknowledgment may include a request that the complainant respond in writing as to whether they consent to participate in this process.

If the ICRC deems certain records to be relevant to their investigation, this acknowledgment may include a request that the complainant provide written consent to authorize the release of medical records, and the relevant consent forms.

The midwife will receive a formal notice of complaint within 14 days of receipt of complaint. The midwife will be provided with a copy of the complaint. If applicable, the College will request the Member to submit the midwifery record to the College.

Note: As part of the investigation process the Client’s personal health information may be obtained by the College.  Midwives are permitted to disclose personal health information about a Client to the College for the purpose of the administration of the Regulated Health Professions Act, 1991 and in accordance with Personal Health Information Protection Act, 2004.

The Complaints Process Overview provides more information about this process.

How is a complaint investigated?

Before the ICRC makes a decision on a complaint, they must complete an adequate investigation. The first step in any investigation is obtaining the midwifery record of the Client (if the complaint is related to a client). The ICRC will determine if further investigation is required. This could include obtaining other health records including hospital records, or other documents relevant to the investigation. It could include interviewing people or witnesses.

Some documents include obtaining the client’s consent to release the medical records. Consenting to release records is voluntary, however, if a complainant chooses not to release records, it may impact the ICRC’s ability to make an informed decision.

Sometimes, the ICRC may request the appointment of a formal investigator. 

The ICRC may obtain an expert or legal opinion for some complaints.

The ICRC attempts to complete its investigation and render a decision within 150 days of receipt of complaint, however this is not always possible. Any additional investigation steps taken may cause delays in the process and impact the ICRC’s ability to complete a timely investigation.

How long does the complaints process take? What are reasons for delays?

The Regulated Health Professions Act ,1991 (RHPA) sets out that complaints shall be disposed of within 150 days after the complaint is received.  The legislation requires the College to send notices to the midwife and complainant when this is not possible and provide a reason for the delay. 

Reasons for delays can include:

  • Delays in receiving medical records from hospitals or other health care providers
  • Delays in receiving coroner reports or other documentation
  • Delays experienced in scheduling and conducting interviews
  • Providing extensions submission deadlines to parties involved
  • Providing the midwife with an opportunity to comment on new information (including subsequent submissions from the complainant) before the ICRC meets
  • Obtaining an expert opinion
  • Obtaining legal advice on a complaint matter
  • Time required for the ICRC to draft their reasons

Letters explaining the delay are sent to the complainant and midwife when the complaint has exceeded 150-days, 210-days, and every thirty days after that until the complaint is disposed of by the ICRC. 

How will I find out the outcome?

You and the midwife will both receive a copy of the final decision made by the panel of the Inquiries, Complaints and Reports Committee in the mail.

What decisions can the ICRC make?

After a thorough investigation and deliberation of the complaint, the ICRC makes decisions based on clinical and/or practice issues along with the risk of harm they pose to clients and the public interest. The outcomes of the complaint process aim to be remedial in nature, rather than punitive.

The ICRC has no authority to assess injury or award compensation to the complainant. That is the subject of civil court proceedings.

The ICRC has a number of options available to them and can include:

  • Taking no action on the complaint. 

This disposition occurs when the ICRC is of the view that the midwife’s conduct presents no/minimal risk to the public.  The ICRC would be of the view that the information in the record does not support taking any regulatory action and there is no impact on client care, safety or the public interest. The ICRC may also be of the view that the midwife appears to be in compliance with the standards of the profession.

  • Offer advice and recommendations on an issue raised in the complaint

This disposition occurs when the ICRC is of the view that the midwife’s conduct is low risk to the public and are unlikely to have an impact on client care, safety or the public interest. The ICRC would be of the view that the midwife could benefit from advice or recommendations that improve practice.

  • Require the midwife to complete a Specified Continuing Education or Remediation Program (SCERP)

This disposition can occur when the ICRC is of the view that the midwife’s conduct may have a direct impact on client care, safety or the public interest. The ICRC would be of the view that the issues raised in the complaint require improvement or remediation. The specific requirements ordered by the ICRC can include that the Member must engage in activities such as educational courses, mentoring, reflective papers and/or undergo chart reviews. This disposition is generally utilized by the ICRC for moderate to high risk matters.

  • Issue an oral caution to the Member

An oral caution is issued when the ICRC has a significant concern that the midwife’s conduct may have a direct impact on client care, safety or the public interest if not addressed. This disposition requires the midwife to appear before a panel of the ICRC and the ICRC will communicate a clear message to the midwife that the conduct is unacceptable and must be changed in order to avoid similar incidents from happening in the future. This disposition is utilized by the ICRC for moderate to high risk matters.

  • Require the midwife to sign an acknowledgment and undertaking

The ICRC may decide to engage in a voluntary agreement between the midwife and the College to place certain restrictions on the member’s practise in order to address moderate risk issues that are likely to have an impact on client care, safety, or the public interest.

  • Refer specified allegations of professional misconduct and/or incompetence in the complaint to the Discipline Committee

This outcome is reflective of high-risk conduct or practise that is likely to have an impact on client care, safety or the public interest. The ICRC would be of the view that the issue is serious enough and there is enough evidence to refer and that the concerns cannot be adequately addressed though other dispositions, or previous dispositions have been unsuccessful in remediating concerns.

  • Refer the matter to the Fitness to Practise Committee, where the matter involves an allegation regarding the physical or mental capacity of the midwife

After a health inquiry is completed, the ICRC may make this decision for high-risk matters if concerned that the midwife’s illness and/or capacity will adversely affect their practise and there is a risk posed to both the member and the public. You and the midwife will both receive a copy of the final decision made by the panel of the ICRC. The Decision and Reasons document that you receive will advise you of the outcome and explain the reasons why they made the decision that they did.