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Revised Second Birth Attendant Standard

November 2, 2018

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

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As midwives are aware, the College rescinded the standard requiring two midwives at every birth, as there is no evidence to support the need for two primary care providers at a birth.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 also has 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 the Canadian Paediatric Society’s Neonatal Resuscitation Program.

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 revised Second Birth Attendant Standard was too high for those who are not members of a regulated health profession to meet, as currently the Canadian Paediatric Society’s Neonatal Resuscitation Program will only certify regulated health professionals. Similarly, we heard that second attendants should not be required to complete the same courses as midwives with regard to the training in obstetric emergency skills.

In June, the College 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.

Alternate Practice Arrangements

As members are likely aware, the College is no longer issuing Alternate Practice Arrangements (APAs). The new Second Birth Attendant Standard and the Professional Standards for Midwives have eliminated the need for APAs at the College. If you would like more information, please click here to read our July 2018 post on the subject.

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