Midwifery in British Columbia has been regulated since 1995 when the government of British Columbia established the College of Midwives of British Columbia (CMBC). Many people across BC worked together for the regulation and integration of midwifery into BC’s health care system to ensure that clients received safe, client‐centred and evidence‐based midwifery care. Midwives who were practicing at that time took part in a special assessment process and in 1998 the first group of 49 registered midwives began to practice.
Since 1998, only registered midwives have been legally allowed to use the title “midwife” and to practice as midwives in BC. CMBC was set up by government to regulate the profession, to set and maintain standards, and to assess midwives for registration. Midwifery practice in BC and across Canada is different from midwifery practice in many other countries. It includes:
1) Autonomous Primary care: midwifery in BC is autonomous, community-based primary care. BC registered midwives have primary care responsibility for their clients. Midwives care for a caseload of clients and newborns from early pregnancy through to six weeks postpartum and only need to refer to other caregivers, such as obstetricians, according to CMBC’s required list of indications for consultation or transfer of care. Clients can access midwifery care directly and do not need a medical referral. Midwives do not work under the supervision of a physician as is the case in some regions of the world.
2) Evidence‐informed practice: midwives are expected to keep up‐to‐date on current research on maternal and newborn care and incorporate appropriate findings into the care that they offer.
3) Informed choice: midwives assist clients and their families to make their own choices and decisions about their care by providing relevant, objective information in a supportive and non-authoritarian manner.
4) Continuity of care: midwives work in small groups and provide all care within a continuity of care model seeing each client in their care from early pregnancy to six weeks postpartum so that each client has a chance to get to know each midwife who might attend the client in labour and also the client has a known care provider at the birth. At least one midwife in the group is available on a 24 hour on‐call basis (usually call is shared between two to four midwives so they can have time off call).
Midwives in BC provide a full spectrum of care. They do not generally specialize in prenatal and postnatal care or only manage births, as they do in many other countries, although occasionally a group of midwives providing continuity may be organized to have one midwife fill such a role for a period of time.
5) Choice of birth setting: midwives must provide healthy, low‐risk clients with the choice of giving birth at home or in the hospital. Midwives have privileges at their local hospital where they provide primary care and work with support from nursing staff and other health professionals as needed. At home births they usually work in teams of two midwives. They generally have their own office where they provide prenatal and postnatal care. Early postnatal visits take place in the client’s home. BC midwives must be competent and comfortable working in both hospital and out‐of‐hospital settings.
6) Independent practice: midwives are independent practitioners similar to doctors. They are funded by government through BC’s Medical Services Plan and they manage their practices as businesses. A full-time midwife is generally involved in providing care to about 80 women per year and is the primary midwife (lead caregiver) for about 40 of those women. Midwives are not employees as they are in many other jurisdictions.
Immigration and Moving to BC
For information about immigration and moving to British Columbia:
http://www.cic.gc.ca and https://www.welcomebc.ca/Immigrate/About-the-BC-PNP.aspx
For information on health services in British Columbia: www.gov.bc.ca/healthservices
For information on midwifery across Canada: www.canadianmidwives.org