Midwifery in Canada - Nova Scotia

Report submitted September 2008

Nova Scotia has continued to progress and move toward implementing midwives into the healthcare system. In December 2007 the Midwifery Implementation Committee (MIC) was formed and guided by the Primary Health Care division of the Department of Health (DoH). Meetings commenced and included representatives from the ANSM, College of Registered Nurses of Nova Scotia (CRNNS), College of Physicians and Surgeons of Nova Scotia (CPSNS), Doctors Nova Scotia (DNS), District Health Authorities (DHA’a), Midwifery Coalition of Nova Scotia (MCNS), and the Metropolitan Immigrant Settlement Association (MISA) to name only a few. It was soon realised that the committee was too large and sub-committees were formed to deal with the tasks of implementation.

Concurrently, the Midwifery Regulations Committee (MRC) was continuing the work of drafting regulations and bylaws and pushing for a financial commitment from the DoH, which came midway through the year. The Department has committed to fund the Midwifery Regulatory Council which will comprise of 3 registered midwives, 1 nurse from CRNNS, 1 physician from the CPSNS and up to 3 public members. They have also committed to fund 6 full-time positions throughout the province for the first two years and budgetary planning intends to gradually increase these numbers yearly.

The MRC completed the Regulations and Bylaws in the spring of this year and those documents were sent for consultation to local Associations and Colleges as well as identified national organisations to receive feedback on the content. Meanwhile, the documents were reviewed and re-drafted by the Registry of Regulations. Recently, the MRC reconvened to review the comments and changes and approved the final draft of midwifery regulations. The DoH is hoping to move forward with proclaiming the Act before the end of the year with and effective date in the near future.

The MIC continues to work on the various complexities of instituting a new health profession. Liability Insurance, admitting privileges and employment contracts are only a few of the many layers required to get midwives working in the community. The DHA’s were notified in the spring as to the intention of implementation and asked to come forward if they were ready to be the first regions involved. Three sites “model sites” came forward including the IWK (located in Halifax), GASHA (Guysborough Antigonish Strait Health Authority) and SSDHA (South Shore). Additional sites also came forward known as “shadow sites” who are not prepared to implement this year, but wish to observe the process to begin preparations.

The MIC now sits with the DHA representatives at the table and each of these regions are moving forward independently and working with local midwives to prepare for the proclamation of the Act.

The DoH in conjunction with Health Canada funding for Internationally Educated Health Professionals (IEHP) has created a local assessment process for Internationally Educated Midwives (IEM’s) who would be considered “practice ready” (no bridging required). This assessment process would not be happening if it weren’t for the hard work of our colleagues across the country and especially those involved with the Midwifery Multi-Jurisdictional Bridging Program, who have been a tremendous resource and supporter allowing us to piece together a one-off assessment for the purpose of having a strong number of midwives in the first cohort. At present, the assessment is moving forward in the next couple of months with midwives from England, Scotland, Germany and Ireland engaging.

There remains an overwhelming amount of work to complete in order to say we are ‘done’….perhaps that will never happen. We are aware that implementation not only involves getting midwifery started but continuing the growth and integration which will likely take many years. Luckily, the energy is high and the motivation appears genuine that midwives are and will be welcomed and that positive change is in the forecast.

Contact Information
P.O. Box 2722
Halifax CRO
Nova Scotia
B3J 3P7
Email: kayuka@eastlink.ca