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B.C. Reg. 281/2008
M241/2008
Deposited October 15, 2008
effective October 17, 2008
This consolidation is current to October 17, 2017.
Link to Point in Time

Health Professions Act

Midwives Regulation

[includes amendments up to B.C. Reg. 274/2016, November 24, 2016]

Contents
1Definitions
2College name
3Reserved title
4Scope of practice
5Restricted activities
6Limits or conditions on services and restricted activities
7Patient relations program
Schedules 1 and 2
Schedule A
Schedule B

Definitions

1  In this regulation:

"aboriginal" means relating to the Indian, Inuit or Métis peoples of Canada;

"aboriginal midwifery" means

(a) traditional aboriginal midwifery practices including the use and administration of traditional herbs and medicines and other cultural and spiritual practices,

(b) contemporary aboriginal midwifery practices which are based on, or originate in, traditional aboriginal midwifery practices, or

(c) a combination of traditional and contemporary aboriginal midwifery practices;

"Act" means the Health Professions Act;

"compound" means to mix with one or more other ingredients;

"dispense" has the same meaning as in the Pharmacy Operations and Drug Scheduling Act, but excludes a sale as defined in that Act;

"Drug Schedules Regulation" means the Drug Schedules Regulation, B.C. Reg. 9/98;

"hospital" has the same meaning as in the Hospital Act;

"midwifery" means the health profession in which a person provides the following services during normal pregnancy, labour, delivery and the post-partum period:

(a) assessment, monitoring and care for women, newborns and infants, including the carrying out of appropriate emergency measures when necessary;

(b) counselling, supporting and advising women, including provision of advice and information regarding care for newborns and infants;

(c) conducting internal examinations of women, performing episiotomies and amniotomies and repairing episiotomies and simple lacerations;

(d) contraceptive services for women during the 3 months following a birth;

"midwifery diagnosis" means a clinical judgment of a woman's mental or physical condition, or that of her newborn, to determine whether

(a) the condition can be ameliorated or resolved by services that the registrant is authorized to provide, or

(b) consultation with, or transfer of responsibility for care to, another health professional is necessary or appropriate;

"narcotic" has the same meaning as in the Narcotic Control Regulations made under the Controlled Drugs and Substances Act (Canada);

"parenteral instillation" means instillation directly into the blood stream;

"prescribe" means to issue a prescription as defined in the Pharmacy Operations and Drug Scheduling Act, except a prescription issued in respect of an animal;

"reserve" means a reserve as defined in the Indian Act (Canada);

"substance" includes air and water, but excludes

(a) a drug specified in Schedule I, IA, II or IV of the Drug Schedules Regulation, and

(b) Repealed. [B.C. Reg. 274/2016, s. 1 (c).]

[am. B.C. Regs. 155/2009, s. 1; 274/2016, s. 1.]

College name

2  The name "College of Midwives of British Columbia" is the name of the college established under section 15 (1) of the Act for midwifery.

Reserved title

3  The title "midwife" is reserved for exclusive use by registrants.

Scope of practice

4  (1) A registrant may practise midwifery.

(2) An aboriginal registrant may practise aboriginal midwifery.

[en. B.C. Reg. 155/2009, s. 2.]

Restricted activities

5  (1) A registrant in the course of practicing midwifery may do any of the following:

(a) make a midwifery diagnosis identifying a condition as the cause of signs or symptoms of an individual;

(b) perform a procedure on tissue below the dermis or below the surface of a mucous membrane, for the purposes of

(i) performing episiotomies or amniotomies,

(ii) repairing episiotomies or simple lacerations, or

(iii) taking a swab or specimen required for a screening or diagnostic test;

(c) insert acupuncture needles under the skin for the purpose of pain relief during labour or the post-partum period;

(d) for the purpose of collecting a blood sample, perform venipuncture;

(e) for the purpose of wound care during the post-partum period, administer a solution by irrigation;

(f) administer a substance by

(i) injection,

(ii) inhalation, or

(iii) parenteral instillation

for the purposes of

(iv) pain relief,

(v) preventing or treating dehydration or blood loss,

(vi) resuscitation or other emergency measures, or

(vii) other purposes as required for midwifery practice;

(g) put an instrument or a hand or finger

(i) beyond the point in the nasal passages where they normally narrow, for the purpose of suctioning a newborn,

(ii) beyond the pharynx, for the purpose of intubating a newborn,

(iii) beyond the opening of the urethra, for the purpose of catheterization of a woman during labour or the post-partum period,

(iv) beyond the labia majora, for the purposes of

(A) conducting internal examinations of women,

(B) performing episiotomies or amniotomies,

(C) repairing episiotomies or simple lacerations, or

(D) conducting the vacuum-assisted emergency delivery of a baby,

(v) beyond the anal verge, for the purposes of

(A) assessing perineal repairs,

(B) administering a substance, or

(C) assisting in the emergency delivery of a baby, or

(vi) into an artificial opening into the body, for the purpose of assisting in the surgical delivery of a baby;

(h) manage labour or normal, spontaneous vaginal delivery of a baby;

(i) apply ultrasound for the purpose of fetal heart monitoring;

(j) give an instruction or authorization for another person to apply, to a named individual, ultrasound for diagnostic or imaging purposes, including any application of ultrasound to a fetus;

(k) in respect of a drug specified in Schedule I or IA of the Drug Schedules Regulation that is prescribed by a medical practitioner or a nurse practitioner,

(i) compound the drug,

(ii) dispense the drug, or

(iii) administer the drug by any method;

(l) in respect of a drug specified in Schedule I or IA of the Drug Schedules Regulation,

(i) prescribe the drug,

(ii) compound the drug,

(iii) dispense the drug, or

(iv) administer the drug by any method;

(m) in respect of a drug specified in Schedule II of the Drug Schedules Regulation,

(i) prescribe the drug,

(ii) compound the drug,

(iii) dispense the drug, or

(iv) administer the drug by any method.

(1.1) Only a registrant may provide a service that includes the performance of an activity set out in subsection (1).

(2) Subsection (1.1) does not apply on a reserve to an aboriginal person who practised aboriginal midwifery prior to March 15, 1995.

[am. B.C. Regs. 155/2009, s. 3; 274/2016, s. 2.]

Limits or conditions on services and restricted activities

6  (1) A registrant must consult with a medical practitioner or nurse practitioner regarding any deviations from the normal course of pregnancy, labour, delivery and the post-partum period that indicate pathology and transfer responsibility for care to another health professional when necessary or appropriate.

(2) A registrant may provide a service that includes the performance of an activity described in section 5 (1) (c), (g) (iv) (D) or (vi) or (l) only if the registrant has successfully completed a certification program established, required or approved under the bylaws to ensure registrants are qualified and competent to provide the service and perform the activity.

(3) A registrant may perform an activity described in section 5 (1) (k) only after consulting with a medical practitioner or a nurse practitioner, unless the registrant is authorized under section 5 (1) (l) and subsection (4) of this section to perform the activity.

(4) A registrant may perform an activity described in section 5 (1) (l) in respect of a drug included in a category of drugs set out in

(a) Column 1 of Schedule A, only for a purpose shown opposite in Column 2 of Schedule A, and

(b) Column 1 of Schedule B, only for a purpose shown opposite in Column 2 of Schedule B.

(5) Repealed. [B.C. Reg. 274/2016, s. 3 (d).]

(6) A registrant may perform an activity described in section 5 (1) (k) to (m) only in respect of a woman or her newborn, as the case may be, during pregnancy, labour, delivery or the post-partum period.

[en. B.C. Reg. 155/2009, s. 4; am. B.C. Reg. 274/2016, s. 3.]

Patient relations program

7  The college is designated for the purposes of section 16 (2) (f) of the Act.

Schedules 1 and 2

Repealed. [B.C. Reg. 155/2009, s. 5.]

Schedule A

[en. B.C. Reg. 155/2009, s. 5; am. B.C. Reg. 274/2016, s. 4.]

Column 1
Category Description
Column 2
Purposes
Antibioticsintra-partum chemoprophylaxis for Group B strep
treatment of topical infection
treatment of breast infection
treatment of urinary tract infection
prophylaxis of ophthalmia neonatorum
Anaestheticsperformance of episiotomies
repair of episiotomies and lacerations
treatment of topical inflammation
localized pain prophylaxis
Anti-coagulantsprophylaxis of venous thromboembolism
Anti-fungalstreatment of candidiasis
Anti-nauseants / Anti-emeticstreatment of nausea and vomiting
Anti-viralssuppression of viral infections during pregnancy
and the post-partum period, excluding HIV/AIDS
management
Benzodiazepinestherapeutic rest in prodromal labour short term management of excessive anxiety in the postpartum period
Corticosteroidstreatment of skin inflammation and haemorrhoids
Galactagoguesenhancement of breast milk production
Histamine antagoniststreatment of anaphylaxis related to the administration of drugs, vaccines or sera
Immune globulinsprophylaxis in the neonate
prophylaxis or treatment of the woman in pregnancy
or the postpartum period
Inhalantspain relief in labour or the immediate postpartum period
Narcotic antagonistsreversal of narcotic-induced depression
Narcoticspain relief in labour or the postpartum period
Nitratestreatment of hypertonic uterine contractions with non-reassuring fetal status
Non-steroidal anti-inflammatoriesrelief of inflammation and pain
Sympathomimeticstreatment of anaphylaxis or allergic reaction following
the administration of a drug, vaccine or serum
neonatal resuscitation
Uterotonic agentsprophylaxis and treatment of uterine atony and postpartum haemorrhage
Vaccinesestablishing an immune response
Vitamin and mineral supplementsnutritional therapy and support

Schedule B

[en. B.C. Reg. 155/2009, s. 5.]

Column 1
Category Description
Column 2
Purposes
Antibioticstreatment of infection not included in Schedule A
Anti-viralsHIV/AIDS management
Cervical ripening agentsinduction of labour
Contraceptivesprevention of conception
Epidural analgesia (continuous infusion maintenance)pain relief during labour and delivery, in a hospital only
Oxytocin (intravenous infusion)induction or augmentation of labour, in a hospital only

[Provisions relevant to the enactment of this regulation: Health Professions Act, R.S.B.C. 1996, c. 183, section 12 (2)]