B.C. is expanding the scope of practice for midwives in several ways, including prescribing the abortion pill to provide a safe, medical abortion in the first trimester.
This makes B.C. one of just three jurisdictions in Canada to allow midwives to provide access to medical abortions early in pregnancy.
Health Minister Josie Osborne announced the new changes on Thursday (May 7), two days after International Midwives Day. The changes will allow the nearly 500 midwives – with 80 to 95 of those working in rural communities – in B.C. to provide more comprehensive care across the full pregnancy journey, she said.
The changes will allow midwives to prescribe medications to manage conditions such as hypothyroidism, as well as medications for lactation suppression. Midwives will also be able to perform ultrasounds for more clinical purposes within their scope of practice, such as determining the location of a pregnancy in its early stages.
That’s in addition to being able to provide the abortion pill, known as Mifepristone.
“It’s worth pausing here to note the importance of this,” Osborne said. “In the U.S., for example, we are seeing the gutting of reproductive rights and healthcare and the ability of a woman to choose about decisions on her own body.”
Osborne said midwives are highly trained experts in pregnancy and reproductive care, and “expanding their scope of practice allows them to fully use that training to support people through a broader range of needs, and that means more seamless, more personalized care throughout pregnancy, childbirth and postpartum.”
She said midwives are involved in almost one-in-three births in B.C., providing “a continuous and relationship-based system of care for families.”
“Their approach is personalized and holistic, treating pregnancy as an end, birth as a person-centred experience – not just a clinical event.”
Osborne said the provincial government will be working with the College and the Nurses of Midwives on the regulatory changes needed to expand the scope of practice. She added that the government will also undertake its own internal analysis of what the financial impacts of that might be.
She did not give a firm timeline on when the changes could be implemented.