Health Professions Act -- MIDWIVES REGULATION

B.C. Reg. 103/95
O.C. 269/95

Deposited March 15, 1995

This archived regulation consolidation is current to December 3, 2004 and includes changes enacted and in force by that date. For the most current information, click here.

Health Professions Act

MIDWIVES REGULATION

[includes amendments up to B.C. Reg. 468/2003]

*Contents*
	1	Definitions
	2	Designation
	3	Reserved title
	4	Scope of practice
	5	Reserved acts
	6	Limitations on practice
	7	Patient relations program
	8	Spent
Schedules 1 and 2

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 such as 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

"reserve" means a reserve as defined in the Indian Act.

[am. B.C. Reg. 103/95, s. 8.]

Designation

2 (1) Midwifery is designated as a health profession.

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

Reserved title

3 No person other than a registrant may use the title "midwife".

Scope of practice

4 (1) Subject to the bylaws, registrants may

(a) assess, monitor, and care for women during normal pregnancy, labour, delivery and the post-partum period,

(b) counsel, support and advise women during pregnancy, labour, delivery and the post-partum period.

(d) care for, assess and monitor the healthy newborn, and

(e) provide advice and information regarding care for newborns and young infants and deliver contraceptive services during the 3 months following birth.

(2) Subject to the bylaws, aboriginal registrants may practise aboriginal midwifery.

Reserved acts

5 (1) Subject to section 14 of the Health Professions Act, no person other than a registrant may, for the purposes of midwifery,

(a) conduct internal examinations of women during pregnancy, labour, delivery and the post-partum period,

(b) manage spontaneous normal vaginal deliveries,

(d) prescribe, order or administer drugs and substances specified in Schedule 1 to this regulation, and

(e) order, collect samples for, perform or interpret the results and reports of screening and diagnostic tests specified in Schedule 2 to this regulation.

(2) Subsection (1) does not apply on a reserve to an aboriginal person who practised aboriginal midwifery prior to the coming into force of this regulation.

[am. B.C. Reg. 245/2003, s. (a).]

Limitations on practice

6 (1) Registrants must

(a) advise clients to consult a medical practitioner for a medical examination during the first trimester of pregnancy,

(b) consult with a medical practitioner regarding any deviations from the normal course of pregnancy, labour, delivery and the post-partum period that indicate pathology and transfer responsibility when necessary, and

(1.1) A registrant may

(a) prescribe or administer a substance in item 1 (2) of Schedule 1 only for intrapartum chemoprophylaxis for Group B Strep,

(b) prescribe or administer a substance in item 1 (3) of Schedule 1 only for therapeutic rest in prodromal labour,

(c) order and administer a drug in item 2 of Schedule 1 only in emergency conditions and in consultation with a medical practitioner, and

(d) administer a drug in item 3 of Schedule 1 only after consulting with and on the order of a medical practitioner.

(2) and (3) Repealed. [B.C. Reg. 103/95, s. 8.]

[am. B.C. Reg. 245/2003, s. (b) and (c).]

Patient relations program

7 The College of Midwives is designated for the purposes of section 16 (2) (f) of the Health Professions Act.

Section Spent

8 Spent.

Schedule 1

Drugs and Substances

[en. B.C. Reg. 245/2003, s. (d); am. B.C. Reg. 468/2003, ss. (a) to (c).]

1 (1) A midwife may prescribe or administer the following substances:

Chloroprocaine – 2%

Clotrimazole

Diphenhydramine hydrochloride – IM

Doxylamine succinate-pyridoxine hydrochloride

Ergonovine maleate

Erythromycin ophthalmic ointment

Hepatitis B immune globulin

Hepatitis B vaccine

Hydrocortisone anorectal therapy compound

Intravenous fluids – normal saline, Ringer’s Lactate, 5% dextrose in water

Lidocaine hydrochloride without epinephrine – 1%

Measles / Mumps / Rubella (MMR) Vaccine

Miconazole

Nystatin

Oxytocin – IV or IM injection

Phytonadione

Pre-mixed 50/50 nitrous oxide and oxygen

RhD Immune globulin

Therapeutic oxygen

Triamcinolone – neomycin sulfate – nystatin – gramicidin (Kenacomb)

Triple dye

(2) Subject to section 6 (1.1) (a) of the regulation, a midwife may prescribe or administer the following substances:

Ampicillin

Cefazolin

Clindamycin

Penicillin G

Vancomycin

(3) Subject to section 6 (1.1) (b) of the regulation, a midwife may prescribe or administer the following substances:

Lorazepam (oral or sublingual)

Oxazepam (oral or sublingual)

2 Subject to section 6 (1.1) (c) of the regulation, a midwife may order and administer the following drugs:

Carboprost tromethamine

Epinephrine hydrochloride

Naloxone hydrochloride

Nitroglycerin

3 Subject to section 6 (1.1) (d) of the regulation, a midwife may administer the following drugs:

Acetaminophen with codeine

Antibiotics

Antiemetic/sedative agents with narcotic analgesics

Barbiturates

Cervical ripening agents – in hospital only

Sedatives

Epidural analgesia (continuous infusion maintenance) – in hospital only

Narcotic antagonists

Narcotics – in hospital only

Oxytocin intravenous infusion – in hospital only

4 A midwife may order, prescribe or administer any drug or substance that may lawfully be purchased or acquired without a prescription.

Schedule 2

Screening and Diagnostic Tests

[en. B.C. Reg. 245/2003, s. (d); am. B.C. Reg. 468/2003, s. (d).]

1 A midwife may order, collect samples for and interpret the report of the following screening and diagnostic tests:

(a) for a woman:

(i) chemistry: blood glucose, urinalysis (routine and microscopic), serum ferritin, serum B12, Maternal Serum Marker Screening;

(ii) cytology: cervical smears (Pap smears);

(iii) hematology: hemoglobin, hematocrit, white blood cell count with differential, red blood cell morphology, platelet count, sickle cell solubility, fetal blood screen, Kleihauer-Betke and Rosette;

(iv) microbiology:

(A) cervical and vaginal cultures and smears (including sensitivities if relevant) for Group B streptococcus, gonorrhoea, chlamydia, yeasts, trichomonas, and bacterial vaginosis;

(B) urine for culture and sensitivities; swabs for culture and sensitivities (e.g. wounds, episiotomies);

(D) viral swabs (e.g. herpes);

(v) serology/immunology; blood group and type with antibody screen, repeat antibody testing, hepatitis, human immunodeficiency virus antibody, rubella antibody, toxoplasmosis antibody, syphilis serology, cytomegalo virus antibody, HSV antibodies IgG and IgM;

(vi) pregnancy test (blood and urine);

(b) for a newborn:

(i) hemoglobin, hematocrit, white blood cell count with differential, blood type and Rh factor, neonatal metabolic screen, glucose, Coombs, and bilirubin;

(ii) microbiology samples: cord and eye, ear, and gastric fluid cultures.

2 A midwife may order, perform and interpret the results of the following screening and diagnostic tests:

(a) urine (dip stick analysis);

(b) pregnancy test (urine);

(d) hemoglobin (finger prick method);

(e) ferning test (amniotic fluid);

(f) non-stress test;

(g) external fetal monitoring.

3 A midwife may order and interpret the report of an obstetrical ultrasound test.

4 Subject to section 6 (1) (c) of the regulation, a midwife may order the following tests for a woman:

(a) 24 hour urine for protein;

(b) BUN;

(d) serum creatinine;

(e) serum electrolytes;

(f) serum uric acid.

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