Plan for health care unveiled today by Health Minister Sylvia Jones missing updates for midwifery

Press Release

TORONTO, Feb. 2, 2023 – Ford government’s plan for health care, unveiled today by Health Minister Sylvia Jones, should include updates for midwifery to ensure Ontarians have access to the medication and tests they need from their midwives.

“Midwives need timely action from Minister Jones. Midwives are primary care providers with the ability to diagnose and prescribe for pregnancy and postpartum, but current ministry rules hamper our ability to do our jobs and, in turn, cause extra expense for taxpayers and extra hassles for pregnant people. We are calling on government to update the medications midwives can prescribe and the tests we can order. These updates are long overdue,” says Jasmin Tecson, Registered Midwife and President of the Association of Ontario Midwives (AOM).

The AOM is calling for Ontario to allow midwives access to all medication approved by Health Canada, within the scope of midwifery practice.

The current restrictions placed on midwives for prescribing medication and ordering tests are outdated, costly, an inconvenience to pregnant people, and cause unnecessary further strain to a health system in crisis. Requests for updates to these restrictions date back 15 years, but little has changed for midwives, despite similar recent changes made by government for pharmacists. The College of Midwives has also made requests and asserts they are in the public’s interest.

“Requests for updates for midwifery languish at the ministry. The changes we are asking for are all within our scope of practice as defined by the Midwifery Act, and midwives already have the skill and knowledge for these changes. This is not only exasperating but has real consequences. It sends the wrong message for me to have to tell a pregnant person to go see a doctor for a routine vaccine when I am not only capable of providing that treatment, but also available and on-call to my client 24-7. We are talking about clients who are already under my care and the government already pays me to care for them. Outdated restrictions on the medications I can prescribe and tests I can order undermine me as a midwife, cause unnecessary physician visits, and disrespect my clients,” says Elizabeth Brandeis, midwife and AOM spokesperson.

Existing rules in Ontario confine midwives to using only specific and limited medications. Drugs and tests are constantly evolving and changing as new evidence drives changes in clinical practice. Government must enable midwives with broad prescribing authority that allows for the best and most responsive treatment. Broad prescribing rights are exactly what was provided for pharmacists. Midwives have asked the ministry repeatedly for an update to their authority to prescribe. Outdated rules contribute to needless dysfunction in an already strained system.

“Midwives simply want to provide the best possible care. We don’t want to put pregnant people through unnecessary hurdles, like additional appointments, for conditions we are capable of treating but outdated rules prevent us from doing so. This is not a question of skill or competence but of government updating an outdated system so that we can provide the care Ontarians need and deserve,” says Brandeis.

Midwives have an excellent safety record and there is no justification for these unnecessary restrictions.

Ontario, for example, now offers a simple non-invasive prenatal test for genetic conditions in a baby’s DNA. Because this specific test didn’t exist when government created the rules that govern midwives, midwives are not able to order it. Instead, a pregnant person in midwifery care needs to access the test through a physician. It’s an example of how Ontarians pay the price, with the additional cost to the system and with inefficiencies and inconvenience, when government rules do not keep pace with changes in standards and the tests available.

“Midwives already prescribe medications and order tests. This is already something I do as a midwife. The problem is that government rules are preventing me from prescribing the right medications and ordering the right tests, so my clients receive timely and convenient care. There have been years of consultation and consideration and it’s time to get on with it. It is ridiculous that this hasn’t been fixed already and midwives the province over are calling on Minister Jones to act now,” says Tecson.
About the Association of Ontario Midwives:

The AOM advances the clinical and professional practice of Indigenous/Aboriginal and Registered midwives in Ontario with a vision of midwives leading reproductive, pregnancy, birth, and newborn care across Ontario. There are over 1,000 midwives in Ontario, serving more than 250 communities across the province. Since midwifery became a regulated health profession in 1994, more than 250,000 babies have been born under midwifery care.

For further information: AOM will arrange interviews on request. Contact Juana Berinstein, Director, Policy and Communications, at juana.berinstein@aom.on.ca or (416) 371-1468

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