New and revised midwifery standards: HPOA

The BCCNM board on Jan. 26 and Feb. 26, 2026, approved revisions to all BCCNM midwifery standards to align with the upcoming Nurses and Midwives Regulation (NMR) and Regulated Health Practitioners Regulation (RHPR) under the Health Professions and Occupations Act (HPOA).

These updates support a consistent, clear, and modern regulatory framework and will take effect on April 1, 2026, when the new regulations come into force.​ The ​​revised standards can all be accessed via the table at the end of this announcement.​

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What are the changes?

For some standards, we made non‑substantive administrative updates, such as:

• Revising titles and headings for consistency
• improving formatting and readability,
• aligning terminology with the HPOA and new regulations,
• standardizing introductions and glossaries, and
• removing explanatory content better suited to learning resources.

For others, a detailed comparison of existing midwifery standards with the NMR, RHPR, and HPOA identified areas where updates were needed to:

• align language and structure with the new regulations;
• clarify expectations related to scope of practice and restricted activities;
• reduce ambiguity and improve consistency across nursing designations; and
• enhance usability for nurses in practice.

While most regulatory changes for midwives were modest, corresponding updates were required to ensure practice standards accurately reflect the new regulatory framework.

Key highlights of the updated standards

The revised practice standards:

• align descriptions of restricted activities with how they are defined in the RHPR;
• update terminology to reflect the NMR;
• reorganize limits and conditions to mirror the structure of the RHPR;
• update language related to certification and use of title to reflect BCCNM bylaws.

Certification programs

The BCCNM board has approved new Certified Midwives practice standards for midwives who hold certification with BCCNM. This was previously known as specialized practice—under the Health Professions and Occupations Act (HPOA), it will now be known as certification, and midwives will be able to use the title "certified".

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Moving forward

The revisions approved at this stage focus​ primarily on scope‑related alignment with the NMR, RHPR, and HPOA. Following adoption as bylaws, BCCNM will continue to review and update practice standards as required under the HPOA, including engagement with Indigenous Peoples and system partners.

All of these standards will come into effect April 1, 2026, and be accessible via the midwifery standards page::

• Midwifery standards

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Questions?

Connect with our Standards Support team.

Table of standards

Standard	Revised Title	Designation(s)	Standard Type (Practice or Ethics)	Summary of Changes
Policy on Appropriate Client-Midwife Relationships	Midwives:​ Boundaries in the Midwife-Client Relationship	Midwife	Ethics	Edited section headings Made minor edits to improve readability Edited language to align with HPOA and/or new HPOA Regulations Removed information more suited to a learning resource Removed clinical/ outdated content Reformatted/rearranged content
RM Code of Ethics	Midwives: Code of Ethics	Midwife	Ethics	Edited language to align with HPOA and/or new HPOA Regulations Reformatted/rearranged content
Policy on Informed Choice	Midwives: Informed Choice	Midwife	Ethics	Edited section headings Made minor edits to improve readability Reformatted/rearranged content Removed clinical/ outdated content Removed duplicative content
RM Standards of Practice	Midwives: Professional Standards	Midwife	Ethics	Made minor edits to improve readability Removed information more suited to a learning resource Removed clinical/ outdated content Replaced outdated term of “cultural competence” with “cultural humility” Removed outdated definition of “cultural safety” Removed outdated reference to “continuing competence requirements”
Policy on Requests for Care Outside Standards	Midwives: Requests for Care Outside Standards	Midwife	Ethics	Edited section headings Removed information more suited to a learning resource Removed clinical/ outdated content
Policy for Required Procedures for Midwife or Client-initiated Termination of Care	Midwives: Termination of Care	Midwife	Ethics	Edited section headings Made minor edits to improve readability Removed clinical/ outdated content Removed duplicative content
Indigenous Cultural​ Safety, Cultural Humility, and Anti-racism	Nurses & Midwives: Indigenous Cultural​ Safety, Cultural Humility, and Anti-racism	All	Ethics	Edited section headings Made minor edits to improve readability Edited language to align with HPOA and/or new HPOA Regulations Removed information more suited to a learning resource Reformatted/rearranged content
n/a	Midwives: Privacy and Confidentiality	Midwife	Ethics	New privacy and confidentiality standard for midwives
Policy Statement on Complementary Therapies	Midwives: Complementary and Alternative Therapies	Midwife	Practice	Edited section headings Made minor edits to improve readability
Consultation, Referral and Transfer of Care	Midwives: Consultation, Referral and Transfer of Care	Midwife	Practice	No changes needed
Home & Community Birth	Midwives: Home & Community Birth	Midwife	Practice	Edited section headings Reformatted/rearranged content
Policy on Hospital Privileges	Midwives: Hospital Privileges	Midwife	Practice	Moved definitions from footnotes into glossary Reformatted/rearranged content Updated introduction
Policy on Medical Records	Midwives: Medical Records	Midwife	Practice	Edited section headings Made minor edits to improve readability Edited language to align with HPOA and/or new HPOA Regulations Removed information more suited to a learning resource Reformatted/rearranged content
Standards for Postpartum Care	Midwives: Postpartum Care	Midwife	Practice	Edited section headings Made minor edits to improve readability Removed information more suited to a learning resource Reformatted/rearranged content Revised Introduction and removed citation
Policy on Practice Protocols	Midwives: Practice Protocols	Midwife	Practice	Made minor edits to improve readability Removed information more suited to a learning resource Removed clinical/ outdated content Revised Introduction
Preventing Transmission of Blood-borne Viruses	Midwives: Preventing Transmission of Blood-borne Viruses	Midwife	Practice	No changes needed
n/a	Midwives: Regulatory Supervision	Midwife	Practice	New regulatory supervision standard for midwives​
​ Screening and Diagnostic Tests and Imaging Standards Limits and Conditions	Midwives: Screening and Diagnostic Tests & Imaging			Expanded permitted use of ultrasound to determine fetal position and presentation Clarifies basic point‑of‑care ultrasound (e.g., fetal heart rate and presentation) versus more advanced obstetric ultrasound applications (which remain outside scope without additional requirements.
Medication and Substances Standards Limits and Conditions	Midwives: Medications and Substances​			Removal of the requirement to consult with a physician or nurse practitioner before compounding, dispensing, or administering a drug when a client‑specific order is in place Updates to drug categories and purposes, including antifibrinolytics, benzodiazepine receptor antagonists, and histamine antagonists, to reflect current midwifery practice Streamlined structure, clearer language, updated certification terminology, and consistent references to midwifery clients and newborns ​
Certified midwife standards
Framework for midwife certification in acupuncture use in labour and in the immediate postpartum	Certified Midwives: Acupuncture	Midwife (Certified)	Practice	Reformatted to align with practice standard template QA and competency content removed and relocated
Framework for midwife certification in epidural maintenance	Certified Midwives: Epidural Maintenance	Midwife (Certified)	Practice	Reformatted to align with practice standard template QA and competency content removed and relocated
Framework for midwife certification in hormonal contraceptive therapy	Certified Midwives: Hormonal Contraceptive Therapy	Midwife (Certified)	Practice	Removal of three-month time limit for contraceptive services Midwives can now offer copper intrauterine contraception Reformatted to align with practice standard template QA and competency content removed and relocated
Framework for midwife certification for prescribing, ordering, administering and managing induction and augmentation of labour in hospital	Certified Midwives: Induction and Augmentation of Labour	Midwife (Certified)	Practice	Reformatted to align with practice standard template QA and competency content removed and relocated
Framework for midwife certification in hormonal contraceptive therapy	Certified Midwives: Intrauterine Contraception Insertion	Midwife (Certified)	Practice	Reformatted to align with practice standard template QA and competency content removed and relocated
Framework for midwife certification in sexually transmitted infections management	Certified Midwives: Sexually Transmitted Infections Management	Midwife (Certified)	Practice	Reformatted to align with practice standard template QA and competency content removed and relocated
Framework for midwife certification for surgical assist for cesarian section	Certified Midwives: Surgical First Assist for Cesarian Section	Midwife (Certified)	Practice	Reformatted to align with practice standard template QA and competency content removed and relocated
Framework for midwife certification for vacuum-assisted emergency delivery	Certified Midwives: Vacuum-Assisted Emergency Delivery​	Midwife (Certified)	Practice	Reformatted to align with practice standard template QA and competency content removed and relocated