In winter 2025, BCCNM conducted a public survey to better understand real-world client experiences when care from a midwife is refused, not provided, or ended. The survey explored associated risks and gathered public expectations for safer, more respectful care.
This work supports the ongoing policy work to review three key BCCNM documents:
The project aims to align standards with the
Health Professions and Occupations Act (HPOA) and address licensee concerns about outdated, unclear, or ethically complex expectations.
We thank the nearly 100 members of the public who shared their time and lived experiences, as well as the community organizations, partners, and networks who supported outreach and participation. These contributions ensured that diverse public perspectives meaningfully informed this work and are helping to shape safer, more equitable, and respectful care expectations.
What we heard
Survey responses showed both what people value in care and where experiences can cause harm. Many respondents described the importance of respectful, continuous, and transparent care. They also shared difficult experiences when care was refused, unavailable, or ended without clear communication or support.
Continuity and access matter deeply: Respondents emphasized how important it is to be able to rely on care, particularly during vulnerable or sensitive times. At the same time, most respondents reported experiencing – either personally or through someone they care for – care that was refused, unavailable, or ended.
Communication can support or undermine care: People valued clear, timely explanations when care arrangements changed. Nearly half of affected respondents said the reasons for care being refused, unavailable, or ended were unclear or not explained, which contributed to confusion, distress, and uncertainty.
Trust and relationship are central: Respondents highlighted the importance of compassion, professionalism, and respectful relationships. Some also described serious emotional and relational impacts when communication was poor, including anxiety, fear, trauma, loss of trust, and feelings of abandonment.
Informed choice must be protected: Many respondents said they want to be active partners in decisions about their care. Some described feeling pressured to follow recommendations, facing threats that care would be withdrawn, or having limited ability to make informed choices when their preferences differed from provider recommendations.
System pressures are real, but do not remove the need for respectful care: Participants acknowledged provider shortages, burnout, and policy constraints. They also emphasized that these pressures do not lessen the need for honest communication, transparency, and respectful, client-centred care.
Respondents described what safer practice looks like: People called for early and honest communication, respect for informed choice, professionalism, smooth handovers, continuity wherever possible, and upfront clarity about scope, limits, safety, and what will happen next.
Clear guidance and support are needed: Participants called for clear expectations and practical system supports that help registrants provide respectful, client-centred care while maintaining continuity and appropriate protections for registrants.
What happens next
Insights from the public survey will inform any revisions to the standards and guide the development of learning resources.