The BCCNM board on Sept. 11, 2026, approved updates to three midwifery practice standards to reflect recent changes to the
Nurses and Midwives Regulation. The revised standards take effect immediately and support safe implementation of expanded midwifery scope, including the use of devices for induction and augmentation of labour; expanded use of ultrasound; prescribing for lactation suppression, hypothyroidism, first-trimester medical abortion; and medication management of early pregnancy loss.
The updated standards are:
Summary of changes
The amended standards clarify when midwives must complete
additional education and when existing certification or prescribing requirements continue to apply. The requirements are based on the complexity and risk of each activity and are intended to support safe, competent, and person-centred care.
Additional education is a board-approved regulatory term already used in BCCNM nursing standards. It means structured education—such as a workshop, course, or program of study—that builds on entry-level competencies and includes theory, application to practice, and an evaluation of competence. BCCNM is developing a resource to help midwives understand this requirement, which will be shared in an upcoming newsletter.
Certified Midwives: Induction and Augmentation of Labour: Updates include the use of devices for induction and augmentation of labour within the existing certification framework. The amended standard clarifies expectations when a midwife uses a device or uterotonic agent, updates criteria previously set out in the limits and conditions and keeps the requirement to consult with a physician when induction or augmentation is considered for a client with a previous caesarean section or uterine surgery.
Midwives: Screening and Diagnostic Tests and Imaging: Updates include additional education requirements for midwives who use ultrasound for purposes beyond fetal heart monitoring and determining fetal position. The amendments also clarify that point-of-care ultrasound does not replace comprehensive diagnostic imaging when it is clinically indicated. Additional education options are available through UBC Continuing Professional Development and other Canadian providers.
Midwives: Medications and Substances: Updates include new prescribing authorities for lactation suppression, hypothyroidism, first-trimester medical abortion, and medication management of early pregnancy loss. Existing prescribing requirements continue to apply to lactation suppression, while additional education is required for the other areas.
With the approval of these scope expansions, additional education will support midwives in acquiring the knowledge and competencies required for implementation, including:
Medical abortion and early pregnancy loss care
- The
Society of Obstetricians and Gynaecologists of Canada (SOGC) offers
Medical Abortion Through Primary Care.
Use of ultrasound for midwifery purposes
-
UBC Continuing Professional Development (UBC CPD) offers
Hands-On Ultrasound Education Obstetrics (HOUSE OB), which supports the development of competencies in point-of-care obstetrical ultrasound.
Management of hypothyroidism in pregnancy
- A course on hypothyroidism management for midwives is being developed by
UBC Continuing Professional Development (UBC CPD) and is anticipated to be available in early 2027.
Midwives are responsible for ensuring that any education undertaken meets the definition of
additional education set out in the BCCNM bylaws and is sufficient to support safe and competent practice within the expanded scope.
Questions about the updated standards?
Contact our
Standards Support team.