Since 1998, only registered midwives have been legally allowed to use the title “midwife” and to practice as midwives in B.C. The BC College of Nurses and Midwives regulates the profession by setting and maintaining standards, granting registration and investigating complaints.
B.C. Midwives provide autonomous, community-based primary care. A midwife in B.C. is the most responsible caregiver during the antepartum period, labour, birth and postpartum period (up to 6 – 12 weeks) as long as the client remains low risk. A full-time midwife is generally involved in providing care for about 40-60 clients per year as the primary midwife. Midwives collaborate with other health professionals and transfer care to a physician when the client’s risk status changes and as necessary.
B.C. midwives provide continuity of care to all clients. This includes 24-hour on call availability by the midwife (or small group of midwives) known to the client, from intake to discharge. Continuity of care allows a relationship to develop over time between a client and their midwife/midwives. In order to share the responsibility of providing care on a 24-hour basis, midwives often work in small teams and share care of a pooled group of clients.
B.C. midwives assist clients and their families to make choices about their care by providing relevant, evidence-based information in a supportive, non-authoritarian manner. Midwives must keep current in their knowledge of relevant research.
B.C. midwives must provide healthy, low-risk clients with the choice of giving birth at home or in the hospital. Midwives must have admitting and discharge privileges at their local hospital(s) with support from nursing staff and other health professionals as needed. At a home birth midwives work with another midwife or a BCCNM-approved second birth attendant. At a hospital birth, the client is supported by both their midwife and a nursing care during labour and birth.
B.C. midwives are self-employed, independent health care providers. They are not employees. The B.C. government funds midwifery and midwives are paid a flat rate per course of care.