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Alternate practice arrangements


Alternate Practice Arrangements (APAs) are carefully monitored and transparent perinatal care arrangements that offer midwifery care outside the standard model. These arrangements typically have approved exemptions to the Standards of Practice (PDF), typically Standard 1.3 (midwife as primary care provider), Standard 6.1 (comprehensive care through all trimesters, labour, birth and postpartum), Standard 6.4 (continuity of care provider, no more than four care providers) and/or Standard 7.2 (providing care in all settings). Care provided must adhere to the Midwives Regulations and Bylaws for the BC College of Nurses and Midwives and be approved by the Approval Panel of the BCCNM Quality Assurance (QA) Committee.

APAs are established based on community, client and/or provider need. This may include but is not limited to serving a population of clients with unique social and/or medical requirements, and/or sustainable practice amongst midwives and/or other perinatal care providers.

For more information and requirements for APAs, please review the Policy on Alternate Practice Arrangements (PDF).​​​

How to ap​​ply

Midwives interested in creating a new Alternate Practice Arrangement should submit a completed: Application to Establish an Alternate Practice Arrangement (PDF).

Midwives seeking to join an established APA for more than six months will each submit an individual: Application to Join an Established Alternate Practice Arrangement (PDF).

BCCNM staff are available to meet with midwives to discuss their applications prior to submission: please send inquiries to qualitymidwives@bccnm.ca for more information.​​​​​​