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BCCNM board approves new medications and substances standard for midwives


Nov 24, 2022

The BCCNM board on Nov. 24, 2022, approved a new standard for registered midwives: Medications and Substances: Standards, Limits and Conditions. The new standard comes into effect March 1, 2023. The board also approved an amendment to the Registered Midwives Standards of Practice to align it with the new standard. This change also takes effect March 1, 2023.

The new Medications and Substances: Standards, Limits and Conditions will replace the following four existing registered midwife standards:

  • Prescribing, Ordering and Administering Therapeutics: Standards, Limits and Conditions
  • Prescribing, Ordering and Administering Controlled Substances: Standards, Limits and Conditions
  • Prescribing, Ordering and Administering Drugs for Sexually Transmitted Infections: Standards, Limits and Conditions
  • Prescribing, Ordering and Administering Contraceptives: Standards, Limits and Conditions

These four standards will be rescinded as of March 1, 2023.

Background

Shortly before the legacy College of Midwives of BC (CMBC) amalgamated with the BC College of Nursing Professionals (BCCNP) in September 2020, CMBC identified the risk of including extensive clinical drug information in a standard and made the recommendation to remove all clinical content from registered midwife standards.

BCCNM continued the work initiated by CMBC to review and revise the midwifery prescribing medication standards, with a goal to combine and harmonize the four standards referenced above, while setting comprehensive principle-based expectations for registered midwives when prescribing, ordering, dispensing, compounding, and administering medications and substances.

This approach is in line with other midwifery regulators in Canada and is an acknowledgment of midwives' high degree of autonomy and clinical judgment. It also removes the risk of potentially outdated clinical information and aligns with BCCNM's right-touch approach to standard setting.

Notable changes in the new standard

Please refer to the Registered Midwives Medications and Substances: Standards, Limits and Conditions (not yet in effect) for more information.

  • Removed lists of medications and related detailed clinical information, and retained only the list of drug categories and corresponding purposes for which they may be prescribed, and applicable limits and conditions as set by BCCNM.
  • Removed limits on types of sexually transmitted infections (STIs) that may be treated by midwives with specialized practice certification (with the exception of HIV, which remains a limit).
  • Removed the specific routes of administration for hormonal contraceptives.
  • Added standard allowing midwives in hospital settings to prescribe or administer anticoagulants for the prophylaxis of venous thromboembolism. 

Minor revision to Standards of Practice

The new Registered Midwives Medications and Substances: Standards, Limits and Conditions required a corresponding change to Standard 15 in the Standards of Practice. The revised Standard 15 removes reference to the Midwives Regulation and requires that midwives prescribe, order, compound, dispense, and administer medications and substances in accordance with BCCNM's Registered Midwives Medications and Substances: Standards, Limits and Conditions.

Questions?

BCCNM recognizes this new standard is a significant change for midwives. The delayed in-effect date of this new standard is intended to give midwives and their clients, clinics, and other key audiences time to prepare. BCCNM will also be providing learning resources to support midwives.

The BCCNM Regulatory Practice team is an excellent resource for all college registrants. We encourage midwives to reach out to our Regulatory Practice Consultants with any questions about this new standard.