The BC College of Nurses and Midwives (BCCNM) is committed to supporting all parents to safely deliver their babies with the expert care of midwives, physicians, and nurses who are key members of our health-care system.
The college recognizes that some pregnant people consider choosing unauthorized providers or unassisted births for a variety of reasons. This public notice is being provided to ensure all expectant parents have the information they need to make safe and informed birth choices.
Midwifery in B.C. is a regulated profession, and the title “midwife" is a protected title.
Only individuals registered with the college are authorized to use this title, and to provide midwifery care.
BCCNM is aware of individuals unlawfully practising midwifery by providing prenatal care, attending labours, delivering babies, and managing home births when they are not permitted to do so. These individuals do not have the same training, experience, and access to life-saving medications and equipment as midwives, nor integration with hospitals for emergency care if needed, resulting in significant risks to the health and safety of birthing persons and their babies.
BCCNM has received reports of tragic outcomes—including death—from people using unauthorized providers.
If you are seeking home birth care, please be aware that:
At present, only registered midwives are entitled to use the title "midwife" or another title that may suggest they are a registered midwife. Unauthorized providers might use variations of the term “midwife" and call themselves titles such as "birth attendant", "birth keeper", or "traditional midwife", but these are also considered unauthorized use of title.
At present, only registered midwives may provide prenatal care, manage labours, or attend home births in the role of midwife. Midwives work with you to honour your birth choices.
In regions where no registered midwives are providing home birth services, physicians or midwives offer high-quality birthing services in hospital.
Unauthorized providers who unlawfully practise midwifery present significant risk to the public, including to the health and lives of birthing persons and their babies. Making a choice to have an unauthorized provider can lead to many risks:
You have no way to verify that they have the education, skills, and qualifications to provide you and your baby with safe, competent, and ethical care. In case of an emergency, you and your baby will not have access to life-saving medical equipment and medications, which can result in unnecessary harm and preventable deaths.
You will not have access to the broad array of lab tests, ultrasounds, other tests, medications, and specialist referrals that are available to pregnant people in B.C. You may not be provided accurate information about the risks and benefits of tests and treatments available before, during, and after birth.
If you need to transfer to hospital during a planned home birth, an unauthorized provider cannot provide care in the hospital. They do not have hospital privileges and are not members of the health care system, so there would be no transfer of medical records or coordination of care with hospital staff.
You will have to pay privately for services from an unauthorized provider. This is in contravention to the law, which states that individuals may not charge a fee for the services provided by registered midwives.
You will have no regulator to file a complaint with, that can investigate and ensure the person's practice is competent. As they do not carry malpractice insurance, you will have no ability to recover damages in court.
All of these risks can result in significant harm and fatal outcomes, as well as a lack of coordination of care and negative birth experiences. If you are not satisfied with the care you received from an unauthorized provider, or you are faced with a tragic outcome like the death of your baby, you will have no recourse.
A doula can
play an important role in a positive birth experience. Doulas provide physical and emotional support to birthing people during labour and birth while a regulated health professional such as a midwife or physician provides clinical care.
While clients may choose to hire a doula for support, doulas are not permitted to perform clinical care, including managing labour, performing assessments (for example, checking cervical dilation or listening to/assessing fetal heart tones), or delivering the baby. To do so would constitute unauthorized practice of midwifery.
B.C. has midwives who are Indigenous. They work within the regulated system alongside all midwives. All midwives are expected to provide
culturally safe care for their Indigenous clients.
BCCNM fully supports the autonomy of traditional Indigenous midwifery including integration into the health-care system as a part of ongoing reconciliation and restoration of Indigenous birthing practices.
For more information on Indigenous midwifery in Canada, please visit the
National Council of Indigenous Midwives and the
Midwives Association of BC.
Unauthorized providers create a public safety risk which is a great concern to BCCNM. As the provincial regulator, we are in a position to take action against these individuals. If you know of a person offering unauthorized midwifery services, you are encouraged to make a report to BCCNM in writing at firstname.lastname@example.org. Please visit our website for information on what to include in your report.
You can search BCCNM's
online registry to verify whether an individual is currently registered with BCCNM. If a person's name is not on our online registry,
they are not a registered midwife in B.C.
The Midwives Association of BC offers an
online tool to search for a registered midwife in your area. Please visit the
Midwives Association of BC for more information on midwifery care.
BCCNM would like to thank our partners who consulted on this notice, including the Midwives Association of BC (MABC) and the MABC Indigenous Midwifery Advisory Council; Perinatal Services BC; the College of Physicians and Surgeons of BC; Midwifery representatives from PHSA and the regional health authorities; the UBC Midwifery Program; the Ministry of Health; and the Midwives Protection Program (Ministry of Finance.)