4 Renewal of
registration
5 Training
programs and examinations
6 Register
7 Use of title
8 Practice of
midwifery
9 Autonomous
practice and medical consultation
10 Standards of
conduct
11 Practice Review
12 Liability
insurance
13 Coming into
force
Schedules
Definitions
1 In this Regulation,
(a) “Act”
means the Health Disciplines Act;
(b) “assessment”
means the gathering of information about the health status of the client,
analysis and synthesis of that data, and the making of a clinical judgment or
diagnosis;
(c) “Association”
means the Alberta Association of Midwives;
(d) “Board”
means the Health Disciplines Board;
(e) “Committee”
means the Midwifery Health Discipline Committee established under section 9(1)
of the Act;
(f) “midwife”
means a person who is registered pursuant to this Regulation;
(g) “primary
health care provider” means a person who
(i) is directly accessible to clients without referral from another
health professional,
(ii) is authorized to provide health services within a defined scope
of practice without supervision by a member of another health profession,
(iii) co‑ordinates health related services and makes referrals to
other health professionals when appropriate, and
(iv) ensures continuity of care;
(h) “registrar” means the registrar of the
designated health discipline of midwives.
AR 328/94 s1;251/2001
Eligibility for
registration
2(1) For
the purposes of section 22(a) of the Act, a person is eligible to be registered
as a midwife if that person
(a) has
satisfactorily completed a program of studies approved by the Board,
(b) has
satisfactorily completed an examination approved by the Board,
(c) has
(i) within the 2 years immediately preceding the date of application,
met the requirements of clause (a),
(ii) within the one year immediately preceding the date of application,
satisfactorily completed a refresher program approved by the Board, or
(iii) maintained competence by actively engaging in the practice of
midwifery in accordance with criteria established by the Committee,
(d) has
completed and submitted to the registrar the forms prescribed by the Minister,
and
(e) has
paid the application fee and registration fee prescribed by the Minister.
(2) Notwithstanding
subsection (1)(a), (b) and (c), a person is eligible to be registered as a
midwife
(a) if
the Committee is satisfied that the person has attained a level of competence
equivalent to that required under subsection 1(a), (b) and (c) because of
directly related training, examinations and practice, or
(b) if the person successfully completes any
training or examinations, or consents to any terms, conditions or limitations
on registration or practice, required by the Committee under section 23(5)(b)
of the Act.
AR 328/94
s2;251/2001;27/2002
Temporary
registration
3(1) Notwithstanding section 2, for the purposes of
section 22(a) of the Act, a person is eligible to be registered as a midwife on
a temporary basis if the Committee is satisfied, on the basis of generally
accepted criteria, that temporary registration is appropriate.
(2) A person who is registered pursuant
to subsection (1) may engage in the practice of midwifery under a type and
level of supervision specified by the Committee and subject to any terms,
conditions or limitations imposed by the Committee.
(3) Temporary registration may be granted for a
maximum period of one year and may, on application and at the discretion of the
Committee, be extended for not more than one additional period of not more than
one year.
AR 328/94 s 3;251/2001
Renewal of
registration
4(1) For the purposes of section 24(3)(a) and (b) of
the Act, a midwife is eligible for an annual renewal of registration if the
midwife has paid the renewal fee prescribed by the Minister and has
(a) within
the 2 years immediately preceding the date of submission of the application for
renewal of registration, met the requirements of section 2(1)(a),
(b) within
the one year immediately preceding the date of submission of the application
for renewal of registration, satisfactorily completed a refresher program
approved by the Board, or
(c) maintained
competence by actively engaging in the practice of midwifery in accordance with
the criteria established by the Committee.
(2) For
the purposes of section 24(1) of the Act, the date for submission of an
application for renewal of registration is May 1.
(3) Notwithstanding
subsection (1), a midwife is eligible for an annual renewal of registration
(a) if
the Committee is satisfied that the midwife has maintained a level of
competence equivalent to that required under subsection (1)(a), (b) or (c)
because of directly related training or practice, or
(b) if the midwife successfully completes any
training and examinations, or consents to any terms, conditions or limitations
on registration or practice, required by the Committee under section 24(7) of
the Act.
AR 328/94
s4;251/2001;27/2002
Training programs and
examinations
5 For the purposes of section 23(5)(a) and
24(7)(a) of the Act, the training programs and examinations that the Committee
may require are the following:
(a) a
refresher program approved by the Board;
(b) the
examination referred to in section 2(1)(b);
(c) all or part of a program of studies referred
to in section 2(1)(a) as prescribed by the Committee or any other training the
Committee considers appropriate.
AR 328/94 s5;251/2001
Register
6(1) The registrar shall enter in the register
(a) the
name, mailing address, practice status and registration number of each midwife,
and
(b) any
terms, conditions or limitations imposed on a midwife’s practice by the
Committee under section 2, 3 or 4 of this Regulation or Part 4 of the Act.
(2) A
midwife shall forthwith notify the registrar of any change in name, mailing
address or practice status.
Use of title
7 A person registered pursuant to this
Regulation may use the name “midwife”.
Practice of midwifery
8 A midwife may
(a) provide
counselling and education related to childbearing,
(b) carry
out assessments necessary to confirm and monitor pregnancies,
(c) advise
on and secure the further assessments necessary for the earliest possible
identification of pregnancies at risk,
(d) identify
the conditions in the woman, fetus or newborn that necessitate consultation
with or referral to a physician or other health professional,
(e) care
for the woman and monitor the condition of the fetus during labour,
(f) conduct
spontaneous vaginal births,
(g) examine
and care for the newborn in the immediate postpartum period,
(h) care
for the woman in the postpartum period and advise her and her family on newborn
and infant care and family planning,
(i) take
emergency measures when necessary,
(j) perform,
order or interpret screening and diagnostic tests in accordance with Schedule
1,
(k) perform
episiotomies and amniotomies and repair episiotomies and lacerations not
involving the anus, anal sphincter, rectum and urethra,
(l) prescribe
and administer drugs in accordance with Schedule 2, and
(m) on
the order of a physician relating to a particular client, administer any drugs
by the route and in the dosage specified by the physician.
Autonomous practice
and medical consultation
9(1) In respect of normal pregnancy, a midwife may,
in accordance with the guidelines approved by the Board,
(a) engage
in the practice of midwifery as a primary health care provider, and
(b) provide
services in a variety of settings.
(2) If
medical conditions exist or arise during the course of midwifery care that may
require management by a physician, a midwife shall consult with a physician in
accordance with the guidelines approved by the Board.
(3) If
the result of the consultation under subsection (2) is a determination that
management by a physician is required, the midwife shall transfer primary
responsibility for care, or aspects of care, to a physician and may engage in
the practice of midwifery in collaboration with the physician, to the extent
agreed to by the client, physician and midwife.
Standards of conduct
10 A midwife shall
(a) execute
all duties in accordance with generally accepted standards of practice and
professional ethics and be guided at all times by the welfare, best interests
and informed consent of the client,
(b) work
within, be limited by and inform clients regarding
(i) the midwife’s scope of practice and individual ability,
(ii) any terms, conditions or limitations on registration or practice
imposed by the Committee, and
(iii) the practical limitations imposed by the environment or equipment
at hand,
(c) maintain
currency in knowledge and skill in the practice of midwifery and enhance
knowledge and skill in accordance with new developments in procedures or
equipment,
(d) work
to encourage high standards of performance and research in the practice of
midwifery,
(e) refer
any incompetent, illegal or unethical professional conduct by colleagues or
other health care personnel to the appropriate authorities,
(f) hold
in confidence all client information unless the midwife is permitted by the
client or required by the Act or any other enactment or by order of a court to
disclose the information, and
(g) comply
with government standards and reporting requirements.
Practice Review
11(1) A Practice Review Committee is established
consisting of
(a) 3
midwives,
(b) 2
consumer representatives, and
(c) one
member of the College of Physicians and Surgeons of Alberta
appointed by the
Association, in accordance with the guidelines approved by the Board.
(2) The
Practice Review Committee may, on its own initiative, and shall, at the request
of the Board, conduct a review of the practice of a midwife in accordance with
guidelines approved by the Board.
(3) After
each review under subsection (2), the Practice Review Committee may provide
advice and make recommendations to the midwife as to the practice of midwifery
by that midwife.
(4) If,
in the course of a review of the practice of a midwife,
(a) the
Practice Review Committee discovers conduct or competence problems it believes
warrant disciplinary action, or
(b) the
midwife does not co‑operate with the Practice Review Committee in
carrying out the review,
the Practice Review
Committee shall refer the matter to the Midwifery Committee and the referral
shall be treated as a complaint under Part 4 of the Act.
(5) The
Practice Review Committee may inquire into, report to and advise the Midwifery
Committee in respect of:
(a) the
assessment and development of educational, experiential and practice standards
that are conditions precedent to registration or renewal of registration under
this Regulation,
(b) the
evaluation of desirable standards of competence of midwives generally, and
(c) the
practice of midwifery generally.
Liability insurance
12 A midwife shall carry professional
liability insurance with an insurer acceptable to the Board and in an amount
that is at least the minimum level of coverage required by the Board.
Coming into force
13(1) This Regulation except for Schedule 2 comes
into force on August 1, 1995.
(2) Schedule
2 comes into force on the coming into force of an order of the Lieutenant
Governor in Council under section 1(1)(v) of the Pharmaceutical Profession
Act that authorizes midwives to prescribe drugs.
Schedule 1
1 A midwife may order, collect
samples for and interpret the report of the following screening and diagnostic
tests:
(a) for
a woman:
(i) chemistry: blood glucose;
(ii) cytology: cervical smears (Pap smears);
(iii) haematology: haemoglobin, haematocrit, white blood cell count,
differential, platelet count, red blood cell morphology, sickle cell
solubility, Kleihauer;
(iv) microbiology:
(A) cervical and vaginal cultures (including
sensitivities where relevant) for group B streptococcus, gonorrhoea, chlamydia,
yeasts, trichomonas, and gardenerella;
(B) urine for culture and sensitivities; swabs
for culture and sensitivities (eg. wounds, episiotomies);
(C) viral swabs (herpes);
(v) serology/immunology: blood group and type with antibody screen,
repeat antibody testing, hepatitis, human immunodeficiency virus antibody,
rubella antibody, toxoplasmosis antibody, syphilis serology, cytomegalo virus
antibody, maternal serum biochemical screening and varicella titre;
(vi) pregnancy tests (blood and urine);
(vii) urine: routine, microscopic urinalysis;
(b) for
a newborn:
(i) haemoglobin, haematocrit, white blood cell count with
differential, neonatal metabolic screen, glucose, direct coombs, direct antiglobulin
test and bilirubin;
(ii) microbiology samples: cord and eye cultures;
(iii) serology/immunology: screen to evaluate possible congenital
syphilis, rubella and herpes simplex; blood group and type with antibody
screen.
2 A midwife may perform and
interpret the results of the following screening and diagnostic tests:
(a) urine
(dip stick urinalysis);
(b) pregnancy
test (urine);
(c) blood
glucose: adult and newborn (stix method).
3 A midwife may order and
interpret the report of an ultra sound test: obstetrical for diagnostic
purposes only.
4 A midwife may order and
perform non‑stress tests and interpret the results of non‑stress
tests.
AR 328/94
Sched.1;119/2003
Schedule 2
1 A midwife may prescribe and administer the following
substances in accordance with the guidelines approved by the Board:
Antibiotics for
prophylactic treatment of
Group
B streptococcus and treatment of mastitis
Antifungal
agents considered safe in pregnancy
and
for newborns
Calcium
gluconate
Carboprost
Dimenhydrinate
Diphenhydramine
hydrochloride
Doxylamine
succinate‑pyridoxine hydrochloride
Entonox
Epinephrine
hydrochloride
Ergometrine
maleate
Erythromycin
ophthalmic ointment
Hepatitis
B Immunoglobulin
Hydralazine
Hydrocortisone
Intramuscular
or intravenous oxytocin
Intravenous
fluids
Lidocaine
hydrochloride with or without epinephrine
Magnesium
Sulphate
Naloxone
Phytonadione
Promethazine
RhD
immune globulin
Therapeutic
oxygen
2 A
midwife may administer, prescribe or order any drug or substance that may
lawfully be purchased or acquired without a prescription.
AR 328/94
Sched.2;82/98;119/2003
