N.S. midwives ‘excited’ to use new scope of practice, but waiting on province to take advantage

Nova Scotia midwives are one step closer to being able to offer more health care to patients, but the health minister says the next step would require more money and there isn’t any in the budget to give.

N.S. midwives ‘excited’ to use new scope of practice, but waiting on province to take advantage Health minister says it’s status quo for now because of tight provincial budget Nova Scotia midwives are one step closer to being able to offer more health care to patients, but the health minister says the next step requires more money and there isn’t any in the budget to give. “Not in this budget year, anyway, so I think things will remain status quo,” Health Minister Michelle Thompson told reporters following a cabinet meeting last week.

A piece of provincial legislation that passed in 2023 recently came into effect for midwives that will allow them, legally, to offer more than just maternity care. “It opens the door for expanded opportunities for us to improve access to care and improve clinical outcomes for women, for trans and gender-diverse people, for families. We’re really excited,” said Liz Fraser, co-president of the Association of Nova Scotia Midwives, in an interview.

Midwives have long been calling for the chance to do more. Since they were first regulated in Nova Scotia 20 years ago, their practice has been restricted to caring for moms and babies during low-risk pregnancies, childbirth and up to six weeks postpartum. Fraser said midwives have training to extend their care further into the postpartum period, to see higher-risk pregnancies — through interdisciplinary care teams — and provide a wide range of sexual and reproductive health care across the lifespan.

The two former colleges for midwives and nurses recently amalgamated, and the new joint oversight body is now responsible for the regulations that will specify the parameters of an “optimized” scope of practice for midwives. The amalgamation stems from the passage of the Regulated Health Professions Act three years ago. One of the Progressive Conservative government’s stated goals with the act was to tap into the full scopes of practice for all regulated health-care providers.

Doug Bungay, the registrar and CEO of the Nova Scotia Nursing and Midwifery Regulator, said identifying the regulatory changes that have to be made for midwives is a priority that’s getting underway this summer. “It’s certainly a big opportunity for midwives to be able to work to their fullest scope of practice,” Bungay said in an interview. “It’s the right thing to do for Nova Scotians to make sure they have access to the kind of care that they want,” he added.

Number of newborns in N.S. without a family doctor, care provider on the rise N.S. midwives push for more funded positions as demand grows for their services New midwifery service poised to launch in Cape Breton Thompson has been clear since the launch of the provincial budget this spring that there’s no fiscal capacity to add more midwives to the system. The province is grappling with a $1.2-billion deficit and is projecting several more years of tight budgets with increasing levels of cuts. But Fraser said adding more midwives to the existing care model — that is, three midwife-led maternity care sites — is not the only way to open up their scope of practice.

Fraser said the province could expand hiring practices to allow midwives to work in different settings. “There are so many settings across the health-care system where it would be extremely appropriate to have a midwife as part of a care team,” she said. Several other health-care professions are still due to migrate from their old governing legislation to the new Regulated Health Professions Act.

The Department of Health and Wellness says the work is expected to be complete early next year. Thompson said as the change progresses, “We’ll continue to see what role individuals can play.” Fraser said she’s looking forward to the Health Department taking full advantage of midwives’ new scope.

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