Alberta midwives granted broader powers to give drugs, insert IUDs, perform ultrasounds

Midwives in Alberta will soon have an expanded scope of care when working with expectant and new mothers, including prescribing and administering medications.

The changes will allow midwives to not only perform more tasks during labour but also provide greater postnatal care.

The Alberta government said starting April 1, 2019, midwives who complete additional training and are authorized by the College of Midwives of Alberta will be able to prescribe, dispense and administer a broader range of prescription drugs — including ones to induce labour — and be able to use ultrasounds to determine fetal position.

In hospital, they will also be allowed to give patients benzodiazepines (anti-anxiety medications) and narcotic painkillers.

Midwives will also be able to prescribe and administer vaccines and post-delivery, will be able to prescribe contraceptives and contraceptive devices, and insert IUDs.

“In that six weeks post-delivery, being able to get birth control from your midwife rather than having to go to yet another doctor’s appointment somewhere else, being able to even have an IUD inserted and not having to worry about getting pregnant again right away, is additional peace of mind,” Health Minister Sarah Hoffman said.

The province said the expanded scope of practice will allow midwives to use their knowledge and skills to the fullest extent and bring Alberta practitioners in line with many other provinces and territories.

It will also help women in rural and remote communities access maternal health services.

“We want to provide Albertans with easier access to maternal and reproductive health services closer to home,” Hoffman said, adding the regulation change will not cost the province anything.

“The way we pay midwives is for a course of care, so to take care of an expectant mother from the time they realize they are pregnant and visit their midwife, through to six weeks post-delivery,” Hoffman explained.

The health minister said she didn’t receive requests for midwives to be paid more – instead, they wanted more power to be a pregnant woman’s primary care provider.

“They said, ‘Rather than seeing a patient, knowing she needs antibiotics and having to send her to go see a family physician, we want to have the training to be able to give her antibiotics.’”

The College of Midwives of Alberta calls the change a “new era and professional status of Alberta midwives.”

“This change will allow midwives to make fuller use of their knowledge and skills in the provision of high-quality, cost-effective maternity care for Alberta’s child-bearing families,” college president Cassie Evans said.

Hoffman said the college will develop training modules for midwives to upgrade their skill set. Evans said the extra training will help cut down on delays during delivery by allowing midwives to do more themselves – such as inductions – instead of having to stop and consult with an obstetrician.

Evans said all of the additional skills will be added to the Bachelor of Midwifery curriculum at Mount Royal University, so the training modules will act as a bridge until new graduates enter the field with the expanded skill set.

The Midwifery Association of Alberta said it is excited about the changes in regulations.

“This will help increase access to primary care in rural, remote and under-served communities,” president Nicole Matheson said.

The province said midwifery is a safe option for women with low-risk pregnancies, adding research has shown that women who give birth with the assistance of a midwife tend to have shorter hospital stays, are more likely to breastfeed and require fewer medical interventions, such as caesarean sections.

The 2016 provincial budget provided a funding increase of $11 million over the course of three years, which aimed to allow about 400 more midwife-assisted births each year – an increase of about 30 per cent.

There are more than 125 midwives practicing in Alberta.

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