HPA Transition FAQs

Health Professions Act

New Midwives Profession Regulation

This Week’s FAQ’s about the HPA Move for Registered Midwives

(Week 1)

Each week the College of Midwives will contribute information here, to highlight the changes this move represents. This is an exciting time for Registered Midwives in Alberta, and we want you to know what it means for you.

What is the Health Professions Act exactly?

Glad you asked. The Alberta Health Professions Act (HPA) was originally proclaimed in December 2001. It was intended to introduce overlapping scopes of practice for health professionals and outline restricted activities to regulated professional groups. The College of Midwives of Alberta (CMA) started on the transition process from the Health Disciplines Act (HDA) and the Health Disciplines Board (HDB) to the HPA over three years ago. As of April 1, 2019, Registered Midwives in Alberta are legislated to be regulated under the HPA. We join 29 other Colleges under the HPA umbrella.

What will the HPA move do for our profession?

This means a new era in professional status for Registered Midwives. Registered Midwives in Alberta have been granted the ability to practice more fully as Primary Health Care Providers; a right of self-regulation and an obligation to monitor and discipline their own membership.

Self-regulation recognizes that a profession is in the best position to determine standards of education and practice. Self-regulation requires the members of a profession to carry out their practice in a manner that fulfills their mandate of serving and protecting the public. Self-regulation safeguards client safety by clearly determining the competencies and qualifications required by individual midwives. The legislated practice statements for the profession of Registered Midwives apply to all members of CMA in clinical practice, research, education, and administration and is outlined in the Health Professions Act in Schedule 13 of the Act.

Required functions for self-regulation:

Registration of Midwives who meet the educational and practice standards are able to confer the title of “Registered Midwife” or “RM”. The HPA sets out the basic process for registration, which is an initial confirmation of a level of competence. In order to practice, a practice permit is also required, of which, CMA has specific requirements. Conditions that relate to registration or continuing competence requirements, or that result from a conduct process, are specified on that permit yearly.
CMA must establish and enforce criteria for midwifery knowledge, skills and experience for entry into the profession. Specifically, CMA approves the entry level midwifery education program, Mount Royal University (MRU) Bachelor of Midwifery Program, ensuring that the MRU program supports Alberta midwifery practice standards. This work is referenced through the CMA Standards of Practice and the Code of Ethics.
Coordinate writing of the Canadian licensure exams (Canadian Midwifery Registration Examination, CMRE). This exam is held twice yearly, for new graduates, as needed in any province or territory in Canada.
Develop and maintain Standards of Practice based on expectations of Registered Midwives from their profession, their employers, and the public. Midwifery Standards of Practice specify the level of performance expected of the Registered Midwives to provide safe, competent and ethical care.
A Code of Ethics that reflects the values and states the Registered Midwives’ ethical responsibilities.
Direction and support for maintaining competence and professional commitment through continuing competence programs.
Define Scope of Practice of the Midwifery profession, with clear boundaries and restricted activities.
Advocate for quality health care; establishing Quality Assurance and Improvement programs for the membership.
Investigation of complaints and administration of disciplinary action, where required.
10. Legislation to detail the structure and functions of midwifery governance.
11. Adoption of bylaws, standards, policies, rules, and position statements that guide midwifery practice, and the CMA in its governance function.
12. Determination of fitness to practice criteria for regulated members; all qualities and capabilities of a midwife relevant to their capacity to practice as a Registered Midwife. This includes, but is not limited to: freedom from any cognitive, physical, psychological or emotional condition and dependence on alcohol or drugs that impair their ability to practice midwifery.

How does self-regulation work?

The midwifery profession governs itself through a regulatory body, the College of Midwives of Alberta and with the involvement of its professionals. All practicing midwives participate in self-regulation when they accept responsibility to practice according to the CMA Standards of Practice and Code of Ethics. Midwives also actively engage in the process of self-regulation by contributing their expertise to the work of the CMA; by participating in the development of standards, code of ethics, and examinations. They may also volunteer for committees or other regulatory activities and run for election to the Council. In Alberta, health regulatory bodies also have members of the public sit on their councils.

Hopefully this move to the HPA will also lead to more respect for the midwifery profession from other disciplines.

So, why do we need the CMA?

The CMA is the legislated regulatory body for Alberta’s more than 133 Registered Midwives under the HPA, including midwives in direct care, education, research and administration.

The Mandate of the CMA is to protect the public. Its vision is to inspire trust and confidence in midwifery care for all childbearing families through regulatory excellence (CMA, September 2017). The goal of midwifery practice in Alberta is to provide safe, competent and ethical midwifery care to childbearing families in Alberta. The CMA operationalizes its roles and responsibilities through the Alberta Midwifery Regulation (view on the CMA Website www.albertamidwives.org).

What do the new Midwifery Regulations cover?

With the move to the Health Professions Act, Alberta midwives will fully achieve autonomous regulation as practiced by other health professions.

The new Alberta Midwifery Regulation, from the HPA, not only provides a framework for establishing the legality of Registered Midwife actions in the care of clients, it also outlines the responsibilities that govern midwifery practice and midwifery relations with Physicians, Registered Nurses, and other health care practitioners within the health care system. The Regulation helps establish boundaries for independent midwifery care and assist midwives in ensuring that they are competent, consistent, and safe.

The Regulation covers the following areas:

Registration Categories and Qualifications, yearly Practice Permits

Reinstatement of Registrations and Practice Permits

Substantial Equivalence

Use of Titles

Restricted Activities (items that the legislation now covers)

Advanced Authorizations (items that midwives as Primary Care Providers can do in the future, with specific additional education and skills, and experience)

Training and Supervision

Continuing Competence Program

Alternate Complaint Resolution

Providing Information (allowable situations for CMA to publish)

Are you sure that you can self-regulate? Does the CMA have what it takes?

The CMA has been working toward this goal for several years and we have worked with government and other regulated professions under the HPA to ensure that the CMA understands the responsibilities and necessary requirements to serve the members of our profession and the public to our full capacity under the new regulations.