Maggie, a registered midwife in B.C., meets with her client Indira who is 23-weeks pregnant with her first baby. Indira has been diagnosed with placenta previa and is awaiting test results for gestational diabetes screening. She tells Maggie she is planning an eight-week trip to Nova Scotia to visit family.
Maggie explains the risk of travelling with placenta previa and possible gestational diabetes, and that Indira will require bloodwork and a follow-up ultrasound during the trip. Indira asks Maggie if she can order the tests and provide care to her virtually while she is in Nova Scotia.
Maggie considers her ability to safely and reasonably provide the care Indira requires while she is outside of B.C., and how she will ensure continuity of care should Indira require immediate care while away.
Providing care virtually to a B.C. client located in another province
Regulatory requirements in B.C.
Maggie knows she must follow BCCNM's midwifery scope of practice, standards, policies, and guidelines when providing virtual care, regardless of the client's location. She should also contact the midwives' liability insurance provider and BCCNM to ensure she has considered all the implications of practicing virtually.
Regulatory requirements in another jurasdiction
Maggie also considers Nova Scotia's regulatory requirements for midwives. As a B.C. midwife providing virtual care to a client outside B.C., she is responsible for contacting the appropriate regulatory body in the jurisdiction where her client is located at the time of care, as there may be registration requirements and additional limits or conditions to consider.
She also understands there may be registration requirements and additional limits and conditions to consider when ordering tests and diagnostics in another jurisdiction.
If Indira decides to travel
Maggie needs to ensure that Indira has all the information to make an informed choice about travelling.
Maggie advises Indira:
She is not able to order tests and diagnostics or provide follow-up virtual care while Indira is outside of B.C.
To find a midwife or physician in Nova Scotia who can provide her with the required care and order the tests and diagnostics
To request a copy of any diagnostics and lab results and provide them to Maggie for her records and Indira's follow-up visit
To seek physician care right away if she becomes symptomatic at any point
To contact Maggie as soon as she's back in B.C. as Indira may require a consultation or transfer of care to a physician depending on the results of her gestational diabetes mellitus screen and third-trimester ultrasound
Maggie recommends Indira does not go on her trip and stays in B.C. for now.
Resources