On June 27, 2024, the BCCNM board approved several changes to registered midwife (RM) home birth standards. These changes take effect Aug. 27, 2024.
Summary of changes
The BCCNM board:
- Rescinded the home birth standards Policy for Home Birth Transport Plan, Home Birth Transport Plan, Required Equipment and Supplies for Home Birth Setting, Planned Place of Birth Handbook, Planned Place of Birth Informed Consent, and Policy for Second Birth Attendants
- Approved a new standard Home and Community Birth: Standards, Limits, and Conditions: Review the new standard
And
- Rescinded the guidelines Clinical Practice Guidelines, Guideline for Managing the Second Stage of Labour, and Guideline for the Use of Water in Labour, and Birth
- Approved corresponding revisions to the RM Standards of Practice: Review the revised standards
Why were these changes made?
Over the course of this year-long project, BCCNM reviewed regulations and standards, and conducted a jurisdictional scan and literature reviews. To better understand the issue and seek input, the college engaged with midwives, Indigenous midwives, and system partners.
Registrants and other key informants previously reported to BCCNM that the standards specific to home birth did not accurately reflect the current practice environment. During this review, it was also identified that the clinical practice guidelines on the use of water in labour and birth and second stage of labour, which apply in all settings, may also be outdated, and are no longer required due to the availability of more up-to-date resources.
Many of the identified risks of home birth are addressed within the current standards, and these principles have been transitioned into the new Home and Community Birth: Standards, Limits, and Conditions. Notable changes within the proposed standard include the removal of clinically focused content and requirements to share completed forms with BCCNM. As well, the expectations regarding infection control and prevention were clarified and the requirements related to additional attendants were revised to specify the clinical skills necessary to support a primary midwife in home and in community settings. The current Required Equipment and Supplies for Home Birth list will be transferred to Perinatal Services BC (PSBC) and BCCNM will require midwives to carry and maintain the equipment and supplies as listed by PSBC.
Indigenous cultural safety and humility
Midwives play a critical role in supporting clients who wish to give birth in their home community. The new Home and Community Birth: Standards, Limits and Conditions are intended to support safe care in home and community settings and will be applied along with the Indigenous Cultural Safety, Cultural Humility and Anti-Racism Practice Standard to ensure that midwives' Indigenous clients and newborns receive culturally safe care.
Midwife representatives from the MABC Indigenous Midwives Advisory Council were consulted throughout BCCNM's policy process. This engagement confirmed that the new Home and Community Birth: Standards, Limits and Conditions would support safe birth in home and community settings and that the rescinding of the clinical practice guidelines are not expected to have unintended consequences for Indigenous midwives or communities.
Questions?
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