NOW

After Jan 1, 1994

(Post-Legislation)

THEN

Before Jan 1, 1994

(Pre-Legislation)

Midwifery services in Ontario are fully covered by government funding. There are no charges to consumers for the care that a midwife provides either to a woman or her newborn.

There was no government funding for midwifery services prior to January 1994. Clients paid midwives directly for the services they provided. Many midwives charged according to a sliding scale, dependent on client income, which ranged from $400 to $1400 for care during pregnancy, labour and birth and the postpartum period.

As primary caregivers for women and newborns, midwives can order diagnostic and laboratory tests that may be necessary in order to provide care.

Midwives did not have access to laboratory or diagnostic tests. Their clients needed to obtain these services from a physician who may or may not have been familiar with their ongoing care.

Midwives can offer women the choice of either hospital or home birth. Should a client choose a hospital birth, the midwife can admit and discharge the client and care for her fully within the hospital.

While midwives had always offered woman a choice of hospital or home birth, they could not provide primary care while in the hospital. The woman needed to be cared for by a physician while in the hospital, with the midwife providing emotional and physical support during that time.

All midwives in Ontario are members of the College of Midwives of Ontario. As the regulating body, the College protects the interests of the public by ensuring that all midwives meet the necessary standards of practice.

The College of Midwives did not exist prior to legislation. Despite the fact that no regulatory body existed, the majority of midwives in Ontario practiced in accordance with the guidelines established by the professional association, the Association of Ontario Midwives.

Newly registered midwives have either completed a four-year baccalaureate degree or have met the requirements of the International Midwives Pre-registration Program, in order to qualify for registration in Ontario.

There was no formal education or route of entry for midwives in Ontario. Many midwives learned their skills through an apprenticeship or through formal or informal training in other countries.

Midwives are increasingly familiar members of the health care team. Midwives are part of the midwifery, obstetrical or family practice department at their local hospital, and take an active part in research, policies and standards affecting maternal and newborn care.

Although many informal relationships existed between midwives, doctors and nurses, midwives were often viewed as being outside of the healthcare system and seen as somewhat of a "fringe" service.