This consolidation is unofficial and is for reference only. For the official version of the regulations, consult the original documents on file with the Registry of Regulations, or refer to the Royal Gazette Part II. Regulations are amended frequently. Please check the list of Regulations by Act to see if there are any recent amendments to these regulations filed with the Registry that are not yet included in this consolidation. Although every effort has been made to ensure the accuracy of this electronic version, the Registry of Regulations assumes no responsibility for any discrepancies that may have resulted from reformatting. This electronic version is copyright © 2009, Province of Nova Scotia, all rights reserved. It is for your personal use and may not be copied for the purposes of resale in this or any other form.
made under Section 9 of the
S.N.S. 2006, c. 18
O.I.C. 2009-108 (March 10, 2009), N.S. Reg. 58/2009
1 These regulations may be cited as the Midwifery Regulations.
Definitions for Act and regulations
2 (1) In these regulations,
(a) “Act” means the Midwifery Act;
(b) “assessment and credential verification process” means the process used by the Council to determine the clinical competence of internationally trained midwives;
(c) “bridging program” means an educational program approved by the Council to address gaps, identified through a competency assessment program, in the competencies of an applicant for registration that must be filled before the applicant can be registered;
(d) “clinical practice of midwifery” means the provision of antepartum, intrapartum, postpartum and newborn care as a primary care provider;
(e) “competency assessment program” means a program approved by the Council to assess the competence of midwives who are seeking registration in the Province;
(f) “non-clinical”, in relation to practising midwifery, means practice that is limited to research, education, consultation, management, administration, regulations, policy or system development relating to the activities in subclauses (i) to (iv) of the definition of the practice of midwifery in clause 2(i) of the Act.
(2) In the Act and these regulations,
(a) “Association” means Association of Nova Scotia Midwives;
(b) “conduct unbecoming the profession” means conduct in a member’s personal or private capacity that tends to bring discredit upon the midwifery profession;
(c) “licensing sanction” means any disciplinary proceedings that result in the limitation, suspension or termination of a member’s licence, and does not include
(i) in accordance with subsection 16(4), conditions and restrictions imposed on a provisional licence, or
(ii) in accordance with Section 36, a counsel or caution issued by the Registrar under clause 38(8)(e), (f) or (g) of the Act;
(d) “midwife” is further defined to include a member with a provisional licence or a provisional licence with conditions or restrictions.
3 (1) The Registrar may also be referred to by the title of Executive Director.
(2) The Registrar is responsible for all of the following duties:
(a) planning and implementing the programs of the Council in accordance with policies and objectives approved by the Council;
(b) the administration of the Council and its internal staffing and management;
(c) any duties required from time to time by the Council.
(3) If the office of the Registrar is vacant or the Registrar is absent or unable to act, the chair of the Council must name a member of the Council to act in the place of the Registrar until the Registrar returns or a new Registrar is appointed.
(4) A member of the Council must not give instructions to any of the employees of the Council except through the Registrar.
(5) The Registrar is the secretary and treasurer of the Council.
Information in Register
4 (1) In addition to the name of the person qualified, as required by the subsection 16(1) of the Act, the Register must contain all the following information for each member:
(a) business mailing address and phone number;
(c)[(b)] the date of first entry in the Register;
(d)[(c)] the date the member’s registration is cancelled or not renewed;
(b)[(d)] the name and location of the academic institution the member graduated from and their and midwifery credentials.
(2) A member must immediately notify the Registrar of any change in their name or mailing address.
5 (1) To establish that they meet the educational requirements of Section 15 of the Act, an applicant for registration must submit any certificates, documents or other information that the Registrar may require in support of the application, including a notarized copy of all certificates, diplomas or degrees and other evidence satisfactory to the Registrar that the applicant is the person named.
(2) In addition to the educational requirements in Section 15 of the Act, an applicant must meet all of the following requirements to be registered:
(a) successful completion of the registration examinations approved by the Council;
(b) payment of the applicable application and registration fees prescribed by the Council;
(c) demonstrated proficiency in the English language in the manner determined by the Council;
(d) meeting the criteria for entry in the active-practising roster in Section 12, or the active-practising with conditions or restrictions roster in Section 14;
(e) providing any information the Registrar requires to establish that the applicant has the capacity, competence, capability and character to safely and ethically practise midwifery;
(f) having a good character consistent with the responsibilities of a member and the standards of practice expected of a member.
(3) To establish that they meet the requirements of subsection (2), an applicant for registration must submit any documentation or proof required by the Registrar, including all of the following:
(a) a photograph of the applicant that clearly shows the applicant’s face and is taken in the 6 months immediately before the application;
(b) all information that relates to the applicant and the practice of midwifery, or is otherwise relevant to their ability to safely and ethically practise midwifery, regardless of where the event took place, including all of the following:
(i) findings of professional misconduct, incompetence or incapacity by a professional college or a professional association that has regulatory responsibility, or a dismissal for cause by an employer,
(ii) current proceedings for professional misconduct, incompetence or incapacity, including proceedings for professional misconduct or fitness to practice by professional colleges or professional associations that have regulatory responsibility,
(iii) denials of registration by professional regulatory colleges and denials of membership by professional associations that have regulatory responsibility,
(iv) negative verdicts and recommendations of coroners’ inquests,
(v) professional liability insurance claims,
(vi) settlements and judgments in any civil lawsuit or particulars of any civil action that is pending to which the applicant is a party;
(c) any information the Registrar requires to satisfy the requirement in subsection 20(2) of the Act to notify the Registrar of any convictions, including a signed criminal record check authorization form;
(d) evidence satisfactory to the Council that the applicant is legally entitled to work in Canada.
(4) An applicant for registration must satisfy the Registrar that any deficiency in their practice or conduct revealed by the matters disclosed under subsection (3) has been remedied and that permitting the applicant to register would not pose a threat to public safety.
Initial registration in Canada
6 An applicant who has not previously been registered in a Canadian province and is seeking registration for the first time is exempt from the requirement in clause 5(2)(a) to complete a registration examination approved by the Council, unless it is determined to be necessary through the assessment and credential verification process.
Missing, false or misleading information relevant to registration
7 If an applicant for registration fails to disclose any information of a previous, present or pending matter required by subsection 5(3), or provides false or misleading information, the applicant’s application for registration may be rejected or their licence to practise may be revoked.
Interview with Registrar
8 The Registrar may require that an applicant for registration attend an interview with the Registrar to discuss their application.
9 (2) [(1)] A candidate must be given a maximum of 3 opportunities to pass the registration examination in the 24 months immediately after they become eligible to write the examination.
(3) [(2)] A candidate may be given 2 further opportunities to write the registration examination after 24 months have passed since they became eligible if they have completed 1 of the following:
(a) a midwifery education program;
(b) at the candidate’s expense, a competency assessment program and any bridging program required by the Council.
(4) [(3)] A candidate who does not pass the registration examination taken under subsection (3) [(2)] cannot write the registration examination again.
(1) [(4)] Any registration examination required to be taken under these regulations must be approved by the Council.
10 (1) The methods used in a competence assessment may include, but are not limited to, interviewing, verification of documents, observation, reflective practice, self-assessments or testing.
(2) The tools used in a competence assessment may include, but are not limited to, chart audits, self-assessments, written tests or live demonstrations of competencies.
Rosters and Licensing
Classes and sub-classes of licences
11 (1) The following are the classes of licences under the Act:
(b) active-practising with conditions or restrictions;
(d) provisional with conditions or restrictions.
(2) The following are the sub-classes within the active-practising licence class:
(a) active-practising (clinical);
(b) active-practising (non-clinical).
(3) The following are the sub-classes of licences within the active-practising with conditions or restrictions licence class:
(a) active-practising (clinical) with conditions or restrictions;
(b) active-practising (non-clinical) with conditions or restrictions.
Criteria for entry in active-practising roster
12 The Registrar must record the name of a member in the active-practising roster who meets all of the following criteria:
(a) the member has 1 of the following prerequisites:
(i) they graduated from a Canadian university midwifery education program or an equivalent education program in the 2 years immediately before their application for entry in the active-practising roster,
(ii) they completed a competence assessment program and any bridging program required by the Council in the 2 years immediately before their application for entry in the active-practising roster,
(iii) they are currently registered or were registered as a midwife in another a province or territory in the 5 years immediately before their application for entry in the active-practising roster;
(b) for a member applying for an active-practising (clinical) licence, the member has completed the following continuing competency requirements:
(i) at least the following practice hours or experience:
(A) 1125 hours or attendance at 40 births in the clinical practice of midwifery in the 5 years immediately before their application, or
(B) 450 hours or attendance at 12 births in the clinical practice of midwifery in the year immediately before their application, and
(ii) current certificates in neonatal resuscitation, cardiopulmonary resuscitation and obstetrical emergency skills from programs that are approved by the Council;
(c) the member’s ability to practise midwifery is not subject to any conditions and restrictions.
Entitlements of members in active-practising roster
13 (1) A member in the active-practising roster who holds an active-practising (clinical) licence is entitled to all of the following:
(a) practise midwifery;
(b) be eligible to serve as an appointed member on any committee of the Council;
(c) receive all official Council publications.
(2) A member in the active-practising roster who holds an active-practising (non-clinical) licence is entitled to all of the following:
(a) practise non-clinical midwifery;
(b) be eligible to serve as an appointed member on any committee of the Council;
(c) receive all official Council publications.
Criteria for entry in active-practising with conditions or restrictions roster
14 (1) The Registrar must record the name of a member in the “with conditions or restrictions” roster who meets all the criteria for entry in the active-practising roster in Section 12 except for the criterion in clause (c), and has conditions or restrictions placed on their licence as a result of 1 of the following:
(a) a decision of the Registrar, the Registration Appeal Committee or a hearing panel;
(b) the Council under subsection 20(1) of the Act.
Entitlements of members in active-practising with conditions or restrictions roster
15 A member in the active-practising with conditions or restrictions roster is entitled to all of the following privileges, subject to the particular conditions or restrictions that are imposed on their licence:
(a) for a member who holds an active-practising licence with conditions or restrictions (clinical), the privileges listed in subsection 13(1);
(b) for a member who holds an active-practising licence with conditions or restrictions (non-clinical), the privileges listed in subsection 13(2).
16 (1) If it is otherwise consistent with the policies and objectives of the Council but impractical to issue an active-practising licence, with or without conditions or restrictions, the Registrar, upon payment of the prescribed licence fee, may enter a person into the provisional roster or the provisional roster with conditions or restrictions roster and issue a corresponding licence to a person who
(a) fails to meet the criteria for entry in the active-practising roster in Section 12 or the active-practising with conditions or restrictions roster in Section 14; or
(b) is registered or licensed to practise midwifery in another jurisdiction.
(2) A provisional licence issued under subsection (1) must be issued for a specified period of time no longer than 12 months.
(3) Conditions or restrictions imposed on a provisional licence under this Section may be imposed if the Registrar considers the conditions and restrictions to be necessary in the interest of the public.
(4) Conditions and restrictions imposed on a provisional licence under this Section are not licensing sanctions.
(5) The Registrar’s decision to issue or refuse to issue a provisional licence or a provisional licence with conditions or restrictions is final.
Expiry of provisional licences
17 A provisional licence or a provisional licence with conditions or restrictions issued under Section 16 expires on the earliest of all of the following dates:
(a) the date the Council receives notice that the licence holder is no longer eligible to write the applicable registration examinations;
(b) the date that an active-practising licence is issued to the licence holder;
(c) the expiry date of the provisional licence;
(d) the date the provisional licence is suspended or revoked under the professional conduct process.
Renewing active-practising licence
18 (1) The following are the requirements for renewing an active-practising (clinical) licence with or without conditions or restrictions under subsection 22(1) of the Act:
(a) payment of all outstanding fees, debts and levies owed to the Council;
(b) completion of 1 of the following continuing competency requirements:
(i) at least 1125 hours or attendance at 40 births in the practice of midwifery in the 5 years immediately before their application for renewal,
(ii) at least 450 hours or attendance at 12 births in the practice of midwifery in the year immediately before their application for renewal; and
(c) holding a current certificate in each of the following from a program that is acceptable to the Council:
(i) neonatal resuscitation,
(ii) cardiopulmonary resuscitation,
(iii) obstetrical emergency skills.
(2) The following are the requirements for renewing an active-practising (non-clinical) licence with or without conditions or restrictions:
(a) payment of all outstanding fees, debts and levies owed to the Council;
(b) completion of 1 of the following continuing competency requirements:
(i) at least 1125 hours in the non-clinical practice of midwifery in 5 years immediately before their application for renewal, or
(ii) at least 450 hours in the non-clinical practice of midwifery in the year immediately before their application for renewal.
Restrictions or conditions on previous licence
19 Restrictions or conditions imposed on a member’s licence that have not expired remain in effect on any licence renewed under Section 22 of the Act.
Suspension of licence not renewed
20 A licence suspended under subsection 22(2) of the Act is suspended effective the day after the licence expires.
Conditions on licences
21 The Council may impose any reasonable conditions or restrictions on a member’s licence that it considers appropriate, including restricting the procedures and interventions that a member may perform.
Licence returned to Council
22 A person whose licence has been revoked must return the licence to the Council at the Council’s request.
Licence suspended for non-payment
23 (1) The Registrar may suspend a member’s licence for contravention of any regulation that requires the member to pay a fee, file a document or to do any other act by a specified or ascertainable date.
(2) A licence suspended under subsection (1) must not be reinstated until the member has paid the fee, filed the document or carried out whatever act was required.
(3) A member whose licence is suspended under subsection (1) must immediately cease practising midwifery until their licence is reinstated by the Registrar and they have received a notice of reinstatement from the Registrar.
Categories of affiliation
24 The following are the categories of affiliation under the Act:
25 (1) A member is entitled to become a non-practising member if the member meets all of the following criteria:
(a) the member was eligible in the past for entry in the active-practising roster or the active-practising with conditions or restrictions roster;
(b) the member is not subject to any disciplinary finding that would prohibit them from practising midwifery in the Province;
(c) the member is not practising midwifery in the Province;
(d) the member has paid the applicable fee prescribed by the Council.
(2) A non-practising member is entitled to all of the following:
(a) be eligible to serve as an appointed member on any committee of the Council;
(b) receive official Council publications.
26 (1) A student may be entered in the student category of affiliation if the student meets all of the following criteria:
(a) they are enrolled in a university midwifery education program approved by the Council;
(b) they have paid the applicable fee prescribed by the Council.
(2) A student whose name is entered in the student category of affiliation is entitled to receive official Council publications.
27 The Registrar must keep up-to-date records of persons who are entered in the non-practising and student categories of affiliation.
Quality assurance program
28 (1) The Registrar must ensure that a quality assurance program is conducted for each midwife at a frequency set by the Council.
(2) The quality assurance program administered by the Council may include, but is not limited to, any of the following:
(a) the assessment of members’ competence to practise;
(b) the monitoring of members’ participation in, and compliance with, the quality assurance program;
(c) continuing education and professional development;
(d) peer case review;
(e) quality of care evaluation;
(g) practice audits.
(3) A member reviewed under the quality assurance program must comply with the requirements established by the Council for a review.
Professional liability insurance for midwives
29 A midwife must carry professional liability insurance in an amount determined by the Council.
Complaint against a member
30 (1) A complaint initiated under Section 33 of the Act must be sent to the Registrar.
(2) A termination letter from a member’s employer notifying the Council that the member’s employment as a midwife has been terminated because of professional misconduct, conduct unbecoming the profession, incompetence or incapacity is deemed to constitute a complaint.
Notification of complaint
31 On receiving a complaint, the Registrar must immediately do all of the following:
(a) send a copy of the complaint to the respondent;
(b) notify the respondent in writing that the respondent may submit an explanation or representation concerning the complaint to the Registrar no later than 15 days after the date of the notice or a longer response period considered necessary by the Registrar.
Complaint dismissed by Registrar
32 The Registrar must dismiss a complaint and notify the complainant and the respondent of the dismissal, if the Registrar decides that any of the following apply:
(a) the subject matter of the complaint is outside the jurisdiction of the Council;
(b) the complaint is frivolous, vexatious or constitutes an abuse of process;
(c) the complaint does not allege facts that, if proven, would constitute professional misconduct, conduct unbecoming, incompetence or incapacity, or would merit a counsel or a caution, or both;
(d) the complaint cannot be substantiated.
33 When conducting an investigation under the Act, a person may do any of the following:
(a) a request for additional written or oral explanations from the complainant, the respondent, or third parties;
(b) a request for an interview of the complainant, the respondent or a third party.
Referral to hearing panel
34 On request from a member whose licence is suspended by the Registrar as a result of a complaint against the member, the Registrar must refer the matter directly to a hearing panel.
Costs of complying with requirements under subsection 38(4) of Act
35 The costs for a respondent to comply with any requirement made by the Registrar under subsection 38(4) of the Act must be borne by the Council.
When counsel or caution not licensing sanction
36 A counsel or caution issued by the Registrar under clause 38(8)(e), (f) or (g) of the Act is not considered a licensing sanction against the respondent, and must be disclosed only to the respondent and the complainant and not published or disclosed to the public without the member’s consent.
Preparing and tendering settlement agreements
37 (1) In addition to the admission and consent to disposition required by subsection 42(1) of the Act, a proposed settlement agreement tendered under subsection 42(1) of the Act must include all of the following:
(a) any undertaking made by the respondent, including
(i) [the] length of time that the undertaking is binding on the respondent, and
(ii) the procedure that the respondent must follow to be released from the undertaking;
(b) a statement of which terms of the settlement proposal may be disclosed to the public.
(2) A settlement agreement may include any disposition of the disciplinary matter that could be ordered by a hearing panel under subclause 52(2)(e)(i) of the Act.
(3) The Council and the respondent may agree to use a mediator to prepare the settlement agreement, and the costs for the mediator must be divided equally between the Council and the respondent, unless the Council and the respondent agree to a different division of the costs.
Registrar recommends changes to settlement agreement
38 (1) Before recommending or refusing to recommend acceptance of a proposed settlement agreement, the Registrar may recommend changes to the settlement agreement.
(2) If the Council and the respondent agree to the changes recommended under subsection (1), the Registrar must recommend acceptance of the proposed settlement agreement to the hearing panel in accordance with subsection 42(3) of the Act.
(3) If the Council and the respondent do not agree to the changes recommended under subsection (1), the Registrar must refuse to recommend the proposed settlement agreement in accordance with subsection 42(4) of the Act.
Breach of settlement agreement
39 Any alleged breach by a respondent of an accepted settlement agreement must be referred to another hearing panel and may form the subject of a new hearing.
Hearing panel conflict of interest
40 A person who was involved in a matter that is the subject of a complaint must not sit on a hearing panel that conducts a hearing related to the same complaint.
Notice of hearing
41 In addition to the requirements of subsection 44(10) of the Act, a notice of hearing must state that the respondent may be represented by their legal counsel or another representative.
Amendment of notice of hearing
42 (1) At any time before or during a hearing, a hearing panel may amend or alter the notice of hearing for any of the following reasons:
(a) to correct an alleged defect in substance or form;
(b) to make the notice conform to the evidence, if there appears to be a difference between the evidence and the notice, or if the evidence discloses any of the following that is not stated in the notice:
(i) potential professional misconduct,
(ii) potential conduct unbecoming the profession,
(iii) potential incapacity,
(iv) potential incompetence.
(2) A respondent must be give an opportunity to respond to an amendment or alteration to a notice of hearing made by a hearing panel.
(3) After receiving a respondent’s response under subsection (2), the hearing panel may decide that an amendment or alteration to the notice of hearing should not be made and, if considered appropriate, may refer any new allegations to the Registrar for processing as a new complaint.
Complainant not party to hearing
43 A complainant cannot participate as a party at a hearing.
44 (1) A hearing panel may determine any additional rules of procedure for hearings not covered by the Act or these regulations.
(2) A witness at a hearing must testify under oath or affirmation.
(3) An oath or affirmation at a hearing may be administered by any member of the hearing panel or other person in attendance who is authorized by law to administer oaths or affirmations.
(4) The costs of complying with a requirement made under clause 52(2)(b) of the Act must be initially borne by the Council and may be awarded as costs against a respondent under Section 53 of the Act.
(5) Subject to costs awarded or reimbursed under Section 51, a respondent is responsible for all expenses incurred in their defence.
Subpoenaed witness fees
45 Witnesses that are present under subpoena at a hearing are entitled to the same allowances as witnesses attending a trial of an action in the Supreme Court of Nova Scotia.
46 Evidence submitted to a hearing panel and information submitted to a hearing panel by the Registrar or an investigator regarding a complaint that has not been dismissed by the Registrar must be preserved for at least 5 years from the date the evidence or information is submitted.
Notice of licensing sanction
47 The Registrar must notify all of the following of any licensing sanctions imposed on a member:
(a) any midwifery regulatory authority in another jurisdiction in Canada;
(b) on request, any midwifery statutory authority or association in a jurisdiction outside of Canada;
(c) any individual or organization, as directed by the hearing panel that conducted the proceeding.
Retention of Registrar and hearing panel records
48 (1) All decisions of the Registrar respecting complaints and decisions of hearing panels must be kept permanently at the Council.
(2) Records of the Registrar and hearing panels, other than decisions kept under subsection (1), must be kept in accordance with the Council’s record retention policies.
Costs for disciplinary action that should have been dismissed
49 (1) If the hearing panel decides that a disciplinary action should have been dismissed, the hearing panel may award costs against any member and may reimburse any member for costs incurred through the disciplinary action, and the costs are a debt due to be recovered by civil action for debts.
(2) The Registrar may suspend the licence of any member who fails to pay any costs awarded under subsection (1) within the time ordered until payment is made or satisfactory arrangements for payment have been established.
Drugs and Minor Surgical and Invasive Procedures
List of permitted drugs
50 (1) A midwife may prescribe and administer medications in the following list of pharmaceutical categories in accordance with the midwifery scope of practice, guidelines and policies approved by the Council:
Categories of Drugs that may be Prescribed and Administered by Midwives
analgesics and sedatives
crystalloid or colloid intravenous solutions
epinephrine sodium bicarbonate (newborn)
lactation aids or suppressants (domperidone)
phytonadione (Vitamin K1 – generic name)
(2) In addition to the list of drugs in subsection (1), a midwife may prescribe and administer narcotics and sedatives that are controlled drugs within the meaning of the Controlled Drugs and Substances Act (Canada) as determined by the federal Department of Health.
List of permitted minor surgical and invasive procedures
51 (1) A midwife may perform any of the following minor surgical and invasive procedures when actually delivering a baby and caring for a patient:
(b) bladder catheterizations;
(d) repairs of episiotomies and first-degree and second-degree tears;
(e) fitting cervical caps and diaphragms for contraceptive purposes;
(f) subcutaneous, intramuscular and intravenous injections;
(g) vaginal examinations;
(h) intravenous cannulations;
(i) taking cytological smears for cancer screening;
(k) internal fetal electrodes – intrapartum;
(l) collection of vaginal and rectal swabs for culture.
(2) A midwife may perform any of the following procedures when actually delivering a baby and caring for a patient in an emergency situation:
(a) placement of laryngeal airway masks;
(b) oral intubation of the neonate;
(c) umbilical venous catheterization in the newborn;
(d) manual extraction of the placenta;
(e) ventouse or vacuum extraction.
Renumeration, allowances and expenses for Council members
52 The Council shall determine remuneration, allowances, and expenses for Council members.