Thank you, Madam Chair and members of the committee. My name is Louise Aerts and I am the board chair of the Canadian Midwifery Regulators Council.
I am speaking to you today from the unceded Coast Salish territory, represented by the Musqueam, Squamish and Tsleil-Waututh Nations.
I am pleased to have this opportunity to appear before the committee regarding your study on midwifery services in Canada.
The Canadian Midwifery Regulators Council is a network of provincial and territorial midwifery regulatory authorities. Collectively, we regulate the profession of midwifery in Canada. As is the case with many other health professionals, each jurisdiction has its own midwifery regulatory authority or college, which works to ensure public safety by setting registration requirements, setting and enforcing standards for safe and ethical care, and responding to complaints from the public about midwifery services. Midwives must register with the college in their province or territory in order to practise.
Midwifery is currently regulated in all jurisdictions in Canada except Prince Edward Island. Ontario was the first jurisdiction to regulate in 1993, followed by B.C. in 1998. Yukon is our newest jurisdiction to be regulated. This took effect in April of this year. The CMRC is now supporting P.E.I. as it works to regulate midwifery.
There are fewer than 1,700 practising midwives in Canada. Ontario has the most, with around 800 practising midwives. The next-largest jurisdiction is B.C., with 325. At the other end of the spectrum, there are 10 midwives in the Northwest Territories, six in New Brunswick and six in Newfoundland and Labrador.
I'd like to speak about indigenous midwifery from a regulatory point of view.
Indigenous students may take any of the recognized midwifery education programs in Canada and are eligible for registration in their jurisdiction through the regular channels. Further, Ontario and Quebec have laws that provide exemptions from registration for indigenous midwives working in their communities. In Ontario, the exemption clause has been enacted, but it has not yet been enacted in Quebec.
In B.C., the Midwives Regulation includes the ability to regulate a class of indigenous midwife. This also has not been enacted.
The CMRC's mission is to encourage excellence among Canadian midwifery regulatory authorities through collaboration, harmonization and best practice. Some of these recent efforts have included revised entry-to-practice midwifery competencies, common registration requirements, and a shared letter of standing and professional conduct. We are also working to harmonize self-assessment by midwives, indigenous midwife self-identification, labour mobility and emergency skills training certification.
The CMRC owns and administers the Canadian midwifery registration exam, the CMRE. All midwifery regulatory authorities except Quebec require applicants to successfully complete this exam prior to registration. Each year, 110 to 150 midwifery candidates write the CMRE. These individuals are from our Canadian baccalaureate midwifery education programs or bridging programs for internationally educated midwives.
As evidenced by these numbers, midwifery is a small professional group and is limited in terms of growth by the numbers of graduates entering the profession each year—i.e., under 150 across the country.
The CMRC was disappointed to learn of the closing of Laurentian University's midwifery program. This leaves only six baccalaureate midwifery education programs in the country, and only in the provinces of B.C., Alberta, Manitoba, Ontario and Quebec. The CMRC hopes that the Laurentian University midwifery program will be relocated to a new university that, like Laurentian, can provide instruction in English and French and serve the needs of indigenous students and communities.
Midwifery regulators in Canada are ready to assist in the creation of indigenous-led pathways for regulation or exemption. We ask that the committee consider ways to expand investment in indigenous midwifery, which includes creating diverse pathways to education.
Midwives play a vital role in the provision of equitable, accessible, culturally safe and high-quality health care. In some jurisdictions, temporary emergency registration has allowed eligible midwives to register quickly, on a short-term basis, to assist with the COVID-19 pandemic efforts. Further, some jurisdictions have issued public health orders that have expanded midwives' scope of practice to fill needs brought about by the pandemic.
Thank you for your time and consideration. I hope these remarks have helped you to understand the regulation of midwifery in Canada. I am happy to take any questions you may have.