Lecture 1&2: History of Midwifery, Ontario Model of Midwifery Care

Question 1

What is self-regulation?

Answer 1

Implementation and enforcement of legislation by a self-governing body such as a college (ex. College of Midwives).

Question 1

What are the two parts of midwifery legislation?

Answer 1

Statutes and regulations.

Question 2

What is the purpose of a code of ethics?

Answer 2

Ensure all midwives understand and adhere to the same set of rules, values, and principles.

Question 3

What is the difference between regulation and standard?

Answer 3

Regulation involves regulation, licensure, approval, accreditation, and sets standards. Standards are a reference point that describes the required level of achievement (ex. standard of care).

Question 4

What are some differences between regulatory authorities and professional authorities?

Answer 4

Regulatory authorities regulate the practice of midwifery by protecting public interest, provide guidance, and investigate complaints about members. Professional authorities publish information and research, negotiate contracts and employment, and hold seminars and conventions.

Question 5

Name the 4 ways the College of Midwives regulates midwives.

Answer 5

Registering midwives, establishing high standards of care, ensure midwives show ongoing improvement, and investigating concerns and complaints about care.

Question 6

WHAT TO EXPECT: Midwives are all registered with the _______________. Meet all ______ of practice and stay ______ on best practices. Ensure you receive all _________, and will consult with a ______ if it becomes necessary. Inform about and _______ your choices. Continue to care for you and your newborn for ____ after birth.

Answer 6

Ontario College of Midwives, standards, current, tests/examinations/check-ups/referrals, physician, respect, 6-8 weeks.

Question 7

Prior to the _______, midwives always attended birth. Post WWII Canada experienced a __________ of birth and _______ of midwifery. By the 70s and 80s, the few midwives that still existed practiced ________.

Answer 7

20th century, medicalization, eradication, alegally.

Question 8

What happened in 1983?

Answer 8

Health Care Professions Act Opens and midwife organizations submitted themselves under the “midwifery coalition.”

Question 9

What did the Ontario College of Physicians and Surgeons declare in 1983?

Answer 9

Homebirth was unsafe and it was professional misconduct to assist it and/or support it.

Question 10

What tragedy happened in 1984?

Answer 10

Death of baby Daniel McLaughin-Harris, which led to a coroner’s inquest. This caused strong support and commitment to autonomous, self-regulated midwifery model of care.

Question 11

What happened in 1987?

Answer 11

HPLR recommends that midwifery be included in legislation as a self-regulated model.

Question 12

What happened in 1989?

Answer 12

Minister of health announced midwifery to be recognized as a health profession.

Question 13

What was the date of when midwives were legally registered and first began practicing?

Answer 13

January 1st, 1994.

Question 14

What are the 5 mandatory principles that form the Professional Standards (from Ontario College of Midwives)?

Answer 14

Demonstrating professional knowledge + practice, providing person-centered care, demonstrating leadership + collaboration, act with integrity, be committed to self-regulation.

Question 15

What are 4 goals that Ontario Midwifery has set for 2022-2025?

Answer 15

Foster sustainable midwifery practice, grow indigenous midwifery, achieve racial justice in midwifery, value midwives.

Question 16

There are 7 AOM (Association of Ontario Midwives) benefits. Name at least 3.

Answer 16

Representation + government advocacy, clinical resources, member support, practice management support, events + education, research support, AOM governance.

Question 17

Midwifery services are covered for ________ clients, but they may still have to pay for additional expenses such as?

Answer 17

Uninsured, ex. hospital stays, labs, physician visits.

Question 18

Although __ of midwifery clients choose to give birth in a hospital, there are sometimes ____. Hospital integration challenges for midwives include applying for and securing ________ _________, caps on the number of _________ with privileges, caps on the number of _________-attended births, and _____ of practice restrictions.

Answer 18

75%, barriers, hospital privileges, midwives, midwifery, scope.

Question 19

What are the four possible education paths to becoming a midwife in Ontario?

Answer 19

MEP, Aboriginal Midwifery Training Program, Internationally educated midwives, Midwifery post-baccalaureate program for Health Professionals.

Question 20

A health care professional’s scope of practice is the range of _____, including decisions and __________, that they are authorized to perform by the ____ that govern their ________.

Answer 20

Activities, procedures, laws, profession.

Question 21

Where would one find the scope of practice statment?

Answer 21

The Regulated Health Professions Act, 1991.

Question 22

What are controlled acts? How many controlled acts are outlined in the RHPA?

Answer 22

Procedures, tests, and treatments that are considered to pose a risk of harm when performed by someone who is not qualified to perform them. 14.

Question 23

What is the difference between public domain and a controlled act?

Answer 23

Public domain is care that can be done by anyone, not just regulated health professionals ex. taking blood pressure. However, ex. making a diagnosis, is a controlled act.

Question 24

1: communicating a ______ of a disease or disorder. 2: Managing ____ and conducting ______ normal vaginal deliveries. 3: Inserting _____ ______ into women.

Answer 24

Diagnosis, labour, spontaneous, urinary catheters.

Question 25

4: Performing _____ and ________ and repairing episiotomies and __________. 5: Administering, by _____ or _____, a substance designated in the regulations. 6: Prescribing drugs designated in the ________.

Answer 25

Episiotomies, amniotomies, lacerations, injection, inhalation, regulations.

Question 26

7: Putting an _____, hand, or finger beyond the ____ ____ or _____ ______. 8: Administering _____ drugs beyond the ____ _____. 9: Taking ___ samples from _____ or people.

Answer 26

Instrument, labia majora, anal verge, suppository, anal verge, blood, newborn.

Question 27

10: Intubation beyond the _____ of a newborn. 11: Administering a substance by _____ or ____ if ordered by a ______. 12:Applying and ordering the application of ______ for ____ or ____ diagnostic ultrasound.

Answer 27

Larynx, injection, inhalation, physician, soundwaves, pregnancy, pelvic.

Question 28

When a client’s condition falls outside the legislative scope of practice, what two options do midwives have?

Answer 28

Transfer care to another provider, or provide care under delegation in accordance with College standards.

Question 29

Prenatal appointments take place once a month for the first __ weeks of pregnancy, every ____ weeks until the 36th week, and then ____ a week until the baby is born.

Answer 29

28, 2, once

Question 30

What is the role of the College of Midwives of Ontario?

Answer 30

To look out for the interest of the public

Question 31

The re-emergence of midwives in Canada….

Answer 31

Reflected a critique of the political and institutional authority through the emergence of the women’s movement