Midwifery across Canada

Midwifery services vary by province and territory. In some provinces, midwifery has been regulated and funded for over twenty years, and in other provinces and territories, it is not yet regulated or funded.

Please click on each province and territory to learn more about the status of midwifery services and to connect to the local midwifery associations.

Midwifery-led births per province and territory, 2015/16
Year of midwifery regulation per province and territory

MORE MAPS >

Data on total births from Statistics Canada for the period July 1, 2015 to June 30, 2016. Data on midwifery-led births and number of midwives is from the same time period if available, and if not, from as similar a time period as possible.
NACM logo

65 Aboriginal Midwives


31 Midwifery students admitted each year


13 Midwifery practices have a specific focus on serving First Nations, Inuit, and/or Métis communities


Overview of indigenous Midwifery in Canada

The National Aboriginal Council of Midwives (NACM) exists to promote excellence in reproductive health care for Inuit, First Nations, and Metis women. We advocate for the restoration of midwifery education, the provision of midwifery services, and choice of birthplace for all Aboriginal communities, consistent with the U.N. Declaration on the Rights of Indigenous Peoples. As active members of the Canadian Association of Midwives, we represent the professional development and practice needs of Aboriginal midwives to the responsible health authorities in Canada and the global community.

Recent accomplishments

Over the previous year, NACM carefully developed a relationship based on mutual values with Save the Children Canada (SCC), an organization that prioritizes Indigenous maternal and child health. NACM signed a partnership agreement in May 2016 that includes funds granted to NACM to undertake some important activities. SCC and their corporate partner, Carters Osh Kosh, have raised funds in Carters stores over the last year, to support Indigenous maternal health. The partnership has allowed NACM to undertake two exciting initiatives in 2016: 1) a situational analysis to help NACM understand its strengths and how best use resources moving forward, and 2) publications on cultural knowledge to support indigenous families looking for cultural knowledge that will help them prepare for giving birth and caring for their babies.

In March 2016, NACM published a discussion paper with support from federal First Nations and Inuit Health, which was seeking information to improve Aboriginal families’ access to midwifery. The report includes: key issues facing midwifery in Aboriginal and Indigenous communities across Canada; case studies that highlight some of the remarkable midwifery practices serving Aboriginal communities; a map of NACM and CAM members by province and territory; policy recommendations. To read the report

1998 year of regulation


111 Registered Midwives


57,449 total births per year


4.9% Midwifery births


1 Education program: Mount Royal University


12 Midwifery students admitted each year


Model of employment: Course of care (majority)


Recent accomplishments

In the past year, the Alberta Association of Midwives has worked to increase midwifery funding and to strengthen itself organizationally. Since September 2015, the association has seen an additional $12.8 million in funding commitments over a three-year period. This came after considerable engagement with government officials and the active involvement of supportive and vocal consumers. To support this initiative, the association participated in an eight-minute video, What is Midwifery, which was produced by the Association for Safe Alternatives in Childbirth. The video can be viewed here.

In April 2016, a Sustainable Funding Model Summit was held among the AAM, Alberta Health (policy), Alberta Health Services (administrator), the College of Midwives of Alberta, Mount Royal University, and a consumer from an underserved community. Since then, the five organizations have collaborated to develop principles for sustainable funding models. A report will be delivered to the Minister of Health. The AAM participated in HIROC’s Risk Assessment Checklist program in late 2015 and was the recipient of a value-added benefit to better serve its members. In April 2016, the association’s first Membership, Insurance & Continuing Education Coordinator was hired. She is designing and building organizational infrastructure including: a revamped member website and database, formalized systems for delivering continuing education, delivery of more workshops, and an Emergency Skills instructor training.

In June, the Board and staff underwent a strategic planning session where mission, vision, values and strategic objectives were revisited. After engaging with membership, this review will be published. A redesigned external website will also be launched. Although last year saw great accomplishments, there is still work to do to bring all midwives to capacity, support new registrants and bring services to more rural, remote, indigenous and other underserved communities. The Alberta Association of Midwives is excited about the future.

Government relations

The funding agreement came up for renewal as of April 1, 2016. While an agreement was reached with the funder regarding funding of professional liability insurance and the client management system, agreement was not reached on the number of courses of care. Fortunately, in April, the Minister of Health made a major announcement of an additional $11 million in funding over a three-year period. This was made following an announcement of $1.8 million in additional funding in September 2015. All of this was during a time of austerity that Alberta had not experienced for decades. Currently, the profession of midwifery falls under the Health Disciplines Act. The College of Midwives of Alberta is working towards moving under the Health Professions Act in order to become a truly self-governing profession which no longer requires oversight by the Alberta Health Disciplines Board. Even though funding has been secured for the next two years, there are several matters to be negotiated with funders to ensure that midwifery can grow in a sustainable way and that funding can be allocated in a transparent and fair manner.

1998 year of regulation


313 Registered Midwives


42,795 total births per year


21% Midwifery births


1 Education program: University of British Columbia


1 Bridging program: Internationally Educated Midwives Bridging Program


20 Midwifery students admitted each year


Model of employment: Per course of care


Overview of Midwifery in BC

In 2016 there were 313 practicing Registered Midwives in BC. Midwives are autonomous self employed care givers currently attending 21% of the province’s births, with BC Health recently confirming that the province is on target to achieve its goal of 35% of accompanied births by 2020. The Midwives Association of British Columbia (MABC) continues to exercise strong leadership in the promotion of the midwifery profession and in the protection of the vested interests of its members. The Board consists of four executive and six general Board members.

Recent accomplishments

In June of 2016, BC celebrated the graduation of twelve students from the UBC Midwifery program. This grew the CMBC membership to more than 300. Midwives are now involved in the care of 21% of BC pregnancies (Perinatal Services BC (May 2016). Midwifery Report: Deliveries in BC 2014/15. Vancouver, BC).

The Midwives Association of British Columbia (MABC) recently contracted NACM co-chair Evelyn George to act as its new MABC Indigenous Lead. A recipient of a First Nations Health Authority grant, Ms. George led a series of birth storytelling gatherings. The MABC has created a list of midwives with Medavie Blue Cross billing numbers who are available to serve refugees, and has translated its new Midwifery FAQ brochure into 7 languages for the International Day of the Midwife. Members are enjoying some of the benefits of MABC’s new contract, including ordering home birth supplies and medications through the newly launched Homebirth Supplies and Medications program. The existence of this program means the association no longer struggles to obtain backordered medications, nor does it have to place large minimum drug orders, most of which expire. It also means new graduates no longer have to stock their home birth bags out of pocket before earning an income. Supplies are delivered to its clinics and billed to their local hospital. They have also launched new fee codes for Supervision of Conditional Registrants and expect fee codes for Surgical First Assist at a Cesarean Section and Most Responsible Provider for Baby at a Caesarean Section by the end of the year.

This fall, the MABC is focusing on connecting with midwives in BC and across Canada, both in person and online. In September 2016, MABC President Alix Bacon began the first visits of the MABC Tour in order to meet members, discuss challenges and successes, and set expectations for the 2017 limited contract re-opener. The MABC also hosted this year’s CAM Conference in Victoria Oct 26-28 and recently launched its new website.

2000 year of regulation


77 Registered Midwives


17,344 total births per year


6.4% Midwifery births


1 Education program (currently administered by McMaster University)


14 Midwifery students admitted each year


Model of employment: Salaried, employee model


Recent accomplishments

Manitoba midwives and Manitoba Association of Midwives (MAM) worked on two major issues in this past year: negotiating fair salaries and fighting for an education program. This past winter, Winnipeg midwives were getting ready to walk the picket lines. Contract negotiations had been stalled for a long time and midwives had been without a contract for two years. An agreement was reached at the last minute, much to the relief of midwives and their clients. Midwifery salaries are now more reflective of midwives’ responsibilities and scope of practice.

Government relations

Manitoba has been trying to establish an education program since regulation in 2000. A program was started and funded through the University College of the North (UCN) in 2006. The program experienced many problems and setbacks but managed to graduate 10 students and recently did a second intake of 14 students who completed their first year of studies in 2015-2016. Negotiations and plans were ongoing to establish a joint program between UCN and the University of Manitoba (UM). Manitoba midwives were hopeful a program created within the UM – which is established and recognized throughout Canada as a leader in inter-professional education and collaboration – would better situate midwifery within the healthcare system. The education program faced a major setback in June 2016 when the newly elected Manitoba government chose not to fund the joint venture.

Manitobans elected a Progressive Conservative government this past spring after nearly 17 years of NDP government. Despite the PC’s vocal and vociferous criticism of the NDP’s failure to establish a sustainable education program, their first action was to cancel a newly created joint midwifery program between UCN and UM. The MAM’s relationship with the new government got off to a rocky start. Midwives and Manitoba families made their voices heard. Letter after letter was sent to voice their outrage. The midwives’ association attended a question period at the Legislature and held demonstrations.

The government did not fund the joint program, but there is a silver lining. Thanks to the hard work of a few key individuals, Manitoba’s 14 midwifery students will be able to graduate with midwifery degrees. They will continue their education in Manitoba, via the McMaster University MEP. Though there is still a lot of work to be done in establishing a sustainable midwifery program in Manitoba, the Manitoba Association of Midwives is looking forward to welcoming these students into their clinics, their practices and their profession.

2016 year of regulation


2 Registered Midwives


6,715 total births per year


0% Midwifery births


Model of employment: Likely will be employee model


Recent accomplishments

In the last year, the Midwives Association of New Brunswick (MANB) approved its first bylaws and held its first AGM. Currently there are 6 registered midwives and 4 student midwife members of the association. There is a great and active consumer support group in the province, advocating for midwifery services.

Government relations

The Midwifery Act was declared in 2010. The Department of Health announced in February 2016 that New Brunswick would soon have its first practice, comprised of four midwives. In 2017, a demonstration site for midwifery was established in Fredericton. There are currently two registered midwives who are accepting patients at the Horizon Health Network.

2016 year of regulation


0 Registered Midwives


4,409 total births per year


0% Midwifery births


Model of employment: Proposed model is still in discussion


Government relations

Midwifery regulations in NL were passed in April 2016 and came into effect on September 30. The first meeting of the College of Midwives of NL (CMNL) took place in October 2016. Members of the Midwifery Implementation Committee have met with two Health Boards, those recommended to begin the roll out of Midwives. The Association of Midwives of NL, with the assistance of the NL Council of Health Professionals, lobbied for some start up funds for the CMNL to cover expenses. The Association received funding for two years and is now waiting to hear back about funding and subsidization of liability insurance.

2005 year of regulation


4 Registered Midwives


685 total births per year


12.7% Midwifery births


Model of employment: Salaried


Overview of Midwifery in NWT

Two midwifery programs currently exist in NWT: one in Fort Smith and one in Hay River. No education programs exist in the NWT, but there have been approximately 3 to 4 midwifery students doing elective placements in the NWT each year.

Recent accomplishments

In 2015-2016 there was a significant increase in active members of the Midwives Association of the NWT (MANWT) which meant that the association had its first AGM in several years and established a board of directors.

Government relations

The Department of Health is currently reviewing and revising the midwifery regulatory framework which was established in 2005. This includes our Practice Framework, pharmacy list, standards of practice, and continuing competency program. This review will lead to an increase in the number of drugs available to midwives and to changes to the midwifery scope of practice in the NWT. Members of the Association are actively participating in the review committee.

2009 year of regulation


9 Registered Midwives


8,821 total births per year


2.8% Midwifery births


Overview of Midwifery in NS

There are nine midwives working in Nova Scotia within three of the district health authorities. As the local professional body, the Association of Nova Scotia Midwives (ANSM) supports the growth, sustainability of midwifery in the province, region, country and beyond. The Nova Scotia Department of Health and Wellness has shown commitment to midwifery in the province. The ANSM hopes to see this support continue in the three health districts with midwifery, and to see expansion into regions that are currently without midwives.

Education

There are currently no midwifery education programs in Nova Scotia or in any of the Atlantic provinces. Midwives have been preceptors for students within Canadian midwifery education programs.

Government relations

An external assessment was requested by the Department of Health and Wellness to provide advice about Nova Scotia’s midwifery program in general as well as site specific recommendations. The report, Midwifery in Nova Scotia: Report of the external assessment team, was published in July 2011.  Following its release, a Midwifery Action Plan was announced by the Minister of Health and Wellness in the House of Assembly on December 7, 2011. A key action of the plan was the establishment of a Provincial Midwifery Practice Specialist.  The report also recommended the hiring of second attendants immediately, and the hiring of 20 full-time midwifery positions by 2017. Currently, there are no second attendants for home births, and no plans for further increases to the number of employed midwives in Nova Scotia.

2011 year of regulation


4 Registered Midwives


857 total births per year


15.4% Midwifery births


Model of employment: Salaried, employee model


Overview of Midwifery in Nunavut

Presently Nunavut has 2 active midwifery practices – one in Rankin inlet with 4 full time positions available, and one in Cambridge Bay with 3 full time positions available.

Registered Midwives are salaried employees for the government of Nunavut.  Taking care of all high and low risk pregnancies, conducting carefully screened low risk deliveries (at the birth centre) caring for all post partum women in their respective communities, in addition to providing counseling for STI’s and well women care, and attendance on medivacs in emergency situations.  Midwives also provide pre and post natal care to women in outlying communities (community visits are provided to these communities when staffing allows). Midwives are working towards being recognized in the role and scope they provide and being paid accordingly through the union.

1994 year of regulation


817 Registered Midwives


139,632 total births per year


15.2% Midwifery births


3 Education programs: Ryerson, McMaster, Laurentian


1 Bridging program: The International Midwifery Pre-Registration Program


90 Midwifery students admitted each year


Model of employment: Per course of care


Overview of Midwifery in ON

There are currently 817 midwives in Ontario. Accessing hospital privileges and maintaining primary care in hospitals with clients who require induction, augmentation or epidurals continues to be a challenge in about 50% of hospitals where midwives hold privileges. Aboriginal Midwives provide care to Aboriginal communities practices in Ontario under an exemption in the Midwifery Act. The Association of Ontario Midwives (AOM) has added a membership category for Aboriginal Midwives and is working to improve access to midwifery care provided by Aboriginal midwives.

Recent accomplishments

In May, the Ontario Ministry of Health and Long-Term Care (MOHLTC) announced that it will provide funding to support Indigenous communities in establishing and maintaining Aboriginal midwifery services and would be accepting applications for community midwifery programs. The MOHLTC will also be making additional development grants available to communities that wish to explore the possibility of submitting an application in the future. The AOM has been advocating for funding to expand Aboriginal midwifery since 2011 and was delighted to celebrate this announcement along with the Aboriginal midwives, Indigenous communities and stakeholders it consulted and collaborated with to bring about this funding.

At its 32nd Annual General Meeting and Conference in May, the AOM presented awards in three categories: Lifetime Achievement, Hospital Integration and Media. Christine Sternberg won the Lifetime Achievement Award for being an early innovator of evidence-medicine and client-centre care. In particular, she pushed forward the evidence on the safety of vaginal birth after caesarean section (VABC), leading the way in VBAC practice in Ontario. Michael Garron Hospital (formerly Toronto East General Hospital) was selected for the Hospital Integration Award for demonstrating excellence in successfully integrating midwives into its organization. The hospital has a Department of Midwifery (which includes a voting seat on the Medical Advisory Committee) and midwives who have privileges at the hospital are actively involved in decision-making and policy development and work to their full scope of practice. An Aboriginal Peoples Television Network (APTN) Chaos and Courage episode about the resurgence of Aboriginal midwifery and the importance of bringing birth back to Indigenous communities won the Media Award. The episode was directed by Ava Karvonen and written by Tihemme Gagnon.

Government relations

In 2013, Ontario midwives brought an application to the Human Rights Tribunal of Ontario (HRTO) that alleges that midwives have experienced a gender-penalty in their pay set by the government for almost two decades. More than 800 present and former midwives are applicants in this precedent-setting case that will review more than 20 years of evidence. Hearings began in June 2016. In the fall of 2016, 11 midwife witnesses, including AOM President Elizabeth Brandeis and seven past-presidents, will take the stand to describe the history of discrimination and their efforts over the years to address the wage gap with the government and advocate for compensation that accurately reflects midwives’ skills, effort, responsibilities and working conditions. As Ontario midwives present their case at the Tribunal, they will continue to provide Ontario families with excellent midwifery care.

Association of Ontario Midwives:
Member site
Public site

Not yet regulated


0 Registered Midwives


1,306 total births per year


0% Midwifery births


Overview of Midwifery in PEI

There is still no midwifery legislation and no practicing midwives in Prince Edward Island.

1999 year of regulation


198 Registered Midwives


87,179 total births per year


3.9% Midwifery births


Education program: Université du Québec à Trois-Rivières


24 Midwifery students admitted each year


Model of employment: Salaried independent professionals


Recent accomplishments

After 7 years as the president of the RSFQ, Claudia Faille has passed the torch to Mounia Amine. The RSFQ thanks Claudia for her passion, dedication and generosity. As the profession of midwifery is still new in Quebec (legalized since 1999), and is set to grow in leaps and bounds in the coming years, several issues have come to the forefront. To take the pulse of its membership, the RSGF organized two days of events on the following themes:

  • Day of consultation and reflection on the practice of midwifery in Quebec (October, 2015)
  • Day of training and reflection on disciplinary processes (June, 2016)

In May of 2016, a cost analysis was published by the firm MCE Conseils – commissioned by the union supporting the RSFQ – comparing the costs of births with midwives versus births with doctors. This report has shown that, in addition to lowering the number of interventions and providing health promotion benefits, midwifery also provides important cost savings for the health care system. MCE Conseil states that if midwives were responsible for 10% of births in Quebec, the province would save $2.9M a year in salaries alone. The results of this study will therefore be useful in promoting the development of the midwifery profession in Québec.

To consult the study.

Development

The RSFQ is working on developing services in the province as well as supporting groups of citizens who want access to midwifery services. Demand is high and many parent-supported projects are gaining traction in different regions across Quebec.

  • Six birth centres (maisons de naissances) are planned for Montreal before 2019. Three of these are already open, one is in the start-up phase with the recent hiring of a midwife director, while two feasibility studies have been completed for the remaining two centres.
  • The Outaouais birth centre has moved to its new location.
  • Multiple ‘points of service’ have been developed in conjunction with existing birth centres.
  • Work is being done to make midwifery services available in Cree territory throughout Northern Quebec.

Government relations

Working Conditions: The second Agreement between the Ministère de la santé et des services sociaux (MSSS) and the RSFQ was signed in April 2014 and concluded in March 2015. The RSFQ has now been in negotiations for a third Agreement since July 2015. After two interruptions, discussions resumed in the fall of 2016. The MSSS has currently positioned itself in favor of the development of midwifery, and the RSFQ hopes that negotiations will reflect this so that it can reach agreements regarding working conditions for midwives that fully recognize the value of the profession.

2008 year of regulation


14 Registered Midwives


15,517 total births per year


2.9% Midwifery births


Model of employment: Salaried, employee model


Overview of Midwifery in SK

Midwifery care is available in three Health Regions and one First Nations Hospital out of thirteen Health Regions in Saskatchewan. Demands for midwives far exceed supply throughout the province. SK continues to work towards recruitment of midwives, offering education and training opportunities for midwives wanting to work in the province, and providing care to Women outside of the urban settings. The government has been finding ways of expanding access to midwifery care in other parts of Saskatchewan. A workforce policy consultant has been in position since the beginning of the 2013 through the ministry of health to enhance recruitment and retention of midwives in Saskatchewan.

Education

No educational program is presently available in the province, but the number of student placements is increasing every year.

Recent accomplishments

The Midwives Association of Saskatchewan is continuing to grow and transition. The association has held a strong presence in union negotiations and it has agreed on a new wage scale for new employees. It continues to negotiate regarding elements of the collective agreement. Water birth is being offered in all facilities where midwifery is available. Saskatoon is thriving with a high home birth rate and Regina is beginning to diversify the care it offers by expanding to provide primary health services to priority populations.

Government relations

Saskatchewan midwives continue to work with the transitional council and the provincial government to expand midwifery and to advocate for the need of an in province educational program.

Not yet regulated


0 Registered Midwives


441 total births per year


0% Midwifery births


Overview of Midwifery in YT

Midwifery remains an unrecognized profession in the Yukon territory. The Community Midwifery Association of Yukon (CMAY) was founded in January, 2015. Since that time the membership has grown to 130 members and a Board of Directors comprised of 14 dedicated members. A Midwifery Stakeholder Working Group was formed by Yukon Health and Social Services on May 5, 2015.

Government relations

The current government granted funds CMAY and the Midwifery Working Group in order to host a Midwifery Symposium in May, 2016. Experts on midwifery were invited to speak with local stakeholders on the success of regulated and funded midwifery across Canada. The symposium was very successful. At this time, the territorial election is around the corner and CMAY and the Yukon public are working hard to ensure that all territorial parties will commit to immediate regulations and funding of midwifery services in the Yukon with the new government. CMAY is very hopeful for the future of midwifery in the Yukon.