S-0.1, r. 14 - Regulation respecting the standards and conditions of practice for conducting home deliveries

Updated to 12 December 2023

This document has official status.

chapter S-0.1, r. 14

Regulation respecting the standards and conditions of practice for conducting home deliveries

Midwives Act

(chapter S-0.1, s. 5, 1st par., subpar. 2).

DIVISION I SCOPE

1. This Regulation applies to midwives who conduct deliveries in a place of birth other than a facility maintained by an institution which operates a local community service centre or a hospital centre, as defined by the Act respecting health services and social services (chapter S-4.2) or by the Act respecting health services and social services for Cree Native persons (chapter S-5), and established under the designation “home”.

O.C. 456-2004, s. 1.

DIVISION II STANDARDS OF PRACTICE

2. The midwife shall provide the woman with the information appearing in the consent form provided for in Schedule I in order to allow her to make an informed choice concerning the place of birth.

In the case of a woman who chooses to give birth at home, the midwife shall have the form signed by her.

O.C. 456-2004, s. 2.

3. When the choice to give birth at home is made during or after the 36th week of pregnancy, the midwife must meet the requirements set out in sections 4 and 5 during the first prenatal appointment following that choice.

O.C. 456-2004, s. 3.

DIVISION III CONDITIONS OF PRACTICE

4. Before the 36th week of pregnancy, the midwife must visit the home chosen for the birth.

The midwife must then ensure that on the due date, services may be provided in a safe environment.

To that end, the midwife shall take into account

(1)  the accessibility to the home for herself and for ambulance services;

(2)  the physical organization of the home;

(3)  the immediate access to an adequate means of communication in the case of a situation requiring a medical consultation or an urgent transfer to a facility maintained by an institution which operates a general and specialized hospital centre; and

(4)  the reasonableness of the distance to travel between the home and that facility.

O.C. 456-2004, s. 4.

5. A midwife shall assess all the elements that are likely to influence the choice of the place of birth or the birthing process and discuss them with the woman.

Where applicable, the midwife shall make the appropriate recommendations to facilitate the birthing process.

O.C. 456-2004, s. 5.

6. At the time of the birth, the midwife must have in her possession a copy of her records concerning the woman.

O.C. 456-2004, s. 6.

7. At the time of the birth, the midwife must have in her possession the equipment, supplies and medications listed in Schedule II.

O.C. 456-2004, s. 7.

8. At the time of the birth, a midwife who recognizes the need for a transfer of clinical responsibility of the woman or child to a physician, in accordance with the Regulation respecting cases requiring consultation with a physician or transfer of clinical responsibility to a physician (chapter S-0.1, r. 4), must accompany the woman or child until medical care is provided.

O.C. 456-2004, s. 8.

9. The midwife must dispose of biomedical waste in accordance with the Regulation respecting biomedical waste (chapter Q-2, r. 12).

O.C. 456-2004, s. 9.

10. A midwife who was unable to meet the requirements set out in sections 2 to 6 may nonetheless proceed with an imminent birth at home.

O.C. 456-2004, s. 10.

11. (Omitted).

O.C. 456-2004, s. 11.

SCHEDULE I

(s. 2)

CONSENT TO SERVICES OF A MIDWIFE FOR HOME BIRTH

I, the undersigned, ______________________________, have decided to give birth at home, at ______________________________ and be accompanied by a midwife.

I acknowledge having been informed of the following:

· the particularities of different places of birth, the advantages and risks related thereto;

· measures related to home birth;

· cases in which consultation with a physician or transfer of clinical responsibility to a physician is required;

· emergency measures to be taken if there is a complication;

· criteria for transportation from the home to the hospital centre where indicated, including the distance involved.

I hereby understand that the planning of a home birth does not guarantee that I will give birth at home.

I hereby understand that I can change my choice of the birthplace at any time.

In witness whereof I have signed: at (municipality) __________

this (date) ________________

Signature: ________________________

________________________

Name of midwife: ________________________

Licence number: ________________________

O.C. 456-2004, sch. I.

SCHEDULE II

(s. 8)

LIST OF EQUIPMENT, SUPPLIES AND MEDICATIONS REQUIRED FOR HOME BIRTH

— The essentials for maternal and fetal monitoring;

— The essentials for a delivery, including sterile instruments;

— The essentials for neonatal resuscitation, including intubation;

— The essentials for suturing, including sterile instruments;

— The essentials for blood samples, injections and intravenous infusions;

— The essentials for bladder catheterization;

— A container to dispose of biomedical waste;

— The following medications: oxytocics, local anaesthetics, replacement solutions for intravenous infusion, oxygen, ophthalmic prophylaxis, vitamin K, epinephrine.

O.C. 456-2004, sch. II.

REFERENCES

O.C. 456-2004, 2004 G.O. 2, 1638