Midwifery Mutual Recognition Agreement on Labour Mobility in Canada - a summary

	Under the Agreement on Internal Trade, Chapter 7 - Labour
Mobility, all professions had to submit their agreements by July 1, 2001,
and be ready to implement these on that day. The objective "is to enable
workers qualified for an occupation in one part of Canada to have access
to employment opportunities in that occupation in any other province or


For the purposes of this agreement, the following definitions apply.

	the set of knowledge, skills and abilities required to practise 
	as a midwife.

	having the set of knowledge, skills and abilities required to
	practise as a midwife.

General registration:
	the category of registration that permits the entire scope of
	practice of midwifery, has no individualized conditions or 
	restrictions, is not temporary, and does not require supervision
	or the completion of additional training or examination.

	regulatory bodies which exercise authority delegated by law to
	regulate midwifery in Canada in their respective jurisdictions
 	and are signatories to this agreement.

	all signatories to this agreement including the Parties.


WHEREAS the undersigned agree that it is in the interest of the
public to have access to midwifery services provided by registered
midwives in all provinces and territories;

AND WHEREAS it is further agreed and understood that, in the interest of
public safety, a standard of competence for the practice of midwifery must
be established, maintained and upheld by regulators;

AND WHEREAS the undersigned agree that it is in the interests of the
members of the profession that registered midwives have access to practice
opportunities in all provinces and territories in Canada;

AND WHEREAS this recognition agreement does not modify the authority of
each regulatory body to set standards and requirements;

AND WHEREAS the undersigned recognize that there are different paths to
achieve the competence required for the practice of midwifery and the
Parties take the responsibility of assessing the competence of applicants
for registration to ensure that the public is protected;

AND WHEREAS the undersigned agree that, with the exception of neonatal
intubation, a high level of commonality exists with respect to scope of
practice and standards of midwifery practice in regulated jurisdictions in

THEREFORE, based on the principles set out above, we the Parties agree

.	No Party will maintain or adopt any requirement for
	residency as part of our occupational standards or occupational

.	Each Party shall ensure that any measures we adopt or
	maintain relating to registration of midwifery is principally
	competency-based, published and readily accessible, and does 
	not result in unnecessary delay nor impose inequitable, 
	burdensome fees, except for cost differentials; and

.	Each Party shall recognize registered midwives according
	to the following terms and conditions.

 TERMS AND CONDITIONS for Labour Mobility of Existing Midwife

	1. An applicant who has general registration at the time of
	   application, and has practised one year or more in a regulated
	   jursidiction will be eligible for registration without
	   additional assessment subject to the following requirements:

	   a. The applicant provides proof of good professional conduct
	      from the Canadian jurisdiction(s) in which they are
	      currently or have been previously registered setting out
	      any relevant information on the applicant's conduct;

	   b. The applicant meets clinical experience requirements as
	      outlined in Appendix "A". Where the applicant meets all 
	      of the requirements with the exception of home/out of
	      hospital/hospital experience due to provincial/territorial
	      barriers which may be legislative, jurisdictional or 
	      administrative in nature, the applicant's clinical
	      experience will be accepted under the MRA with the
	      understanding that temporary conditions will be applied 
	      to address these requirements;

	   c. The applicant satisfies other non-competency registration
	      requirements specified by jurisdictional laws, regulations
	      and by-laws;

	   d. The applicant has completed and submitted the prescribed 
	      application form with related documents;

	   e. The applicant's current and past registration(s) have
	      been verified; and

	   f. The applicant pays the fees required.

	2. For an applicant who has not met all the requirements specified
	   in paragraph 1, a Party may require the applicant to undergo
	   additional assessment and may or may not register the applicant
	   with or without conditions or restrictions.

	3. An applicant who comes from a jurisdiction that does not
	   require certification in neonatal intubation will be required
	   to obtain such certification prior to registration in a 
	   jurisdiction where it is required.


	4. Each Party agrees to seek the necessary legislative changes
	   from their respective government if, in order to implement this
	   Agreement, there is a need for such changes. Each Party also
	   agrees to make the necessary changes to by-laws, policies or
	   procedures in order to implement this Agreement.

	5. The Parties agree to implement this agreement on or before
 	   July 1, 2001.

	6. The Parties agree, that whenever possible, each jurisdiction
	   will give a minimum of six months' notice to other
	   jurisdictions when introducing new registration requirements
 	   or making changes to existing requirements that may impact this
	   Agreement. The Parties will continue to assess differences in
	   requirements and work toward reconciliation of the
	   differences to the extent possible for mutual recognition of
	   midwives across Canada.

	7. The Parties agree that in the event of a disagreement between
	   two or more Parties with respect to the interpretation or
	   application of any clause of this agreement, the Parties
	   involved may initiate consultation with a view to resolving 
	   the matter. A Party may request a consultation either on its
	   own behalf or on behalf of a person who is covered by this
	   agreement. This request for consultation will not affect
	   an individual or Party's capacity to access dispute settlement
	   procedures established under the Agreement on Internal Trade

	8. The Parties agree that in the event that a Party does not wish
	   to continue to be a Party to this agreement, that Party will
	   consult with the jursidictional Labour Mobility Coordinator,
	   and advise the other Parties, in writing with reasons, at least
	   12 months before the Party withdraws from the agreement. The
	   notice period is waived where withdrawal is not within the
	   Party's control.

	9. Each Party agrees that this is a dynamic and evolving
 	   agreement that may be amended with unanimous consent. The
	   Parties agree to initiate periodic reviews of this agreement
	   two years after July 1, 2001 and a minimum of three to five
	   years thereafter, or more frequently as necessary and to 
	   review the operation of this agreement when such a request is
	   made by one of the Parties.

	10. The Parties agree that any Canadian entity that has been
	   delegated authority to regulate midwifery by their government
	   may acede to this agreement and on such terms as are agreed 
	   to by all Parties.

APPENDIX "A" - Clinical Experience
The following clinical experience to be completed during the previous five years (and may include experience obtained as a student of midwifery): 60 births Been in attendance 30 (of 60) As a midwife providing "continuity of care"* 40 (of 60) As primary midwife** 10 (of 40) Home/out of hospital*** 10 (of 40) Hospital*** For the purposes of labour mobility: * continuity of care shall be deemed to have been provided to an individual woman and her newborn when one midwife, or student of midwifery, has attended a minimum of four antenatal visits, the labour and birth and three postnatal visits. ** a midwife who, in her practice or as a part of her education program, is the most responsible care provider for a woman during the intrapartum period. Such responsibility would normally include conducting the delivery of the newborn and managing the third stage of labour, unless there were clinical indications for transferring care to a physician. *** Note: Where applicants meet all requirements but are unable to obtain home/out of hospital/hospital experience due to provincial/territorial barriers, see 1(b) of Terms and Conditions (above). Non-Regulatory Associations The Association of Midwives of Newfoundland and Labrador was represented, and signed as a non-regulatory association from a jurisdiction that has not yet designated regulatory authority for midwifery. While not a body which exercises authority delegated by law, the Association has participated in the development of the Mutual Recognition Agreement, and understands and concurs with its terms and precepts. For further information regarding the Agreement on Mobility for Midwifery in Canada, contact the College of Midwives of Ontario.