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.
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
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
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).
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
For further information regarding the Agreement on Mobility for
Midwifery in Canada, contact the College of Midwives of Ontario.