B.C. to let midwives prescribe abortion pill and expand reproductive care services

The B.C. government says it will expand the scope of practice for midwives, allowing them to prescribe the abortion pill Mifegymiso and several other medications as part of a broader push to improve access to reproductive health care across the province.

Once the changes take effect, midwives will be able to independently prescribe Mifegymiso, also known as RU-486, for medical abortion and for the treatment of early miscarriage. The province says the move will help make care more accessible, particularly for people living in rural, remote and underserved communities where reproductive health services can be harder to access.

Expanded role for midwives

The changes will also allow midwives to prescribe medication to stop breast milk production after childbirth, treat hypothyroidism, and perform obstetric ultrasounds to determine the location of a fetus during early pregnancy. The province says these additions are intended to support more comprehensive and continuous care throughout pregnancy and the postpartum period.

British Columbia says it will join Quebec and Saskatchewan as the only provinces in Canada where midwives can independently prescribe Mifegymiso for medical abortion.

Changes tied to broader scope update

The province says the latest expansion follows earlier changes that came into effect on April 1 under the new Health Professions and Occupations Act. Those earlier updates allowed midwives to provide copper IUD insertions and prescribe hormonal birth control at any stage of life, rather than only within three months after childbirth. Midwives with appropriate certification can also now use all methods to induce labour and use ultrasound to check a baby’s presentation and position before birth.

College still needs to finalize standards

The government says the changes were made in consultation with the B.C. College of Nurses and Midwives, and that it is now working with the regulator to bring them into effect as quickly as possible. The college says it still needs to develop standards, limits and conditions for the expanded practice areas, including determining whether additional training will be required before midwives can begin offering the new services.

The college says the expanded role should support more timely, person-centred care and help reduce the need for patients to see multiple providers over the course of their pregnancy and reproductive care.