S-0.1 - Midwives Act

Updated to 26 February 2003

This document has official status.

chapter S-0.1

Midwives Act

The Minister of Justice is entrusted with the application of this Act. Order in Council 29-2016 dated 28 January 2016, (2016) 148 G.O. 2 (French), 1254.

DIVISION I ORDRE DES SAGES-FEMMES DU QUÉBEC

1. All the persons qualified to practise the profession of midwifery in Québec constitute a professional order called “Ordre professionnel des sages-femmes du Québec” or “Ordre des sages-femmes du Québec”.

1999, c. 24, s. 1.

2. Subject to this Act, the Order and its members shall be governed by the Professional Code (chapter C‐26).

1999, c. 24, s. 2.

3. The head office of the Order shall be within the territory of Ville de Montréal or at any other place in Québec determined by regulation of the Bureau pursuant to paragraph f of section 93 of the Professional Code (chapter C‐26).

1999, c. 24, s. 3; 2000, c. 56, s. 219.

DIVISION II BUREAU

4. The Order shall be governed by a Bureau constituted as provided in the Professional Code (chapter C‐26).

1999, c. 24, s. 4.

5. In addition to the regulations and by-laws the Bureau is required to adopt in accordance with the Professional Code (chapter C‐26), the Bureau shall, by regulation,

(1)  determine standards relating to the form and content of the verbal and written prescriptions made by a midwife ;

(2)  determine the standards of practice and the conditions for engaging in the practice of midwifery that must be complied with for conducting home deliveries ;

(3)  determine the cases presenting a risk for a woman or her child during pregnancy, labour, delivery and the first six weeks of the postnatal period that requires, as a consequence, a consultation by a physician or the transfer of clinical responsibility to a physician, and the conditions under which the consultation or transfer is to be effected.

Sections 95.2 and 95.3 of the Professional Code apply to a regulation made pursuant to subparagraph 1 of the first paragraph.

1999, c. 24, s. 5; 2000, c. 13, s. 95.

DIVISION III PRACTICE OF MIDWIFERY

6. Any act the purpose of which is to provide the professional care and services required by a woman during normal pregnancy, labour and delivery and to provide a woman and her child with the professional care and services required during the first six weeks of a normal postnatal period constitutes the practice of midwifery. The professional care and services concerned consist in

(1)  monitoring and assessing a woman and her child during pregnancy, labour, delivery and the first six weeks of the postnatal period, and include the provision of preventive care and the detection of any abnormal conditions in the woman or child ;

(2)  conducting spontaneous deliveries ;

(3)  performing an amniotomy, performing and repairing an episiotomy and repairing a first or second degree perineal tear or laceration.

In addition, in an emergency, while awaiting the required medical intervention or in the absence of medical intervention, applying suction, conducting a breech delivery, performing manual placental extraction followed by digital exploration of the uterus or performing resuscitation procedures on the woman or newborn also constitutes the practice of midwifery.

1999, c. 24, s. 6.

7. The practice of midwifery by a midwife also includes the provision of

(1)  counselling and information on parenting, family planning, contraception, preparation for delivery and breastfeeding, the usual care to be provided to a child up to the age of one year, in particular as regards diet, hygiene and accident prevention, and on the resources available in the community ; and

(2)  counselling and information to the public on perinatal health care.

1999, c. 24, s. 7.

8. For the purpose of providing the professional care and services referred to in section 6, a midwife may prescribe or administer a drug designated on the list established by a regulation made under the first paragraph of section 9, according to such conditions as may be fixed in the regulation.

For the same purpose, a midwife may prescribe, conduct or interpret any examination or analysis designated on the list established by a regulation made under the second paragraph of section 9, according to such conditions as may be fixed in the regulation.

1999, c. 24, s. 8.

9. The Office des professions du Québec shall, after consultation with the Conseil du médicament, the Ordre des sages-femmes du Québec, the Collège des médecins du Québec and the Ordre des pharmaciens du Québec, establish, by regulation, a list of the drugs that may be prescribed or administered by a midwife pursuant to the first paragraph of section 8 and determine, if necessary, the conditions according to which the drugs may be prescribed or administered.

The Office shall also, after consultation with the Ordre des sages-femmes du Québec and the Collège des médecins du Québec, establish, by regulation, a list of the examinations and analyses that may be prescribed, conducted or interpreted by a midwife pursuant to the second paragraph of section 8 and determine, if necessary, the conditions according to which the examinations and analyses may be prescribed, conducted or interpreted.

1999, c. 24, s. 9; 2002, c. 27, s. 41.

10. Midwifery may not be practised under a name other than that of the practising midwife.

However, midwives may practise under a firm name which may be the name of one, several or all of the partners. The name of any partner who has ceased to practise may be included in the firm name for a period not exceeding three years from the date on which the partner ceased to practise, provided the name of the partner was included in the firm name at the time the partner ceased to practise.

1999, c. 24, s. 10.

11. Midwives shall not, in their professional practice, hold themselves out otherwise than as midwives.

1999, c. 24, s. 11.

DIVISION IV ILLEGAL PRACTICE

12. Subject to the rights and privileges granted by law to other professionals, no person may perform an act described in section 6 unless the person is a midwife.

In particular, section 6 shall not be construed as prohibiting nurses from providing a woman and her child with the nursing care required during pregnancy, labour and delivery and the postnatal period.

The provisions of the first paragraph do not apply to an act performed by a person acting in accordance with

(1)  a regulation made under paragraph h of section 94 of the Professional Code (chapter C-26);

(2)  an agreement between the Government and a Native nation represented by the band councils of all the communities forming the Native nation, a Native community represented by its band council or by its council in the case of a Northern village, a group of communities so represented or any other Native group, allowing a Native person who is not a member of the Order to perform acts described in section 6 in the territory defined in the agreement, in accordance with the conditions fixed therein and to the extent that the terms of the agreement are observed.

1999, c. 24, s. 12.

13. Every person who contravenes section 12 is liable, for each offence, to the penalties prescribed in section 188 of the Professional Code (chapter C‐26).

1999, c. 24, s. 13.

DIVISION V AMENDING PROVISIONS

HEALTH INSURANCE ACT

14. (Amendment integrated into c. A-29, s. 3).

1999, c. 24, s. 14.

ACT RESPECTING PRESCRIPTION DRUG INSURANCE

15. (Amendment integrated into c. A-29.01, s. 8).

1999, c. 24, s. 15.

PROFESSIONAL CODE

16. (Amendment integrated into c. C-26, s. 31).

1999, c. 24, s. 16.

17. (Amendment integrated into c. C-26, s. 32).

1999, c. 24, s. 17.

18. (Amendment integrated into c. C-26, Schedule I).

1999, c. 24, s. 18.

MEDICAL ACT

19. (Amendment integrated into c. M-9, s. 19).

1999, c. 24, s. 19.

20. (Amendment integrated into c. M-9, s. 43).

1999, c. 24, s. 20.

ACT RESPECTING LABOUR STANDARDS

21. (Amendment integrated into c. N-1.1, s. 81.3).

1999, c. 24, s. 21.

22. (Amendment integrated into c. N-1.1, s. 81.6).

1999, c. 24, s. 22.

ACT RESPECTING INCOME SECURITY

23. (Amendment integrated into c. S-3.1.1, s. 14).

1999, c. 24, s. 23.

24. (Amendment integrated into c. S-3.1.1, s. 16).

1999, c. 24, s. 24.

ACT RESPECTING HEALTH SERVICES AND SOCIAL SERVICES

25. (Amendment integrated into c. S-4.2, s. 34.1).

1999, c. 24, s. 25.

26. (Amendment integrated into c. S-4.2, s. 41).

1999, c. 24, s. 26.

27. (Amendment integrated into c. S-4.2, s. 131).

1999, c. 24, s. 27.

28. (Amendment integrated into c. S-4.2, s. 151).

1999, c. 24, s. 28.

29. (Amendment integrated into c. S-4.2, s. 159).

1999, c. 24, s. 29.

30. (Amendment integrated into c. S-4.2, s. 173).

1999, c. 24, s. 30.

31. (Amendment integrated into c. S-4.2, ss. 208.1-208.3).

1999, c. 24, s. 31.

32. (Amendment integrated into c. S-4.2, ss. 225.1-225.6).

1999, c. 24, s. 32.

33. (Amendment integrated into c. S-4.2, s. 226).

1999, c. 24, s. 33.

34. (Amendment integrated into c. S-4.2, s. 236).

1999, c. 24, s. 34.

35. (Amendment integrated into c. S-4.2, ss. 259.2-259.11).

1999, c. 24, s. 35.

36. (Amendment integrated into c. S-4.2, s. 347).

1999, c. 24, s. 36.

37. (Amendment integrated into c. S-4.2, s. 398.1).

1999, c. 24, s. 37.

38. (Amendment integrated into c. S-4.2, ss. 432.1-432.3).

1999, c. 24, s. 38.

39. (Amendment integrated into c. S-4.2, s. 505).

1999, c. 24, s. 39.

40. (Amendment integrated into c. S-4.2, s. 506.2).

1999, c. 24, s. 40.

41. (Amendment integrated into c. S-4.2, s. 530.24).

1999, c. 24, s. 41.

42. (Amendment integrated into c. S-4.2, s. 530.62).

1999, c. 24, s. 42.

43. (Amendment integrated into c. S-4.2, s. 530.78.1).

1999, c. 24, s. 43.

ACT RESPECTING HEALTH SERVICES AND SOCIAL SERVICES FOR CREE NATIVE PERSONS

44. (Amendment integrated into c. S-5, ss. 63.1-63.2).

1999, c. 24, s. 44.

ACT RESPECTING ADMINISTRATIVE JUSTICE

45. (Amendment integrated into c. J-3, Schedule I).

1999, c. 24, s. 45.

ACT RESPECTING INCOME SUPPORT, EMPLOYMENT ASSISTANCE AND SOCIAL SOLIDARITY

46. (Amendment integrated into c. S-32.001, s. 24).

1999, c. 24, s. 46.

47. (Amendment integrated into c. S-32.001, s. 28).

1999, c. 24, s. 47.

DIVISION VI TRANSITIONAL AND FINAL PROVISIONS

48. Notwithstanding section 4 of this Act, the first Bureau shall be composed of the following persons :

(1)  six directors appointed by the Office des professions du Québec and chosen from among the persons who, on 30 June 1999, are certified to practise within the framework of pilot projects in accordance with the Act respecting the practice of midwifery within the framework of pilot projects (chapter P‐16.1) ; the directors are deemed to be elected directors ;

(2)  two directors appointed by the Office des professions du Québec in accordance with the first paragraph of section 78 of the Professional Code (chapter C‐26);

(3)  a chair elected by the directors referred to in paragraph 1 from among their number by secret ballot ; the chair is deemed to be elected in the manner provided in subparagraph b of the first paragraph of section 64 of the Professional Code.

1999, c. 24, s. 48.

49. For the purposes of section 75 of the Professional Code (chapter C‐26), the territory of Québec constitutes a single region until the date of the coming into force of a regulation made under section 65 of that Code.

1999, c. 24, s. 49.

50. The term of the directors of the first Bureau is four years, beginning on their appointment.

1999, c. 24, s. 50.

51. Any vacancy in the office of a director deemed elected shall be filled for the unexpired portion of the term by a new director appointed by the Office des professions du Québec from among the persons referred to in paragraph 1 of section 48, if the vacancy occurs before 24 September 1999, or from among the members of the Order, if the vacancy occurs after that date.

1999, c. 24, s. 51.

52. Every person who, on 30 June 1999, is the holder of a qualification certificate for the practice of midwifery within the framework of pilot projects issued by the committee on admission to the practice of midwifery, in accordance with the Act respecting the practice of midwifery within the framework of pilot projects (chapter P-16.1), also becomes the holder of a permit for the practice of midwifery issued by the Bureau.

Every person who, on that date and in accordance with that Act, is deemed to be certified to practise within the framework of the perinatal care project under the responsibility of the Centre de santé Inuulitsivik also becomes the holder of a restricted permit issued by the Bureau. Under the permit, the person shall be allowed to practise midwifery only in a centre operated by the institution administering the project.

1999, c. 24, s. 52.

53. A candidate declared eligible by the committee on admission to the practice of midwifery but who has not, on 30 June 1999, satisfied all the conditions imposed by the committee to obtain a qualification certificate for the practice of midwifery within the framework of pilot projects, becomes the holder of a permit issued by the Bureau upon satisfying those conditions.

1999, c. 24, s. 53.

54. A person whose qualification certificate for the practice of midwifery within the framework of pilot projects has on 30 June 1999 been suspended by the committee on admission to the practice of midwifery becomes the holder of a permit issued by the Bureau upon satisfying the conditions imposed by the committee for the lifting of the suspension.

1999, c. 24, s. 54.

55. The persons referred to in section 52 and the persons who obtain a permit upon satisfying the conditions referred to in section 53 or 54 shall be entered on the roll of the Order if they meet the requirements of section 63 of this Act and the other conditions for entry on the roll set out in section 46 of the Professional Code (chapter C-26).

However, Divisions IV, VI, VII and VIII of Chapter IV and section 192 of the Professional Code do not apply before 24 September 1999.

1999, c. 24, s. 55.

56. Where a midwife holds a permit and is on the roll of the Order at the time the committee on admission to the practice of midwifery decides to suspend the midwife’s qualification certificate, the midwife’s name is struck from the roll by the Bureau and cannot be re-entered until the conditions imposed by the committee are satisfied.

The Bureau shall revoke a permit issued to a person whose qualification certificate for the practice of midwifery within the framework of pilot projects is revoked by the committee on admission to the practice of midwifery.

1999, c. 24, s. 56.

57. The provisions of the Regulation respecting the general standards of competence and training for midwives within the framework of pilot projects, made pursuant to the third paragraph of section 23 of the Act respecting the practice of midwifery within the framework of pilot projects (chapter P‐16.1) and approved by Order in Council 1193‐92 (1992, G.O. 2, p. 4343), apply until the coming into force of the regulation to be made by the Government pursuant to the first paragraph of section 184 of the Professional Code (chapter C‐26) for the purpose of determining the diplomas which give access to the permit concerned.

1999, c. 24, s. 57.

58. The provisions of the Regulation respecting obstetrical and neonatal risks made pursuant to the third paragraph of section 23 of the Act respecting the practice of midwifery within the framework of pilot projects (chapter P-16.1) and approved by Order in Council 413-93 (1993, G.O. 2, p. 2009), apply until the coming into force of the regulation to be made by the Bureau pursuant to subparagraph 3 of the first paragraph of section 5 of this Act.

1999, c. 24, s. 58.

59. Until the coming into force of the regulations to be made by the Office des professions du Québec in accordance with section 9, midwives are authorized to prescribe or administer the same drugs and to prescribe, conduct or interpret the same examinations and analyses as in the case of pilot projects.

1999, c. 24, s. 59.

60. The provisions of the code of ethics for midwives, adopted by the Regroupement Les sages-femmes du Québec on 4 December 1997, apply until the coming into force of the regulation to be made by the Bureau pursuant to section 87 of the Professional Code (chapter C‐26).

1999, c. 24, s. 60.

61. Midwives may not conduct home deliveries before the coming into force of the regulation to be made by the Bureau pursuant to subparagraph 2 of the first paragraph of section 5.

1999, c. 24, s. 61.

62. Notwithstanding the provisions of the second paragraph of section 86 of the Professional Code (chapter C-26), the resolution to be adopted by the Bureau for the purpose of fixing the first annual assessment need not be approved by a majority of the members of the Order in order to come into force.

1999, c. 24, s. 62.

63. Until the coming into force of the regulation to be made by the Bureau pursuant to paragraph d of section 93 of the Professional Code (chapter C-26), the security to be furnished in accordance with paragraph 3 of section 46 of the Professional Code must be at least equivalent to the security required within the framework of pilot projects.

1999, c. 24, s. 63.

64. The records, registers and documents kept by the committee on admission to the practice of midwifery and relating to the persons who have applied for admission, in accordance with subparagraph 2 of the first paragraph of section 23 of the Act respecting the practice of midwifery within the framework of pilot projects (chapter P-16.1), become the records, registers and documents of the Order.

1999, c. 24, s. 64.

65. The chair of the committee on discipline of the Collège des médecins du Québec shall act as chair of the committee on discipline of the Order until replaced or reappointed in accordance with section 117 of the Professional Code (chapter C‐26).

1999, c. 24, s. 65.

66. An institution which, pursuant to the Act respecting the practice of midwifery within the framework of pilot projects (chapter P‐16.1), is responsible for a pilot project on 24 September 1999 is deemed to be an institution designated by the regional board under the fourth paragraph of section 347 of the Act respecting health services and social services (chapter S‐4.2).

1999, c. 24, s. 66.

67. The midwives employed under a contract by an institution responsible for a pilot project pursuant to section 9 of the Act respecting the practice of midwifery within the framework of pilot projects (chapter P‐16.1), and who hold a position on 24 September 1999 shall continue to practise under that contract until 31 March 2000 or any later date determined by the Government.

By the latter date, the midwives must have entered into a service contract in conformity with the provisions of sections 259.2 and 259.5 of the Act respecting health services and social services (chapter S‐4.2) and have furnished proof of compliance with section 259.9 of that Act.

1999, c. 24, s. 67.

68. Every public institution referred to in section 66 must ensure that the midwifery services coordinator and the council of midwives, if any, are able to exercise their functions on 31 March 2000 or any later date determined by the Government. Until that date, the multidisciplinary board established for the institution under section 11 of the Act respecting the practice of midwifery within the framework of pilot projects (chapter P‐16.1) shall exercise their functions.

On the date mentioned in the first paragraph, the records and other documents of the multidisciplinary board shall be transferred to the midwifery services coordinator, to the council of midwives or, where section 225.2 of the Act respecting health services and social services (chapter S‐4.2) applies, to the council of physicians, dentists and pharmacists, according to their respective requirements.

1999, c. 24, s. 68.

69. The rules of care established by the multidisciplinary board under subparagraph 1 of the first paragraph of section 16 of the Act respecting the practice of midwifery within the framework of pilot projects (chapter P‐16.1) shall continue to apply until new rules of care established under paragraph 2 of section 208.2 of the Act respecting health services and social services (chapter S‐4.2) come into force.

1999, c. 24, s. 69.

70. The board of directors of a public institution not governed by section 66 that wishes to enter into a service contract with a midwife pursuant to section 259.2 of the Act respecting health services and social services (chapter S-4.2) is not required to obtain the recommendations referred to in the second paragraph of that section 259.2 before the midwifery services coordinator is appointed by the institution in accordance with section 208.1 of the Act respecting health services and social services.

1999, c. 24, s. 70.

71. An advisory council is hereby instituted within the Order for a term of four years, which may be renewed by the Government.

1999, c. 24, s. 71.

72. The mandate of the advisory council is to advise and make recommendations to the Bureau concerning the draft regulations of the Order, before their adoption by the Order, and concerning any other matter pertaining to the practice of midwifery which the Bureau considers expedient to submit to the advisory council.

The advisory council shall also, through the agency of the Bureau, advise and make recommendations to the Minister responsible for the administration of legislation respecting the professions or to the Office des professions du Québec concerning any matter they consider expedient to submit to the advisory council in relation to the practice of midwifery.

1999, c. 24, s. 72.

73. The advisory council shall be composed of the following six members appointed by the Government and chosen by reason of their knowledge of and experience with the professional system or their professional expertise in the fields related to the practice of midwifery :

(1)  one midwife, after consultation with the Bureau ;

(2)  two physicians, after consultation with the Collège des médecins du Québec ;

(3)  one nurse, after consultation with the Ordre des infirmières et infirmiers du Québec ;

(4)  one pharmacist, after consultation with the Ordre des pharmaciens du Québec ;

(5)  one representative of the public, after consultation with interested groups.

The advisory council may consult any person whose particular expertise is required and any person representing a body concerned with the practice of midwifery and authorize them to participate in its meetings.

1999, c. 24, s. 73.

74. The advisory council may, by by-law, adopt rules governing the conduct of its affairs.

1999, c. 24, s. 74.

75. The advice and recommendations submitted by the advisory council must, if necessary, contain explanations on the particular position of each member.

The advice and recommendations are filed with the Bureau which shall transmit them to the Office des professions du Québec or, as the case may be, to the Minister responsible for the administration of legislation respecting the professions.

1999, c. 24, s. 75.

76. The secretary of the Order shall provide the required administrative support to the advisory council, see to the preparation and conservation of its minutes, advice and recommendations and convene its meetings when requested.

The Order shall defray the operating costs of the advisory council, including the travel and lodging expenses of its members and the flat-rate fees determined by resolution of the Bureau that are granted to them.

1999, c. 24, s. 76.

77. Not later than six months before the expiry of the term of the first Bureau and after consultation with the bodies concerned, the Office des professions du Québec shall report to the Minister responsible for the administration of legislation respecting the professions on the functioning of the Order, the efficiency of its human and financial resources and the advisability of renewing the term of the advisory council.

1999, c. 24, s. 77.

78. To enable the Order to fulfil all the obligations imposed on it by this Act and the Professional Code (chapter C-26) for the protection of the public during its first eight years of activity, a fund is hereby established consisting of the balance remaining on the amounts reserved for the financing of pilot projects.

The fund, to be managed by the Office des professions du Québec, shall transfer each year to the Order a sum calculated on a regressive averaging basis.

The costs incurred for the management of the fund shall be paid out of the interest it produces.

The annual report of the Order must contain a note to its financial statements detailing the use of the sum transferred pursuant to the second paragraph.

1999, c. 24, s. 78.

79. Not later than six months before the expiry of the eight years of financial assistance granted to the Order in accordance with section 78, the Office des professions du Québec shall report to the Minister responsible for the administration of legislation respecting the professions on the Order’s ability to fulfil the duties imposed on it by this Act and the Professional Code (chapter C‐26).

1999, c. 24, s. 79.

80. The reports referred to in sections 77 and 79 shall be tabled in the National Assembly by the Minister responsible for the administration of legislation respecting the professions within 30 days after receiving them or, if the Assembly is not sitting, within 30 days after resumption.

1999, c. 24, s. 80.

81. Unless the context indicates a different meaning, the provisions of any regulation or other document referring to the practice of midwifery within the framework of pilot projects shall be interpreted to refer to the practice of the midwifery profession pursuant to this Act.

1999, c. 24, s. 81.

82. (Omitted).

1999, c. 24, s. 82.

REPEAL SCHEDULE

In accordance with section 9 of the Act respecting the consolidation of the statutes and regulations (chapter R-3), chapter 24 of the statutes of 1999, in force on 1 April 2000, is repealed, except section 82, effective from the coming into force of chapter S-0.1 of the Revised Statutes.