Midwives ready to broaden services as province signals budget hold
Nova Scotia midwives have moved a step closer to offering care beyond pregnancy and the early weeks after birth, after a provincial law enabling an expanded scope for the profession came into force. But the province says patients should not expect immediate changes because there is no new funding available in the current fiscal year.
Health Minister Michelle Thompson told reporters following a recent cabinet meeting that the government is not positioned to add money right now to support service changes.
“Not in this budget year, anyway, so I think things will remain status quo,”she said.
What changes are on the table
The legal framework now allows midwives to be authorized for a wider range of care than traditional low‑risk pregnancy, birth and up to six weeks postpartum. According to the profession’s leadership, the training midwives receive could support:
- Extended postpartum follow-up beyond six weeks
- Shared care for some higher‑risk pregnancies as part of interdisciplinary teams
- A spectrum of sexual and reproductive health services across the lifespan for women, trans and gender‑diverse people, and families
Liz Fraser, co‑president of the Association of Nova Scotia Midwives, said the profession views the legislative shift as an opportunity to improve access and outcomes.
“It opens the door for expanded opportunities for us to improve access to care and improve clinical outcomes for women, for trans and gender-diverse people, for families. We're really excited,”she said in an interview.
Regulation now moves to the forefront
The practical next step is regulatory. The former separate colleges for midwives and nurses were combined under a new oversight body after the province implemented the Regulated Health Professions Act. With amalgamation complete, the Nova Scotia Nursing and Midwifery Regulator is responsible for defining the profession’s “optimized” scope in regulation and practice standards.
Registrar and CEO Doug Bungay said work to identify the regulatory changes midwives require is a priority and will begin over the summer. Those changes would set out the specific activities and settings in which midwives could expand their services, and the conditions under which they would collaborate with physicians and other providers.
Why budget matters to timing
Even with legal authority and updated rules, expanding services typically requires funded positions, training time, supervision, and integration with hospitals and clinics. Thompson’s comments signal that any growth in midwifery services will have to wait until the next budget cycle, unless resources are reallocated internally.
That delay matters for patients who struggle to find timely reproductive health care, postpartum support, or coordinated care during more complex pregnancies. Fraser said midwives see a chance to reduce bottlenecks by working to full training within team‑based models. The government has previously stated a goal of enabling all regulated health professionals to work to their full scope — an aim aligned with using midwives more broadly to meet demand.
What patients can expect this year
For now, the minister’s message suggests midwifery services will continue in their current form through this fiscal year. Families can still access midwives for low‑risk pregnancy, birth and early postpartum care. The profession’s leaders say they are preparing for broader roles once regulations and resources are in place.
Patients and providers will be watching the regulatory process over the coming months, alongside next year’s budget deliberations, to see whether an expanded model of care can move from legal possibility to day‑to‑day practice.
Key milestones and responsibilities
| Milestone | Details |
|---|---|
| Legislation enabling broader scope | Passed in 2023 and now in effect for midwifery |
| Oversight body change | Midwifery and nursing regulators amalgamated into the Nova Scotia Nursing and Midwifery Regulator |
| Regulatory next steps | Regulator prioritizing identification of changes starting this summer |
| Government funding signal | No new funds this budget year; services expected to remain status quo |
What to watch next
- Draft regulatory changes from the Nova Scotia Nursing and Midwifery Regulator outlining the expanded scope
- Any interim measures enabling team‑based models for higher‑risk patients
- Budget planning signals that could support implementation in the next fiscal year
