I need your help re midwifery regulation changes

I'm writing to ask for your help. On Aug 16/25 the he Minister of Health signed new midwifery regulation that limits our scope of practice- removing mental health from our scope. As of April 1/25 we will only be able to counsel regarding "newborn care."

This change is bizarre- it is not consistent with the scope of practice across Canada or around the world, nor is it aligned with midwifery curriculums or the International Confederation of Midwives standards. It will mean the end of my consultancy based practice supporting neurodivergent folks in the perinatal period.

I know you are a very busy pregnant person or new parent or referer, but if you have time to write your MLA and the Health Minister I'd be very grateful. I've included a copy of my letter to the minister that you could riff off of.

Email address: "HLTH.Minister@gov.bc.ca"

Email subject: HPOA Midwifery Regulation Changes

Email content: Honourable Minister Osborn,

Please find attached correspondence regarding HPOA Midwifery Regulations changes signed Aug 16/25.

Letter content:

Day/Month/Year

Honourable Minister of Health,

As a neurodivergent parent/Someone who care for neurodivergent parents I am deeply concerned and discouraged by the removal of perinatal mental health from the midwifery scope.

Stimulants are among the most commonly prescribed medications during pregnancy & lactation, with an estimated 1% exposure prevalence in some areas (Bang Madsen, 2024). In March 2025 Song published a US nationwide analysis of ADHD in pregnancy. They show the prevalence of pregnant patients with a diagnosis of ADHD increased 39.5% from 2016 to 2020! As the prevalence of pregnant patients with ADHD and other forms of neurodivergence (including Autism) rises, individualized midwifery care tailored to patients’ needs becomes increasingly important. Research on ADHD & Autism and pregnancy is emerging and imperfect but shows that neurodivergent people have unique needs, receive less support, and face an increased chance of complications.

Alixandra Bacon is a Registered Midwife who has consultancy based practice supporting neurodivergent clients in the perinatal period. I/my clients have benefited from her care. Alixandra sees >40 clients per month and covers 40x 1hr virtual consults a month

• psychosocial education on the physiological impact of neurodivergence in the perinatal period

• health coaching on perinatal health care behaviours that ADHD and ASD make difficult e.g. nutrition and sleep, remembering to take PNV and medications, making and keeping appointments, going for required bloodwork and ultrasounds etc

• medication advising re the safety of stimulant medications during pregnancy and lactation

• preparation for birth and parenthood & lactation given limitations to executive function, sensory sensitivity etc 

This scope change is completely inconsistent with the previous scope, UBC curriculum and the International Confederation of Midwives (ICM) competencies of a midwife. It is also inconsistent with scope across Canada. The ICM Philosophy of Midwifery Care ( https://internationalmidwives.org/resources/philosophy-andmodel-of-midwifery-care/) states, "Midwifery care is holistic and continuous in nature, grounded in an understanding of the social, emotional, cultural, spiritual, psychological and physical experiences of women." The ICM Cross Functional The ICM Essential Competencies for Midwifery Practice (https:// internationalmidwives.org/resources/essential-competencies-for-midwifery-practice/) makes multiple references to midwives role in provision of mental health care as part of holistic person centred care including 

• Identify Maternal mental health risks and early diagnosis

• Obtain a comprehensive health history (including emotional/mental health assessment)

• Provide perinatal and and maternal mental health care

• Assess the woman during postnatal period to detect signs and symptoms of complications

• Counsel for mood disorders, distinguish postnatal depression from transient anxiety about caring for newborn, assess availability of help and support at home, and provide emotional support • Provide counselling and followup care for women and family members who experience stillbirth, neonatal death, serious newborn illness and congenital conditions 

I would encourage you to immediately revise these regulations prior to enactment. 

Sincerely,