British ColumbiaB.C.’s midwifery regulations will be changed next year to remove references to counselling, which some midwives worry will tie their hands when it comes to providing mental health support.One health authority has already limited midwives’ ability to refer their patients to mental health servicesKatie DeRosa · CBC News · Posted: Nov 07, 2025 6:24 PM EST | Last Updated: November 7Listen to this articleEstimated 4 minutesThe audio version of this article is generated by text-to-speech, a technology based on artificial intelligence.Upcoming changes to B.C. regulations mean that new mothers may not be able to get mental health care through their midwives — which is alarming some parents and midwives in the province. (Monkey Business Images/Shutterstock)Midwives in B.C. have long been able to refer patients to perinatal mental health services. That’s no longer the case for midwives in Greater Victoria.And B.C.’s midwifery regulations will be changed next year to remove references to counselling, which some midwives worry will tie their hands when it comes to providing mental health support.The new Health Professions and Occupations Act removes mental health support, counselling and advocacy from midwives’ scope of practice.The previous regulation, from 2020, describes midwifery as providing services which include “counselling, supporting and advising persons, including providing advice and information regarding care for newborns and infants.”The new act, which takes effect next April, removes the reference to counselling and changes the wording to “supporting and advising persons with respect to the provision of care to newborns and infants.”WATCH | Midwives worry about scope of practice changing:Some B.C. midwives worry changes to scope of practice will limit mental health supportsSome B.C. midwives say there’s a big change coming that will limit how they can help pregnant people who need mental health support. One health authority has already limited midwives’ ability to refer their patients to mental health services. As Katie DeRosa reports, critics say the move flies in the face of a new law that aims for universal access to mental health care for pregnant women and new mothers.Adrienne Carruthers, a registered midwife and professor with the University of B.C.’s school of midwifery, worries those changes will limit the care midwives are able to provide.“A midwife is a primary care provider during pregnancy, birth and postpartum,” the professor said.”And if a midwife can’t talk to their clients about mental health during a very vulnerable time, who’s going to do that work?”WATCH | Tory MLA’s bill on perinatal and postnatal mental health care passes:B.C. Conservative MLA’s private member’s bill on perinatal, postnatal mental health care passesFor the fourth time this century, a private member’s bill was passed in the B.C. Legislature. Langley-Willowbrook MLA Jody Toor’s bill on perinatal and postnatal mental health care will soon become law. She says the bill aims to ensure no family goes through mental health struggles before and after pregnancy.Conservative MLA Jody Toor says the changes fly in the face of her private member’s bill that aims to give universal access to mental health care for pregnant women and new mothers.The bill received rare cross-party support in the legislature and is now law. “I was shocked,” Toor said. “Taking that language out of [midwives’] scope will really shrink their practice for holistic care for families.” Health Minister Josie Osborne says the new language around midwives’ scope of practice aims to expand — rather than limit — the type of care they can provide. (Mike McArthur/CBC)Health Minister Josie Osborne insists the new language will not limit the care midwives provide — but actually expand the scope of their practice. “There’s no limitation to the services that midwives already provide,” Osborne said. “Midwives will continue to do that work in supporting women and people who are about to give birth and who have just given birth.” Regardless of those assurances, Carruthers and Toor are calling on the health minister to change the regulations so that mental health support and counselling is explicitly included in the care midwives provide. If midwives can’t provide mental health support or referrals, they say there will be longer wait times in an already backlogged primary care system.Island Health changes cause concernThere’s already evidence in one health authority of midwives being restricted from referring to mental health services. Since March 2024, in the Island Health region, midwives cannot refer patients to a mental health specialist — it can now only be done by a primary care provider or specialist physician.Island Health told CBC News in a statement the changes were made “to improve care continuity that is challenged by the time-limited nature of both midwifery and the involvement of perinatal psychiatry.”The health authority says the referral policy will ensure immediate support, treatment and ongoing follow-up care — and that high-risk patients are seen as soon as possible.CBC News has confirmed with the other health authorities in B.C. that no changes have been made to midwives’ ability to refer to perinatal mental health services.Anniken Chadwick and her 15-month-old Espen Indergand. The Sunshine Coast mom worries about changes that mean midwives can’t refer mothers to perinatal or postnatal care in the Island Health region. (Submitted by Anniken Chadwick)Anniken Chadwick worries this will cut off a key lifeline for pregnant women struggling with their mental health. When Chadwick was pregnant with her first child, she found herself battling extreme anxiety and intrusive thoughts.The mom from B.C.’s Sunshine Coast said her midwife referred her to a perinatal mental health team.Anniken Chadwick says her midwife referred her to a perinatal mental health program when she was pregnant with her first child. (Submitted by Anniken Chadwick)“I was struggling so much. So I don’t know what I would have done if I didn’t have the midwife to take the reins with that for me,” Chadwick said. “Stripping that away from [midwives] just feels like such a backwards step.”Angie Knott, executive director of the Midwives Association of B.C., says not every patient has a family doctor or obstetrician-gynecologist.“There are challenges with access, for example, to family physicians,” Knott said. “So this directive potentially delays really important care.”Knott shares Carruthers’ concerns about whether midwives’ scope of practice is being narrowed under the new act. “The concern we have here is that these changes risk fragmenting care, creating those delays and access to mental health supports,” Knott said. ABOUT THE AUTHORKatie DeRosa is the provincial affairs reporter for CBC British Columbia. She is based in Victoria. You can contact her at katie.derosa@cbc.ca.
B.C. midwives worry that changes to scope of practice will limit mental health support
