This amendment to the Midwifery Act adds a non‑binding government objective that the Nova Scotia Health Authority (NSHA) make midwifery services available to everyone who requests them and that each health management zone have one midwife for every 14,000 residents. It also forces the Midwifery Regulatory Council of Nova Scotia to publish an annual report with counts of registered (including non‑practising) midwives and the number of clients who gave birth in the preceding year, with province‑by‑province and OECD comparisons.
The bill matters because it converts workforce goals into statutory objectives, creates a new public data stream for benchmarking midwifery capacity, and delegates to the Minister of Health and Wellness the authority to set timelines for the NSHA to meet those objectives. The measure signals stronger performance expectations but does not itself allocate funding or create a direct enforcement mechanism, so its practical effect will depend on regulatory choices and budgetary decisions downstream.
At a Glance
What It Does
Adds a statutory objective that zones should have one midwife per 14,000 residents and requires the Midwifery Regulatory Council to publish an annual report with counts of midwives (including non‑practising) and annual births. It requires comparative data broken down by province and OECD countries and lets the health minister set a timeline for NSHA to reach the objective.
Who It Affects
Directly affects the Nova Scotia Health Authority (responsible for delivering services in management zones), the Midwifery Regulatory Council (responsible for reporting), practising and registered non‑practising midwives, and pregnant people seeking midwifery care. The Department of Health and Wellness gains regulatory authority to set timelines.
Why It Matters
Putting a staffing ratio into statute reframes midwifery from a clinical program to an explicit workforce target that agencies must plan around. The required benchmarking and public reports will create transparency and comparative pressure on provincial planners and can drive recruitment or regulatory changes — but only if paired with funding and operational plans.
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What This Bill Actually Does
The amendment inserts a short new objective into the Midwifery Act: the government, through the Nova Scotia Health Authority, should make trained and regulated midwives available to everyone who requests them and aim for a staffing level of one midwife per 14,000 residents in each health management zone. Placing this as an objective in statute elevates midwifery capacity to an express policy goal that the NSHA and the Department of Health and Wellness must consider when planning services.
The Midwifery Regulatory Council must now publish an annual public report that counts midwives operating in the province — and explicitly includes those who are registered but not currently practising — alongside the number of clients who gave birth in the previous year. That reporting must contain two kinds of comparisons: across Canadian provinces and against OECD country data.
Those additions will require the Council to collect or standardize data for external benchmarking and present supply and service indicators in a comparative context.The bill gives the Minister of Health and Wellness the power to make regulations that set a timeline for the NSHA to reach the statutory objectives. Practically, that delegates the implementation schedule to the executive branch rather than fixing specific deadlines in the statute.
The amendments to the Act’s regulation‑making subsection add the Minister to the list of actors who may make regulations connected to the new objective, which is the mechanism by which a timeline and potentially other operational rules would be imposed.Read together, the measures create transparency and a target for planning but stop short of prescribing how to reach the target or funding the gap. That leaves operational decisions — hiring, education seats, scope‑of‑practice adjustments, contracts with community providers, and rural distribution — to the NSHA, the Department, and regulators working under any ministerial timeline or subsequent regulations.
The inclusion of registered but non‑practising midwives in headline counts and the requirement to compare to OECD averages are likely to influence public perceptions of capacity and could shape policy responses even if they do not change service levels immediately.
The Five Things You Need to Know
The bill adds a statutory objective requiring the NSHA to aim for one midwife per 14,000 residents in each health management zone.
The Midwifery Regulatory Council must publish an annual public report that lists the number of midwives in Nova Scotia, explicitly counting registered but non‑practising members.
Annual reports must also state the number of clients of midwives who gave birth during the preceding year.
Reports must include province‑by‑province comparison data and benchmarking with OECD countries, adding an international context to the statistics.
The Minister of Health and Wellness may, by regulation, set a timeline for the NSHA to achieve the statutory objectives; the bill expands the Act’s regulatory references to permit ministerial rules tied to that timeline.
Section-by-Section Breakdown
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Statutory objective: universal access and a 1:14,000 midwife ratio
This new subsection places two objectives in the Act: availability of midwifery services to anyone who requests them and a target ratio of one midwife per 14,000 residents for each management zone under the Health Authorities Act. The provision frames workforce planning as a statutory priority; however, the language is aspirational — an "objective" — rather than a mandatory duty that creates an automatic enforcement mechanism or funding obligation.
Annual public reporting by the Midwifery Regulatory Council
The Council must publish at least one annual report listing (a) the total number of midwives in the province, explicitly including those registered but non‑practising, and (b) the number of clients who gave birth in the preceding year. The report requirement forces the regulator to collect service and workforce metrics on a recurring basis and makes those metrics public, which will affect transparency and stakeholder accountability. Including non‑practising registrants in the count complicates how supply is read — additional work will be needed to separate licensure numbers from active clinical capacity.
Comparative benchmarking obligations
Subsection (1B) requires the Council’s report to contain province‑by‑province comparisons and comparisons with OECD countries. That pushes the regulator to collect or harmonize metrics that align with national and international datasets. The mechanics — which indicators to use, how to adjust for differing health systems or definitions of midwifery practice — are left to the Council and will determine how meaningful the comparisons are in practice.
Ministerial authority to set a delivery timeline
The amendment authorizes the Minister of Health and Wellness to make regulations establishing a timeline for the NSHA to meet the objectives in new Section 1A and updates the Act’s regulation‑making cross‑references to include that new authority. This delegates the important decision about pace and sequencing to the executive branch and positions the Minister and Department to define enforceable steps, targets, or reporting requirements by regulation rather than in the statute itself.
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Every bill creates winners and losers. Here's who stands to gain and who bears the cost.
Who Benefits
- People seeking midwifery care: The statutory objective and clearer reporting create a policy framework aimed at improving access and make gaps more visible to policymakers and the public.
- Midwives and the profession: Elevating a staffing ratio to statute gives midwifery stronger policy recognition and may strengthen recruitment and bargaining arguments for training seats, hiring, and service funding.
- Health system planners (NSHA and Department of Health and Wellness): The required data and OECD/provincial benchmarks provide standardised inputs for workforce planning and priority‑setting.
- Advocacy groups and researchers: Annual, comparable public data will improve evidence for campaigns, policy analysis, and cross‑jurisdictional study of maternal care capacity.
Who Bears the Cost
- Nova Scotia Health Authority (NSHA): The NSHA will carry the operational burden and likely the financial cost of meeting any ministerial timeline — recruiting, employing, or arranging midwifery services across zones.
- Midwifery Regulatory Council of Nova Scotia: The Council must expand data collection, standardization, and public reporting capacity to meet the new annual and comparative reporting obligations.
- Department of Health and Wellness / Minister’s office: The Department must design regulations, timelines, and potentially enforcement or reporting frameworks to operationalize the statutory objective.
- Provincial budget/taxpayers: If the government chooses to fund increased midwifery capacity to meet the target, that will have fiscal implications for health budgets; absent new funding, the objective may require reallocations within health services.
Key Issues
The Core Tension
The central tension is between creating a visible, statutory target for midwifery access to drive planning and accountability, and the absence of binding funding or operational requirements to achieve that target — a situation that risks turning the ratio into a political benchmark rather than a deliverable service standard.
The bill converts workforce goals into statutory objectives and layers on reporting and ministerial regulation‑making, but it does not allocate funds or create a statutory obligation on the NSHA to hire or deploy midwives. That gap creates practical uncertainty: a public target can generate pressure and transparency, yet achieving it will depend on subsequent regulations, budget choices, education seats for midwives, and labour market realities.
Metric design creates further tradeoffs. The chosen ratio — one midwife per 14,000 residents — is simple to communicate but poorly tuned to actual need, which correlates with pregnancies and births, geography, and healthcare models rather than raw population.
Counting registered but non‑practising midwives in headline totals risks overstating active capacity. Likewise, OECD benchmarking will require careful indicator selection and adjustment for differing scopes of practice and health systems; superficial comparisons could mislead policymakers or the public.
Finally, giving the Minister power to set timelines centralizes discretion and can speed implementation, but it also concentrates political risk and could produce ambitious targets without commensurate resources.
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