133/2025

M221/2025

July 16, 2025

April 1, 2026

Health Professions and Occupations Act

Nurses and Midwives Regulation

[Last amended April 1, 2026 by B.C. Reg. 41/2026]

General Matters

Definitions

In this regulation:

authorized health professional means a person who is one of the following:

a medical practitioner or nurse practitioner;

a person who is authorized under the Act to practise the designated health profession of dentistry, midwifery, naturopathic medicine, podiatric medicine or pharmacy;

a person who is authorized to practise an equivalent health profession in Alberta, Yukon or the Northwest Territories, if the person's patient

has transferred from one of those jurisdictions to British Columbia and, on transfer, requires immediate health services, and

has not been assessed by a person described in paragraph (

a) or (

b) of this definition or by whichever of the following applies:

in the case of orders issued to registered nurses or registered psychiatric nurses, by a certified registered nurse or certified registered psychiatric nurse;

in the case of orders issued to licensed practical nurses, by a registered nurse or registered psychiatric nurse;

hospital has the same meaning as in

section 1 of the Hospital Act ;

Indigenous midwifery means midwifery practices that are based on Indigenous practices;

licensed practical nurse means a licensee who is authorized to practise practical nursing;

midwife means a licensee who is authorized to practise midwifery;

midwifery means the health profession in which a person provides

the types of health services referred to in

section 56 [scope of practice for midwifery] , and

Indigenous midwifery, if applicable;

narcotic has the same meaning as in the Narcotic Control Regulations made under the Controlled Drugs and Substances Act (Canada);

nursing means the health profession in which a person provides the types of health services referred to in

section 6 [scope of practice for nursing] ;

practical nursing means the health profession in which a person provides the types of health services referred to in

section 27 [scope of practice for practical nursing] ;

psychiatric nursing means the health profession in which a person provides the types of health services referred to in

section 39 [scope of practice for psychiatric nursing] ;

registered nurse means a licensee who is authorized to practise nursing;

registered psychiatric nurse means a licensee who is authorized to practise psychiatric nursing.

Designation of health professions

Each of the following continues to be designated as a designated health profession for the purposes of the Act:

nursing;

practical nursing;

psychiatric nursing;

midwifery.

Regulator

The British Columbia College of Nurses and Midwives is the regulator responsible for governing the designated health professions referred to in

section 2.

No sale of drugs

The authority to dispense a drug under this regulation does not include the authority to sell the drug.

Practice of Nursing

General Practice Matters

Exclusive titles

Except as permitted under the Act,

only a registered nurse who is authorized under the bylaws to do so may use the titles "nurse", "registered nurse" and "licensed graduate nurse", and

only a registered nurse who is authorized under the bylaws to practise nursing as a nurse practitioner may use the titles "nurse practitioner" and "registered nurse practitioner".

Scope of practice for nursing

The following types of health services, provided primarily for the purposes set out in subsection (2), constitute the scope of practice for nursing:

assessing the health status of patients for the purpose of providing the health services referred to in paragraph (b);

preventing, treating and managing physical and mental diseases, disorders and conditions, including by planning, implementing and evaluating interventions;

monitoring, providing and coordinating care to patients;

advising on physical and mental health.

The primary purposes for providing the health services described in subsection (1) in the practice of nursing are to promote, maintain and restore physical and mental health.

Without limiting subsection (1), the following types of health services are included in the scope of practice for nursing:

Repealed. [B.C. Reg. 41/2026, Sch. 2, s. 1.]

providing medical assistance in dying.

[am. B.C. Reg. 41/2026, Sch. 2, s. 1.]

Limits and conditions

A registered nurse may provide the health service of medical assistance in dying only if the registered nurse is a nurse practitioner.

Practice standards

The board must make bylaws establishing or adopting practice standards respecting the following:

the provision, by nurse practitioners, of medical assistance in dying;

the prescribing, by registered nurses, of

Schedule IA drugs for the purpose of treating opioid use disorder.

Limited Restricted Activities (Non-Nurse Practitioners)

Application

This Division applies to registered nurses who are not nurse practitioners.

List of limited restricted activities

A registered nurse may perform the restricted activities described in the following items of the Restricted Activities Table, but only as provided for in this Division:

item 1 [diagnoses] ;

items 2 to 4 [procedures on tissue] ;

item 6 [venipunctures] ;

item 8 [bone fractures] ;

items 11 to 17 [substances] ;

items 18 to 25 [insertions] ;

item 27 [labour] ;

items 28, 30 to 32 and 35 [hazardous energy] ;

items 37 and 45 [authorizations] ;

items 46 to 49 [drugs] ;

items 51 to 53 [therapeutic diets] ;

items 65 and 66 [allergy testing and treatment] .

Diagnoses

A registered nurse may diagnose a physical or mental condition that the registered nurse is authorized to treat without an assessment or diagnosis of the patient by a person who practises another designated health profession.

Procedures on tissue

A registered nurse may perform a procedure on tissue below the dermis or the surface of a mucous membrane for the purpose of wound care, including the suturing of skin lacerations.

Venipunctures

A registered nurse may perform venipuncture for the following purposes:

collecting a blood sample or blood donation;

establishing intravenous access.

Substances

A registered nurse may administer substances as follows:

by injection, in the case of purified protein derivative administered for the purpose of tuberculosis screening;

by inhalation, in the case of

oxygen,

humidified air, or

iii

a mixture of oxygen and nitrous oxide administered for the purpose of pain management during labour;

by irrigation or enteral instillation, in the case of a solution administered for the purpose of assessment or treatment;

by parenteral instillation, in the case of a solution administered for the purpose of managing hypovolemia or maintaining patency.

Insertions

A registered nurse may do any of the following for the purpose of assessment or treatment:

perform the restricted activities described in items 18 to 24 [insertions] of the Restricted Activities Table;

insert the following into the external ear canal:

air that is under pressure no greater than the pressure created by the use of an otoscope;

water that is under pressure no greater than the pressure created by the use of an ear bulb syringe.

For certainty, the performance of the restricted activity of inserting a device into the external ear canal includes the insertion of a wearable hearing instrument, or a part of or an accessory for it.

Labour

A registered nurse may manage labour in a hospital if the primary maternal care provider is absent.

Hazardous energy

A registered nurse may apply ultrasound for the following purposes:

bladder volume measurement;

blood flow monitoring;

fetal heart monitoring.

A registered nurse may apply electricity for the purpose of defibrillation in the course of emergency cardiac care.

Authorizations

A registered nurse may, in the course of assessment, issue an authorization to do the following:

apply ultrasound for diagnostic or imaging purposes;

apply X-rays for diagnostic or imaging purposes, except for the purpose of a computed tomography scan.

Drugs

A registered nurse may prescribe, compound, dispense or administer a

Schedule I drug for any of the following purposes:

treating anaphylaxis, cardiac dysrhythmia, hypoglycemia, opiate overdose, post-partum hemorrhage or respiratory distress in a known asthmatic;

treating conditions that are symptomatic of influenza-like illness;

preventing disease using immunoprophylactic agents or post-exposure chemoprophylactic agents.

A registered nurse may prescribe, compound, dispense or administer a

Schedule II drug.

Therapeutic diets

A registered nurse may compound or administer a therapeutic diet if nutrition is to be administered by enteral instillation.

A registered nurse may dispense a therapeutic diet if nutrition is to be administered orally or by enteral instillation.

Restricted activities if order or certified

Subject to subsection (2), a registered nurse may do the following:

perform the restricted activities described in the following items of the Restricted Activities Table:

items 2 to 4 [procedures on tissue] ;

items 11 to 17 [substances] ;

iii

items 18 to 25 [insertions] ;

items 28, 30 to 32 and 35 [hazardous energy] ;

items 65 and 66 [allergy testing and treatment] ;

issue an authorization to apply X-rays for diagnostic or imaging purposes, except for the purpose of a computed tomography scan;

compound, dispense or administer

Schedule I or IA drugs.

A registered nurse may perform a restricted activity under subsection (1) only if one of the following applies:

the registered nurse is acting under an order issued by

an authorized health professional,

a certified registered nurse or a certified registered psychiatric nurse, or

iii

a person who is authorized in Alberta, Yukon or the Northwest Territories to

practise a health profession that is equivalent to that of nursing or psychiatric nursing, and

to perform restricted activities that a certified registered nurse or a certified registered psychiatric nurse is authorized to provide;

the registered nurse is a certified registered nurse.

Other restricted activities if order

A registered nurse may cast a fracture of a bone if acting under an order issued by a medical practitioner or nurse practitioner.

A registered nurse may administer a therapeutic diet by parenteral instillation if acting under an order issued by an authorized health professional.

Other restricted activities if certified

A certified registered nurse may diagnose a disease, disorder or condition for which they have received certification.

A certified registered nurse may prescribe the following for the purposes of treating or managing a disease, disorder or condition that they may diagnose under subsection (1):

a

Schedule I drug;

a

Schedule IA drug, for the purpose of treating opioid use disorder.

Restricted Activities (Nurse Practitioners)

List of full restricted activities

A nurse practitioner may perform the following restricted activities:

item 1 [diagnosis] ;

items 2 to 4 [procedures on tissue] ;

item 6 [venipunctures] ;

items 8 and 9 [fractures and dislocations] ;

items 11 to 17 [substances] ;

items 18 to 25 [insertions] ;

items 28, 30 to 32 and 35 [hazardous energy] ;

items 37, 42, 44 and 45 [authorizations] ;

items 46 to 49 [drugs] ;

items 50 to 53 [therapeutic diets] ;

items 65 and 66 [allergy testing and treatment] .

Limited restricted activities

A nurse practitioner may perform the restricted activities described in the following items of the Restricted Activities Table, but only as provided for in this section:

item 7 [setting fractures] ;

item 27 [labour] ;

item 36 [X-rays] .

A nurse practitioner may set a simple closed fracture of a bone.

A nurse practitioner may manage labour in a hospital if the primary maternal care provider is absent.

A nurse practitioner may apply X-rays for diagnostic or imaging purposes, except for the purpose of a computed tomography scan.

Practice of Practical Nursing

General Practice Matters

Exclusive titles

Except as permitted under the Act, only a licensed practical nurse may use the titles "nurse", "licensed practical nurse" and "practical nurse".

Scope of practice for practical nursing

The following types of health services, provided primarily for the purposes set out in subsection (2), constitute the scope of practice for practical nursing:

assessing the health status of patients for the purpose of providing the health services referred to in paragraph (b);

preventing, managing and treating physical and mental diseases, disorders and conditions, including by planning, implementing and evaluating interventions;

monitoring, providing and coordinating care to patients;

advising on physical and mental health.

The primary purposes for providing the health services described in subsection (1) in the practice of practical nursing are to promote, maintain and restore physical and mental health, with a focus on stable or predictable states of health.

Practice standards

The board must make bylaws establishing or adopting practice standards for the performance, by licensed practical nurses, of the restricted activities described in items 47 to 49 [drugs] of the Restricted Activities Table.

Limited Restricted Activities

List of limited restricted activities

A licensed practical nurse may perform the restricted activities described in the following items of the Restricted Activities Table, but only as provided for in this Division:

item 1 [diagnoses] ;

items 2 and 3 [procedures on tissue] ;

item 6 [venipunctures] ;

item 8 [bone fractures] :

items 11 to 16 [substances] ;

items 18 to 25 [insertions] ;

items 28 and 31 [ultrasounds and electricity] ;

items 47 to 49 [drugs] ;

items 51 to 53 [therapeutic diets] .

Diagnoses

A licensed practical nurse may, if the patient is in a stable or predictable state of health, diagnose a physical or mental condition that the licensed practical nurse is authorized to treat without an assessment or diagnosis of the patient by a person who practises another designated health profession.

Procedures on tissue

A licensed practical nurse may perform a procedure on tissue below the dermis or the surface of a mucous membrane for the purpose of wound care, other than the suturing of skin lacerations.

Substances

A licensed practical nurse may administer substances as follows:

by injection, in the case of purified protein derivative administered for the purpose of tuberculosis screening;

by inhalation, in the case of oxygen or humidified air.

Insertions

A licensed practical nurse may insert the following into the external ear canal:

an instrument, device or finger, for the purpose of assessment;

a wearable hearing instrument, or a part of or an accessory for it;

air that is under pressure no greater than the pressure created by the use of an otoscope, for the purpose of assessment.

A licensed practical nurse may insert an instrument, device, finger or hand beyond the labia majora, up to the cervix, for the purpose of providing personal hygiene care.

A licensed practical nurse may insert an instrument, device or finger beyond the anal verge for the purpose of assessment or treatment.

Hazardous energy

A licensed practical nurse may apply ultrasound for the following purposes:

bladder volume measurement;

blood flow monitoring.

A licensed practical nurse may apply electricity, using an automatic external defibrillator, for the purpose of defibrillation in the course of emergency cardiac care.

Drugs

A licensed practical nurse may compound, dispense or administer a

Schedule I drug for any of the following purposes:

treating anaphylaxis, hypoglycemia or respiratory distress in a known asthmatic;

preventing disease using immunoprophylactic agents.

A licensed practical nurse may

compound or dispense a

Schedule II drug, or

administer a

Schedule II drug as follows:

by any method, if administered for a purpose described in subsection (1);

orally, intranasally or by intradermal, intramuscular or subcutaneous injection, if administered for any other purpose.

Restricted activities if order

Subject to subsection (2), a licensed practical nurse may do the following:

perform the restricted activities described in the following items of the Restricted Activities Table:

items 2 and 3 [procedures on tissue] ;

items 11 to 16 [substances] ;

iii

items 18 to 25 [insertions] ;

items 47 to 49 [drugs] ;

perform venipuncture for the following purposes:

collecting a blood sample or blood donation;

establishing intravenous access;

apply ultrasound, except to a fetus, for diagnostic or imaging purposes;

apply ultrasound to a fetus for the purpose of fetal heart monitoring;

compound a therapeutic diet in which nutrition is to be administered by enteral instillation;

dispense a therapeutic diet in which nutrition is to be administered orally or by enteral instillation;

administer a therapeutic diet by enteral instillation or parenteral instillation.

A licensed practical nurse may perform a restricted activity under subsection (1) only if the licensed practical nurse is acting under an order issued by

an authorized health professional,

a registered nurse or registered psychiatric nurse,

a person who is authorized in Alberta, Yukon or the Northwest Territories to practise a health profession that is equivalent to that of nursing or psychiatric nursing, or

a dietitian.

Other restricted activities if order

A licensed practical nurse may cast a fracture of a bone if acting under an order issued by a medical practitioner or nurse practitioner.

Practice of Psychiatric Nursing

General Practice Matters

Exclusive titles

Except as permitted under the Act, only a registered psychiatric nurse may use the titles "nurse", "psychiatric nurse" and "registered psychiatric nurse".

Scope of practice for psychiatric nursing

The following types of health services, provided primarily for the purposes set out in subsection (2), constitute the scope of practice for psychiatric nursing:

assessing the health status of patients for the purpose of providing the health services referred to in paragraph (b);

preventing, treating and managing physical and mental diseases, disorders and conditions, including by planning, implementing and evaluating interventions;

monitoring, providing and coordinating care to patients;

advising on physical and mental health.

The primary purposes for providing the health services described in subsection (1) in the practice of psychiatric nursing are to promote, maintain and restore physical and mental health, with a focus on

mental, psychosocial and emotional conditions, and

associated or comorbid physiological conditions.

Practice standards

The board must make bylaws establishing or adopting practice standards respecting the prescribing, by registered psychiatric nurses, of

Schedule IA drugs for the purpose of treating opioid use disorder.

Limited Restricted Activities

List of limited restricted activities

A registered psychiatric nurse may perform the restricted activities described in the following items of the Restricted Activities Table, but only as provided for in this Division:

item 1 [diagnoses] ;

items 2 and 3 [procedures on tissue] ;

item 6 [venipunctures] ;

items 11 to 16 [substances] ;

items 18 to 25 [insertions] ;

items 28, 31 and 32 [hazardous energy] ;

item 45 [authorizations to apply X-rays] ;

items 46 to 49 [drugs] ;

items 51 to 53 [therapeutic diets] .

Diagnoses

A registered psychiatric nurse may diagnose a physical or mental condition that the registered psychiatric nurse is authorized to treat without an assessment or diagnosis of the patient by a person who practises another designated health profession.

Procedures on tissue

A registered psychiatric nurse may perform a procedure on tissue below the dermis or the surface of a mucous membrane for the purpose of wound care, other than the suturing of skin lacerations.

Venipunctures

A registered psychiatric nurse may perform venipuncture for the following purposes:

collecting a blood sample;

establishing intravenous access.

Substances

A registered psychiatric nurse may administer substances as follows:

by injection, in the case of purified protein derivative administered for the purpose of tuberculosis screening;

by inhalation, in the case of oxygen or humidified air;

by irrigation or enteral instillation, in the case of a solution administered for the purpose of assessment or treatment;

by parenteral instillation, in the case of a solution administered for the purpose of managing hypovolemia or maintaining patency.

Insertions

A registered psychiatric nurse may do any of the following for the purpose of assessment or treatment:

perform the restricted activities described in items 18 to 24 [insertions] of the Restricted Activities Table;

insert the following into the external ear canal:

air that is under pressure no greater than the pressure created by the use of an otoscope;

water that is under pressure no greater than the pressure created by the use of an ear bulb syringe.

For certainty, the performance of the restricted activity of inserting a device into the external ear canal includes the insertion of a wearable hearing instrument, or a part of or an accessory for it.

Hazardous energy

A registered psychiatric nurse may apply ultrasound for the following purposes:

bladder volume measurement;

blood flow monitoring.

A registered psychiatric nurse may apply electricity for the purpose of defibrillation in the course of emergency cardiac care.

Authorizations

A registered psychiatric nurse may issue an authorization to apply X-rays for the purpose of tuberculosis screening, except for the purpose of a computed tomography scan.

Drugs

A registered psychiatric nurse may prescribe, compound, dispense or administer a

Schedule I drug for any of the following purposes:

treating anaphylaxis, hypoglycemia, opiate overdose or respiratory distress in a known asthmatic;

treating conditions that are symptomatic of influenza-like illness;

preventing disease using immunoprophylactic agents or post-exposure chemoprophylactic agents.

A registered psychiatric nurse may prescribe, compound, dispense or administer a

Schedule II drug.

Therapeutic diets

A registered psychiatric nurse may compound or administer a therapeutic diet if nutrition is to be administered by enteral instillation.

A registered psychiatric nurse may dispense a therapeutic diet if nutrition is to be administered orally or by enteral instillation.

Restricted activities if order or certified

Subject to subsection (2), a registered psychiatric nurse may do the following:

perform the restricted activities described in the following items of the Restricted Activities Table:

items 2 and 3 [procedures on tissue] ;

items 11 to 16 [substances] ;

iii

items 18 to 25 [insertions] ;

item 32 [electricity] ;

compound, dispense or administer

Schedule I or IA drugs.

A registered psychiatric nurse may perform a restricted activity under subsection (1) only if one of the following applies:

the registered psychiatric nurse is acting under an order issued by

an authorized health professional,

a certified registered nurse or a certified registered psychiatric nurse, or

iii

a person who is authorized in Alberta, Yukon or the Northwest Territories to

practise a health profession that is equivalent to that of nursing or psychiatric nursing, and

to perform restricted activities that a certified registered nurse or a certified registered psychiatric nurse is authorized to provide;

the registered psychiatric nurse is a certified registered psychiatric nurse.

Other restricted activities if order

A registered psychiatric nurse may administer a therapeutic diet by parenteral instillation if acting under an order issued by an authorized health professional.

Other restricted activities if certified

A certified registered psychiatric nurse may do all of the following:

diagnose opioid use disorder;

for the purpose of treating opioid use disorder, prescribe, compound, dispense or administer a

Schedule I or IA drug.

Practice of Midwifery

General Practice Matters

Midwifery patients

In this Part, "midwifery patient" means a patient who

is pregnant,

is in labour or is delivering a baby, or

is in the postpartum period.

Exclusive title

Except as permitted under the Act, only a midwife may use the title "midwife".

Scope of practice for midwifery

The following types of health services, provided primarily for the purposes set out in subsection (2), constitute the scope of practice for midwifery:

assessing the health status of midwifery patients and their newborns and infants for the purpose of providing the health services referred to in paragraph (b);

preventing, treating and managing physical and mental diseases, disorders and conditions of midwifery patients and their newborns and infants, including carrying out appropriate emergency measures when necessary;

monitoring and providing care to midwifery patients and their newborns and infants;

supporting and advising persons with respect to the provision of care to newborns and infants;

providing contraceptive services for midwifery patients.

The primary purposes for providing the health services described in subsection (1) in the practice of midwifery are to promote, maintain and restore the physical and mental health of midwifery patients and their newborns and infants.

[am. B.C. Reg. 41/2026, Sch. 2, s. 2.]

Limits and conditions

Subject to subsection (2), the health services described in

section 56 [scope of practice for midwifery] may be provided only during

normal pregnancy, labour and delivery, and

the postpartum period, if the condition of the midwifery patient and the patient's newborn or infant is normal.

If there is a deviation from the normal course of a midwifery patient's pregnancy, labour, delivery or postpartum period, a midwife

must consult with a medical practitioner or nurse practitioner, and

must, if necessary or appropriate, transfer responsibility for the midwifery patient's care to another suitable health professional.

A midwife who is not an Indigenous person must not practise Indigenous midwifery.

Exception for Indigenous midwifery

Despite any prohibition, limit or condition imposed under the Act, an Indigenous person may perform the restricted activities described in Divisions 2 and 3 of this

Part if both of the following conditions are met:

the person practised Indigenous midwifery, before March 15, 1995, on a reserve within the meaning of the Indian Act (Canada);

the person performs the restricted activities on a reserve.

Full Restricted Activities

List of full restricted activities

A midwife may perform the restricted activities described in item 37 [authorizations to apply ultrasound] of the Restricted Activities Table.

Limited Restricted Activities

List of limited restricted activities

A midwife may perform the restricted activities described in the following items of the Restricted Activities Table, but only as provided for in this Division:

item 1 [diagnoses] ;

items 2 and 3 [procedures on tissue] ;

item 6 [venipunctures] ;

items 11, 12, 14 and 16 [substances] ;

items 19 to 24 [insertions] ;

item 27 [labour and delivery] ;

item 28 [ultrasounds] ;

items 46 to 49 [drugs] .

Diagnoses

A midwife may diagnose a disease, disorder or condition that the midwife is authorized under

section 56 (1) (b) [scope of practice for midwifery] to prevent, treat and manage.

Procedures on tissue

A midwife may perform a procedure on tissue below the dermis or the surface of a mucous membrane for any of the following purposes:

performing episiotomies or amniotomies;

repairing episiotomies or simple lacerations;

taking a swab or specimen required for a screening or diagnostic test.

Venipunctures

A midwife may perform venipuncture for the following purposes:

collecting a blood sample;

establishing intravenous access.

Substances

A midwife may administer a substance or

Schedule III drug by inhalation, injection or parenteral instillation for any of the following purposes:

relieving pain;

preventing or treating dehydration or blood loss;

resuscitation or other emergency measures;

other purposes as required for the practice of midwifery.

A midwife may administer a solution by irrigation for the purpose of wound care during the postpartum period.

Insertions

A midwife may insert an instrument, finger or hand beyond the following:

the point in the nasal passages where they normally narrow, for the purpose of suctioning a newborn;

the pharynx, for the purpose of intubating a newborn;

the opening of the urethra, for the purpose of catheterizing a midwifery patient during labour or the postpartum period;

the labia majora, for the purpose of

conducting internal examinations of midwifery patients,

performing episiotomies or amniotomies, or

iii

repairing episiotomies or simple lacerations;

the anal verge, for the purpose of

assessing perineal repairs,

administering a substance, or

iii

assisting in the emergency delivery of a baby.

Labour and delivery

A midwife may manage labour or the normal, spontaneous vaginal delivery of a baby.

Hazardous energy

A midwife may apply ultrasound for the following purposes:

fetal heart monitoring;

determining fetal position and presentation.

Drugs

A midwife may prescribe, compound, dispense or administer a

Schedule I or IA drug for midwifery patients and their newborns if both of the following conditions are met:

the drug is included in a category set out in Column 1 of the table to Appendix 1;

the activity is performed for a purpose shown opposite in Column 2.

A midwife may prescribe, compound, dispense or administer a

Schedule II drug for midwifery patients or their newborns.

Restricted activities if order

A midwife may compound, dispense or administer a

Schedule I or IA drug if acting under an order issued by a medical practitioner or nurse practitioner.

Restricted activities if certified

A certified midwife may do all of the following:

insert acupuncture needles under the skin for the purpose of relieving pain during labour or the postpartum period;

insert an instrument, device, finger or hand beyond the labia majora, for the purpose of administering a contraception or inducing labour;

insert an instrument, finger or hand

beyond the labia majora for the purpose of conducting the vacuum-assisted emergency delivery of a baby, or

into an artificial opening into the body for the purpose of assisting in the surgical delivery of a baby;

prescribe, compound, dispense or administer

Schedule I or IA drugs for midwifery patients and their newborns, if

the drug is included in a category set out in Column 1 of the table to Appendix 2, and

the activity is performed for a purpose shown opposite in Column 2.

Appendix 1

(section 68 (1) [drugs] )

Midwives (Schedule I and IA Drugs — Certification Not Required)

Item

Column 1 Drug Category

Column 2 Purpose

Antibiotics

Intra-partum chemoprophylaxis for Group B strep

Treatment of topical infection, breast infection or urinary tract infection

Prophylaxis of ophthalmia neonatorum

Anaesthetics

Performance and repair of episiotomies

Repair of lacerations

Treatment of topical inflammation

Localized pain prophylaxis

Anti-coagulants

Prophylaxis of venous thromboembolism

Antifibrinolytics

Treatment of postpartum hemorrhage

Anti-fungals

Treatment of candidiasis

Anti-nauseants/Anti-emetics

Treatment of nausea and vomiting

Anti-virals

Suppression of viral infections during pregnancy and the postpartum period, except HIV/AIDS management

Benzodiazepines

Therapeutic rest in prodromal labour

Short term management of excessive anxiety in the postpartum period

Benzodiazepine receptor antagonists

Treatment of benzodiazepine overdose

Corticosteroids

Treatment of skin inflammation and haemorrhoids

Galactagogues

Enhancement of breast milk production

Histamine antagonists

Manage symptoms associated with allergic reactions

Treat signs and symptoms of gastrointestinal discomfort

Immune globulins

Prophylaxis in the neonate

Prophylaxis or treatment of the patient in pregnancy or the postpartum period

Inhalants

Pain relief in labour or the immediate postpartum period

Narcotic antagonists

Reversal of narcotic-induced depression

Narcotics

Pain relief in labour or the postpartum period

Nitrates

Treatment of hypertonic uterine contractions with non-reassuring fetal status

Non-steroidal anti-inflammatories

Relief of inflammation and pain

Sympathomimetics

Treatment of anaphylaxis or allergic reaction following the administration of drugs, vaccines or sera

Neonatal resuscitation

Uterotonic agents

Prophylaxis and treatment of uterine atony and postpartum haemorrhage

Vaccines

Establishing an immune response

Vitamin and mineral supplements

Nutritional therapy and support

Appendix 2

(section 70 (d) [restricted activities if certified] )

Midwives (Schedule I and IA Drugs if Certified)

Item

Column 1 Drug Category

Column 2 Purpose

Antibiotics

Treatment of infection other than topical, breast or urinary tract infections

Anti-virals

HIV/AIDS management

Cervical ripening agents

Preparation of the cervix for labour

Contraceptives

Prevention of conception

Epidural analgesia (continuous infusion maintenance)

Pain relief during labour and delivery, in a hospital only

Uterotonic agents

Induction or augmentation of labour

[Provisions relevant to the enactment of this regulation: Health Professions and Occupations Act , S.B.C. 2022, c. 43, ss. 25 and 27.]