Skip to main content
SpringerLink
Log in

The Transition to Clinical Practice for New Registrant Midwives in Ontario, Canada

  • Chapter
  • First Online:
Starting Life as a Midwife

Abstract

Midwives in Ontario are integrated into the provincial health-care system, providing primary antenatal, intrapartum, and postpartum care to low-risk women throughout pregnancy and for 6-week postpartum. Midwives are educated through a 4-year direct-entry, university-based Bachelor of Health Science program or, if internationally trained, through a 9-month bridging program. During the first year of clinical practice, newly qualified midwives are known as new registrants and are subject to a number of practice restrictions outlined by the College of Midwives of Ontario (CMO). While there is limited research regarding the new registrant year, a qualitative study identified three phases—building, bridging, and being—through which new registrants progress as they transition to clinical practice. There is considerable variation with respect to the experience of new registrants during the transition to clinical practice; however, four elements—preparation, orientation, mentorship, and ongoing education—help new registrants navigate the experience of commencing clinical practice. In order to offer a more standardized approach to supporting Ontario midwives in the first year of clinical practice, it may be beneficial for midwifery stakeholders to look to established transitional models employed in midwifery communities outside of Canada.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

AOM:

Association of Ontario Midwives

BCC:

Billable course of care

CMO:

College of Midwives of Ontario

CMRE:

Canadian Midwifery Registration Exam

MEP:

Midwifery Education Program

MFYP:

Midwifery First Year of Practice Program

References

  • Association of Ontario Midwives. Maintaining primary care for clients who access induction, augmentation or epidural; 2011, January. pp. 1–4.

    Google Scholar 

  • Association of Ontario Midwives. Association of Ontario midwives. 2015. Available at: http://www.ontariomidwives.ca/midwife/regulation/association. Accessed 25 Oct 2017.

  • Association of Ontario Midwives. Choice of birthplace. 2017a. Available at: http://www.ontariomidwives.ca/midwife/philosophy/birthplace. Accessed 23 Nov 2017.

  • Association of Ontario Midwives. Midwifery Q & A. 2017b. Available at: http://www.ontariomidwives.ca/midwife/q-a. Accessed 23 Nov 2017.

  • Butler MM, Hutton EK, Mcniven PS. Midwifery education in Canada. Midwifery. 2016;33:28–30.

    Article  Google Scholar 

  • Cameron C. Becoming and being a midwife: a theoretical analysis of why midwives leave the profession. CJMRP. 2011;10(2):22–8.

    Google Scholar 

  • Canadian Association of Midwives. Midwifery education in Canada. 2015. Available at: http://www.canadianmidwives.org/midwifery-education.html.

  • Canadian Association of Midwives. Midwifery education in Canada. 2017a. Available at: https://canadianmidwives.org/education/#1465250089874-d93eb1f9-32f0.

  • Canadian Association of Midwives. Midwifery across Canada. 2017b. Available at: https://canadianmidwives.org/midwifery-across-canada/. Accessed 25 Oct 2017.

  • Canadian Midwifery Regulators Consortium. Canadian model of midwifery practice. 2010.

    Google Scholar 

  • Canadian Midwifery Regulators Consortium. Requirements for initial registration as a midwife in a Canadian jurisdiction. 2011.

    Google Scholar 

  • Casey K, et al. The graduate nurse experience. J Nurs Adm. 2004;34(6):303–11.

    Article  Google Scholar 

  • Chandler GE. Succeeding in the first year of practice: heed the wisdom of novice nurses. J Nurses Staff Dev. 2012;28(3):103–7.

    Article  Google Scholar 

  • Charnley E. Occupational stress in the newly qualified staff nurse. Nurs Stand. 1999;13(April):7–13.

    Google Scholar 

  • Clements V, Fenwick J, Davis D. Core elements of transition support programs: the experiences of newly qualified Australian midwives. Sex Reprod Healthc. 2012;3(4):155–62.

    Article  Google Scholar 

  • College of Midwives of Ontario. New registrants policy. 2005.

    Google Scholar 

  • College of Midwives of Ontario. Guidelines to the new registrants policy. 2006.

    Google Scholar 

  • College of Midwives of Ontario. Consultation and transfer of care. 2014a.

    Google Scholar 

  • College of Midwives of Ontario. Epidural monitoring and management. 2014b.

    Google Scholar 

  • College of Midwives of Ontario. Induction and augmentation of labor. 2014c.

    Google Scholar 

  • College of Midwives of Ontario. The Ontario midwifery model of care. 2014d.

    Google Scholar 

  • College of Midwives of Ontario. Second birth attendants. 2015.

    Google Scholar 

  • College of Midwives of Ontario. New registrant clinical experience reporting form. n.d. pp. 1–2.

    Google Scholar 

  • Duchscher JEB. Out in the real world newly graduated nurses in acute-care speak out. J Nurs Adm. 2001;31(9):426–39.

    Article  CAS  Google Scholar 

  • Duchscher JB. A process of becoming: the stages of new nursing graduate professional role transition. J Contin Educ Nurs. 2008;39(10):441–50.

    Article  Google Scholar 

  • Ellis C. Assessment of the midwifery education program at the University of British Columbia – a survey of graduates and midwife mentors. Can J Midwifery Res Pract. 2013;12(1):8–18.

    Google Scholar 

  • Fenwick J, et al. Surviving, not thriving: a qualitative study of newly qualified midwives’ experience of their transition to practice. J Clin Nurs. 2012;21(13–14):2054–63.

    Article  Google Scholar 

  • Fink R, et al. The graduate nurse experience. J Nurs Adm. 2008;38(7):341–8.

    Article  Google Scholar 

  • Heitz LJ, Steiner SH, Burman ME. RN to FNP: a qualitative study of role transition. J Nurs Educ. 2004;3(9):416–20.

    Google Scholar 

  • Hughes AJ, Fraser DM. “SINK or SWIM”: the experience of newly qualified midwives in England. Midwifery. 2011;27(3):382–6.

    Article  Google Scholar 

  • International Confederation of Midwives. International definition of the midwife. 2017.

    Google Scholar 

  • Jordan R, Farley CL. The confidence to practice midwifery: preceptor influence on student self-efficacy. J Midwifery Womens Health. 2008;53(5):413–20.

    Article  Google Scholar 

  • Kaufman K, et al. Graduates’ views of the Ontario midwifery education program. Can J Midwifery Res Pract. 2007;6(1):7–12.

    Google Scholar 

  • Lavis JN, Hammill AC. Care by sector. In: Lavis JN, editor. Ontario health system: key insights for engaged citizens, professionals and policymakers. Hamilton: McMaster Health Forum; 2016. p. 209–69.

    Google Scholar 

  • Mattison CA, Lavis JN. Delivery arrangements 2: workforce. In: Lavis JN, editor. Ontario health system: key insights for engaged citizens, professionals and policymakers. Hamilton: McMaster Health Forum; 2016. p. 175–207.

    Google Scholar 

  • Midwifery Education Program. Policy and information handbook. 2017.

    Google Scholar 

  • Ontario Hospital Association. Resource manual for sustaining quality midwifery services in hospitals. 2010.

    Google Scholar 

  • Ontario Regulation 168/11. Midwifery Act, 1991. 1991. Available at: https://www.ontario.ca/laws/regulation/110168. Accessed 10 Jan 2018.

  • Pairman S, et al. The midwifery first year of practice programme: supporting New Zealand midwifery graduates in their transition to practice. N Z Coll Midwives J. 2016;52:12–20.

    Article  Google Scholar 

  • Robertson LJ, Griffiths S. Graduates’ reflections on their preparation for practice. Br J Occup Ther. 2009;72(3):125–32.

    Article  Google Scholar 

  • Rosenfeld P, et al. Nurse residency program. JONA: J Nurs Adm. 2004;34(4):188–94.

    Article  Google Scholar 

  • Sandor C. Building, bridging, being: the transition to clinical practice for new registrant midwives in Ontario: McMaster University; 2018.

    Google Scholar 

  • The G. Raymond Chang School of Continuing Education. International midwifery pre-registration program (IMPP). 2014. Available at: http://ce-online.ryerson.ca/ce/default.aspx?id=2161.

  • University of British Columbia. Internationally educated midwifery bridging program. 2015. Available at: https://iembp.midwifery.ubc.ca. Accessed 28 Apr 2015.

  • van der Putten D. The lived experience of newly qualified midwives: a qualitative study. Br J Midwifery. 2008;16(6):348–58.

    Article  Google Scholar 

  • Versaevel N. Why do midwives stay? A descriptive study of retention in Ontario midwives. Can J Midwifery Res Pract. 2011;10:29–45.

    Google Scholar 

  • York Community Services Centre & Community Midwives of Hamilton MPG#110. Agreement between the transfer payment agency and the practice group. 2009.

    Google Scholar 

  • Zinsmeister LB, Schafer D. The exploration of the lived experiences of the graduate nurse making the transition to registered nurse during the first year of practice. J Nurses Staff Dev. 2009;25(1):28–34.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics & Gynecology, Midwifery Education Program, McMaster University, Hamilton, ON, Canada

    Christine Sandor, Beth Murray-Davis & Corey Bryant

  2. Department of Family Medicine, McMaster program for Education Research, Innovation & Theory (MERIT), McMaster University, Hamilton, ON, Canada

    Meredith Vanstone

Authors
  1. Christine Sandor
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Beth Murray-Davis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Meredith Vanstone
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Corey Bryant
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. School of Nursing, Midwifery and Paramedicine University of the Sunshine Coast, Sippy Downs, QLD, Australia

    Michelle Gray

  2. Faculty of Health Sciences, University of Southampton Faculty of Health Sciences, Southampton, Hampshire, UK

    Ellen Kitson-Reynolds

  3. Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia

    Allison Cummins

List of Terms

Full scope

Midwives who maintain care for low-risk clients who require oxytocin infusion for induction or augmentation of labor and/or epidural analgesia

Limited scope

Midwives who are required to transfer care to an obstetrician when a client requires epidural analgesia and/or oxytocin infusion for labor induction or augmentation

New registrant

Registered midwife in the first year of independent clinical practice

Primary call

Call model where midwives carry a caseload of four clients per month; off-call time typically includes one or two weekends off call per month and 2–3-month vacation per calendar year

Primary midwife

Midwife who assumes responsibility for the care of a women during the intrapartum and immediate postpartum period (Ontario Regulation 168/11 1991)

Second midwife

Midwife in attendance at a birth who assumes responsibility for the immediate assessment and care of the newborn following birth (Canadian Midwifery Regulators Consortium 2010)

Shared call

Call model where midwives work in teams of two to four and clients are assigned to a team rather than to a particular midwife; midwives within the team rotate call coverage with at least one midwife from the team on call at any time

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Sandor, C., Murray-Davis, B., Vanstone, M., Bryant, C. (2019). The Transition to Clinical Practice for New Registrant Midwives in Ontario, Canada. In: Gray, M., Kitson-Reynolds, E., Cummins, A. (eds) Starting Life as a Midwife. Springer, Cham. https://doi.org/10.1007/978-3-319-93852-3_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-93852-3_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-93851-6

  • Online ISBN: 978-3-319-93852-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation