Revised: June 13, 2017
The following are the standards for midwives to independently prescribe, order and administer controlled substances as designated under federal and provincial/territorial regulation.
Registered midwives in British Columbia are permitted to prescribe drugs according to the Health Professions Act – Midwives Regulations and CMBC Standards, Limits and Conditions for Prescribing, Ordering and Administering Drugs and CMBC Standards, Limits and Conditions for Prescribing, Ordering and Administering Controlled Substances.
The College of Midwives of BC (CMBC) expects diligence when prescribing all drugs, including controlled substances. The midwife must maintain proper records, supply necessary information to the client regarding the proper use of the drug(s) and maintain adequate security for drug inventories as per the College of Pharmacists Operations and Drug Scheduling Act. The midwife must check each prescription for accuracy prior to its release to clients as a pharmacist would prior to filling a prescription.
Standards, Limits and Conditions for Prescribing, Ordering and Administering Controlled Substances in Midwifery Practice
The standards below provide midwifery indications, routes of administration and upper dosage limits where appropriate and adverse effects and contraindications for the use of controlled substances approved for use in midwifery practice. Midwives may only prescribe, order or administer the following controlled substances within the standards set out in this document and to a client under their professional care where the drug is required for the purposes outlined below.
Please note that the summaries provided regarding medication suitability in pregnancy and lactation are brief. Prior to counselling a patient on the benefits and risks of drug therapy, please review the detailed information in the specific references provided at the end of the document.
- Fentanyl citrate
- Morphine sulphate
- Dimenhydrinate (Gravol®)
- Meperidine (Demerol®)
- Naloxone Hydrochloride (Narcan®)
- Acetaminophen with Codeine (Tylenol® with Codeine No.3)
- Acetaminophen with Oxycodone
- Hydromorphone (Dilaudid-HP®, Dilaudid®)
- Acetaminophen with Tramadol (Apo-Tramadol/Acet®, Tramacet®)
1. Formerly Guidelines for Prescribing, Ordering and Administering Drugs
2. Education (e.g. online module, workshop, course or program of study) and assessment that addresses the competencies required to prescribe narcotics and controlled drugs and/or benzodiazepines in the management of labour, birth and the postpartum period.
3. Principles of securely dispensing and managing drug inventory for prescribing narcotics and controlled drugs and/or benzodiazepines are in place for quality assurance purposes.
Approved: June 24, 2013
Revised: December 9, 2013
Revised: March 17, 2014
Revised: December 7, 2015
Revised: February 29, 2016
Revised: June 6, 2016
Revised: December 1, 2016
Revised: March 6, 2017
Revised: June 13, 2017