The Safety and Feasibility of Contraception Care by Midwives and Other Nonphysician Providers: A Scoping Review of Randomized Control Trials
Beth Currie, Olivia Marquez, and Elizabeth Darling, RM
Background: Although midwives in most Canadian provinces and other high-income countries have contraceptive prescribing ability, it is not within the Ontario midwifery scope of practice.
Aim: To outline the contraceptive-related scope of practice of midwives in Canada and other high-income countries and to review the outcomes of contraceptive provision by physician versus nonphysician providers.
Methods: We conducted an environmental scan through a search of grey literature to summarize contraception-related scopes of practice of midwives in provinces across Canada and in other high-income countries. We then conducted a scoping review of randomized controlled trials (RCTs) that examined the outcomes of physicians compared with nonphysician providers for the provision of contraception care, and summarized that evidence.
Findings: Our environmental scan revealed that Quebec and Ontario are the only provinces in Canada in which midwives cannot prescribe contraception. In the following industrialized countries, midwives with education similar to that of Ontario midwives are able to prescribe contraception: New Zealand, Australia, United States, Sweden, Norway, Netherlands, Finland, and France. Our review of RCTs indicates that for most measures of competency, the outcomes of physician and nonphysical providers are similar when providing contraception care.
contraception, scoping review, midwifery, physicians, task sharing
This article has been peer reviewed.