Client Request for Care Out of Scope

  • Section: Professional Practice

    Subject: Client Request for Care Out of Scope

    Distribution: All Employees & Members

    Section Number: I

  • Issued: August 2007

    Revised: September 2019

    Approved: Transitional Council August 2007, November 2019


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The purpose of this guideline is to set out the requirements to be followed by midwives to support a client’s decision to choose care outside of midwifery scope of practice after an Informed Choice Discussion has occurred.

Ethical principles underlying health care emphasize the rights of individuals to choose among alternative approaches, weighing risks and benefits according to their needs and values. Midwives are responsible for being clear about their scope of practice and limitations, giving recommendations for care if appropriate and for informing clients about risks, benefits and alternative approaches.


When a midwife, or team of midwives, advises a client that a certain course of action must be followed to comply with midwifery scope of practice, or with the midwife’s judgment of safe care, and the client refuses to follow that advice, the following steps shall be followed in non-emergency situations and when it is reasonable to expect there is time to find a solution: