Alternate Practice Arrangements (APAs) are carefully monitored and transparent perinatal care arrangements that offer midwifery care outside the standard model. These arrangements typically have approved exemptions to the Standards of Practice Policy,typically Standard 1.3 (midwife as primary care provider), Standard 6.1 (comprehensive care through all trimesters, labour, birth and postpartum), Standard 6.4 (continuity of care provider, no more than four care providers) and/or Standard 7.2 (providing care in all settings). Care provided must adhere to the Midwives Regulations and Bylaws for the College of Midwives of BC and be approved by the Approval Panel of the CMBC Quality Assurance (QA) Committee.
APAs are established based on community, client and/or provider need. This may include but is not limited to serving a population of clients with unique social and/or medical requirements, and/or sustainable practice amongst midwives and/or other perinatal care providers.