No, not for care. Midwifery is on Canada’s list of HST-exempt health services, so a registered midwife doesn’t charge tax on prenatal, birth, or postpartum care provided to a client. In most provinces the ministry of health pays for that care anyway, so HST never even reaches the invoice. Where midwives do get caught is the side income: group classes, workshops, product sales, doula-style add-ons, and reports written for insurers or lawyers. Once that taxable side passes $30,000 a year, you register and charge HST on it while your clinical care stays exempt.
Midwives probably think about HST less than any other health profession, and that’s exactly why the ones who get caught are surprised. Core midwifery care is both exempt and, in most of Canada, paid by the province. It’s easy to conclude tax rules simply don’t apply to you. They do, just not where you’d look first.
Care for a client is exempt
Midwifery services rendered to an individual are exempt from GST/HST under the same provision that covers physiotherapists, dietitians, and psychologists. If you’re assessing, monitoring, or caring for a client through pregnancy, birth, and the postpartum weeks, there’s no tax on that service.
Two conditions sit underneath. You need to be registered with your provincial college where midwifery is regulated, or hold equivalent qualifications where it isn’t. And the service has to be rendered to an individual, meaning real care delivered to a real client. That second condition sounds like a technicality, but it’s the one that decides the tax status of your classes and workshops, as we’ll get to.
Who pays doesn’t change the answer. Ministry-funded care is exempt, and so is the same care billed privately to a client the provincial program doesn’t cover, such as a client without provincial health insurance. The exemption follows the service, not the payer.
The catch: exempt doesn’t mean refundable
Because your care income is exempt rather than zero-rated, you can’t claim back the HST you pay on the costs of delivering it. The tax buried in your equipment, supplies, mileage, clinic rent, and professional fees just stays there as a cost of practice. Plenty of midwives assume they’re owed those credits. They aren’t, and filing for them is how you end up reversing a refund with interest.
Where the taxable income hides
This is the part worth reading twice.
The exemption covers midwifery care rendered to an individual. It doesn’t cover things sold around that care. Group prenatal classes are the classic example: CRA has ruled that group prenatal education isn’t a service rendered to an individual within a care relationship, and it reached that conclusion for a registered nurse whose profession is also on the exempt list. Education woven into your one-on-one visits with your own client is part of exempt care. A ticketed class open to the public is a different supply, and you should treat it as taxable by default.
The same logic applies to the rest of the side table. Birth kits, TENS rentals, herbs, and any other product sales are taxable. Doula or labour-support services sold outside a midwifery care relationship aren’t on the exempt list at all. Placenta encapsulation isn’t midwifery care either. And any report prepared for an insurer or a lawyer rather than for the client’s own health, including expert testimony, has been taxable since the purpose test came in. Occupational therapists and psychologists deal with that same split on their assessment work.
Care for the client
Prenatal, birth, and postpartum care a registered midwife provides to an individual client, whether the ministry pays or the client does.
Classes, products, reports
Public prenatal classes and workshops, birth kits and product sales, doula-style services, placenta encapsulation, and medico-legal reports. HST applies once you’re registered.
When you’d actually have to register
The $30,000 small-supplier threshold counts taxable sales only, over four rolling calendar quarters. Exempt care income never counts, so a midwife doing purely clinical work stays outside the HST system entirely, with nothing to register and nothing to file.
But classes, products, and report writing count in full from the first dollar. A midwife who builds a popular class series or an online course can cross $30,000 on the side income alone, and at that point registration isn’t optional. You’d charge HST on the taxable stream, file returns, and claim credits only on costs tied to that stream, while your care income stays exempt. Keeping those two streams cleanly separated in the books is the whole game, and it’s the same structure we build for clinics with mixed exempt and taxable income.
Common questions
I’m paid through my province’s midwifery program. Do I need to do anything?
For HST, no. Funded care is exempt, and exempt income never pushes you toward registration. Your obligations are income tax ones, not sales tax ones.
Are my prenatal classes really taxable if I’m a registered midwife?
If they’re group sessions sold as their own service, treat them that way until a professional has looked at your setup. Your registration doesn’t exempt the class; the nature of the supply decides it.
Do I charge HST on a birth kit I resell to clients?
Yes, if you’re registered. If you’re still under the threshold, you don’t charge tax, but the sales count toward the $30,000 line.
Building classes, products, or assessment work alongside your practice and not sure what carries HST? Send us a note and we’ll map the line for you.