Midwifery in Saskatchewan. Many are not even aware that such a thing exists.Those
from provinces where midwifery is well established are usually shocked to ﬁnd out that
regulated midwifery has only been here for a few short years and is still virtually
inaccessible to the vast majority of families living in Saskatchewan. As a province we
are booming and for the ﬁrst time in recent memory people are moving here from out of
province, laying down roots instead of ﬂeeing at astonishing rates. But aside from the
surplus of trade jobs, Saskatchewan is struggling to keep up with the needs of a
growing population especially in terms of healthcare.
Midwifery was regulated in Saskatchewan in March 2008 and funds earmarked for
midwifery programs in every region were promised and distributed shortly thereafter.
The Saskatoon Health Region was the ﬁrst to provide services as they were lucky
enough to have previously unregulated midwives in the community who met the
seemingly impossible requirements to be hired by the region. However, in other
communities it would be more than two years before services became available. Now,
after ﬁve years of what the Saskatchewan government calls “successful 900% growth”
there are only 11 midwives working in the province, six of whom are allocated to one of
the province’s 13 health regions. In the capital city, Regina (a region that also serves
surrounding rural areas), only two of ﬁve midwifery positions are currently ﬁlled.
While it is reasonable to expect that new services will take time to establish there are a
number of issues at play which keep midwifery in Saskatchewan from becoming
accessible and sustainable.
In order to build a sustainable program, Saskatchewan needs to start training midwives
here at home. So far no post-secondary institution in the province offers this training.
Even if they did, the Saskatchewan College of Midwives does not allow student
midwives to work in the province at this time. This means that most who leave to
become midwives do not come back. By the time they have completed the training to
meet the College’s requirements, they have laid down roots in other communities and
have been offered better positions in places where midwifery is better established, more
highly respected and effectively integrated into the maternal health care system.
Recruitment and Retention
In order to train new midwives it is vital to have preceptors, established working
midwives willing to train and support new midwives as they study and work to meet
program requirements. Since a training program is unlikely to start showing results
immediately, it is vital for the government and health region to take a good hard look at
how they recruit midwives and how to prevent the high rate of turnover some regions
are seeing. Working in a brand new program that runs very differently from midwifery
programs in other provinces is demanding and understafﬁng means the midwives who
are here work double or triple time to meet the needs of their communities. With most
regions struggling to keep up with basic care it would seem that recruitment has fallen
to the back burner; for example the only public job posting seeking midwives in the
Regina area is buried deep within the RQHR website. Not very helpful when most
people outside of Saskatchewan don’t know that midwifery services are even available
While there is funding earmarked for Saskatchewan health regions to hire midwives, it is
unclear what, if any, funding there is for support staff to help run these programs.
Support staff could mean anything from ofﬁce assistants working alongside midwives to
help with scheduling and paperwork, second attendants who can provide skilled birth
support to ease the demand on home birth midwives, and postpartum professionals to
ensure better continuity of care should an overworked midwife be unable to check in
with families in the days following the birth. Providing proper job support is vital to
retaining the midwives we do manage to recruit. Some of the workplace problems facing
health workers in Saskatchewan are system wide, some are speciﬁc to midwifery, but all
need to be addressed quickly if Saskatchewan is serious about expanding this program
Barriers to Independent Midwives
Currently, all midwives in Saskatchewan are employed directly by individual Health
Regions and must work within the system as employees. Since each region faces its
own barriers and limitations to providing care, some are better equipped to provide
midwifery services than others, leaving many areas without any access to services at
all. In other provinces, midwives practice and run their clinics independently under
standards set forth by their certifying body with direct funding from the provincial health
system on the same basis as physicians and other healthcare providers. Not only does
the current restrictive model prevent Saskatchewan from recruiting midwives, it also
places unnecessary burden on smaller health regions which may not have the
administrative resources to effectively run “additional” programs.
It has never been made clear why Saskatchewan policy makers have chosen to restrict
midwifery in this way.While there may be a place to increase maternal education and
support for at-risk families through region-run midwifery programs in communities at
socio-economic disadvantage, it is clear that this model cannot meet the full demand for
midwifery services in Saskatchewan without support from independent midwives.
So what does all this mean for families seeking midwifery care in Saskatchewan?
It means that most families cannot access midwifery care at all. It means that families
who do get into the program and are promised midwifery care can end up waiting up to
20 weeks for their care to begin. Worse still, it means that some families,after such a
long wait, are informed that they won’t be able to access services after all and are left
scrambling to ﬁnd another provider.
Homebirth, an option that many families seeking midwifery care are looking for, is not
adequately supported. In many areas the option is not offered at all. In other areas, the
option is provided conditionally, creating stress and uncertainty for families while
preparing for the birth of their baby. These conditions can mean that if you labour while
one midwife is on holiday or at the same time as another woman, you could face being
forced to change your plans in labour and be transferred to hospital even if things are
progressing normally. Home-birthing families prepare themselves for the possibility of
being transferred to hospital in the case of a medical emergency, however home to
hospital transfers in Saskatchewan are more commonly made for scheduling and
stafﬁng reasons leaving families feeling confused, disappointed, and ultimately
Postpartum care is another area where the current programs are leaving families
unsupported. Because a midwife would traditionally be more involved than a GP or
OBGYN in the immediate postpartum period some regions in Saskatchewan do not
grant midwifery clients access to the same postpartum services available to other
families like region lactation consultants or public health visiting programs. In some
cases this means that a potential concern a midwife could have caught and treated at
one day postpartum turns into an emergency situation by the time that midwife can
make it back from another birth on day three.
Ultimately it is clear that the current state of midwifery in Saskatchewan does not meet
the needs of Saskatchewan families or the needs of midwives and potential midwives
who wish to work here. This is why members of this community have come together to
form a Saskatchewan chapter of the Where’s My Midwife? movement. There has
always been support for midwifery here, and many have come before us in the ﬁght for
better services, we hope that connecting to this larger movement will bring all of us
together and inspire the kind of passion and energy needed to make change.
Our current plan is to focus on improvements in the areas identiﬁed above by
encouraging community involvement in a number of different ways. A postcard
campaign targeting our Health Minister is coming very soon. A community art project to
create awareness and discussion around these issues is currently taking submissions.
A small delegation will be addressing the provincial Legislature in the week leading up
to the International Day of the Midwife on May 5th. The day itself will be marked with a
community blessing-way for families to gather and celebrate what midwifery means to
us and our communities.
We want to thank the Where’s My Midwife? movement for its support in helping us
activate members of our community. We hope to have some progress to show for it very
Doula, Activist, Writer
Co-Director WMM? Saskatchewan
SMITHS FALLS – CALL TO ACTION
We’ve been busy in Ontario! Not only are we preparing for our trip to the Farm in Tennessee, where we will join our US counterparts and birth activists from all over the US and Canada; we have started a new team in Smiths Falls! We were contacted by local consumers after reaching out on our Facebook page, asking who needed help in their town.
Smiths Falls is a community with one hospital and several midwifery practices in the surrounding area. Perth & Smiths Falls District Hospital is the closest hospital for most of the women in the community. There are no midwives privileged at Perth & Smiths Falls District Hospital. Our job is to make sure that changes in the near future!
Where’s My Midwife? has announced our presence and concerns with both the Chief of Obstetrics at Perth & Smiths Falls District Hospital and the local midwifery practices. Our local team is growing and this is an issue we will not let rest. If you are unhappy with the lack of access to midwifery care at Perth & Smiths Falls District Hospital, make sure you let your midwives and neighbours know!
- SHARE this story
- CONTACT the midwifery practices and let them know you want them to seek privileges at Perth & Smiths Falls District Hospital
- LIKE our Facebook page https://www.facebook.com/WMM.ON (be sure to hover over the ‘like’ button and select ‘show in news feed’)
Where will we go next? Email firstname.lastname@example.org if you would like help in your community.