Canada

Where’s My Midwife? – Canada is a grassroots network of activists, advocating for access to midwifery care for families across the nation.

ALBERTA

NO ADDITIONAL MIDWIVES IN ALBERTA UNTIL AT LEAST 2015!!

Why? The new allotted funding is highly insufficient.

Some facts about midwifery in Alberta:

  • In 1992, legislation was passed that legalized the profession of midwifery in Alberta. Midwives were not publicly funded then, families had to pay out of pocket.
  • In 2009, Alberta began funding midwifery services.
  • Mount Royal University is offering a four-year Bachelor degree in midwifery. The first graduates will come in 2015.
  • There are 74 registered midwives in Alberta. Together, they deliver only 2% of the province’s babies.
  • The deal signed June 2013 limits a midwife to 40 courses of care per year. But at $37 million over three years, there isn’t enough funding to have all 74 registered midwives reach the maximum. Nor is there any funding to accommodate midwives who move into Alberta, or new midwives expected to graduate from the Mount Royal University program in 2015.

What can you do?

For more information contact:  lucielapierre@outlook.com

Follow us on Facebook here:  https://www.facebook.com/WheresMyMidwifeAlberta

Please join us in a province-wide rally to protest against the limited funding of midwives on SEPTEMBER 2ND 2013 AT 11AM:

  • Watch this video and “Keep contracts out of contractions”!

SASKATCHEWAN

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.

Training

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
here.

Supporting Staff

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
and others.

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
unsupported.

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
soon.

Julian Wotherspoon-
Doula, Activist, Writer
Co-Director WMM? Saskatchewan