Women need the holistic care of midwives

Politicians should prioritize funding for positions, writes Cynthia Wallace.

Nearly a year ago, my son joined us in a birth much swifter than I’d ever anticipated. After an hour of active labour and 10 minutes of pushing, he was in my arms, damp and warm and perfect.

Thankfully, it was a planned home birth; I wouldn’t have made it to Royal University Hospital. My midwife team hustled up Highway 11 to Warman and arrived just as I needed to push. With quiet efficiency they filled my bedroom with supplies, suggested a Pitocin shot to avoid hemorrhaging (a risk of such powerful, brief deliveries), and stood ready with oxygen and suction when our baby took a moment to start breathing on his own. And then they cleaned up, checked us over, helped with breastfeeding, and sent my husband down to the kitchen for peanut butter toast and juice.

They’d known to be ready for the call; they’d known our hopes for the birth; they’d known our older daughter by name. This is what midwifery offers: holistic, familycentred care. Midwives are highly trained professionals who provide prenatal, birth, and postnatal care for low-risk pregnancies in both home and hospital settings. Studies show that their care helps reduce the number of unwanted interventions and is just as safe — at hospital or home — as obstetrical care. Midwifery is also a much more cost-effective model than requiring uncomplicated pregnancies to be under the care of surgeons.

It’s not surprising that many women desire this model of care. But in the Saskatoon Health Region, dozens of women are turned away each month due to lack of resources. Further, Saskatoon is one of only three of the 13 health regions in Saskatchewan to develop a midwifery program since the Midwifery Act was proclaimed in 2008. Women who live in the Saskatoon, Regina Qu’Appelle, and Cypress health regions at least have a chance at a midwife-attended birth; those in other health regions have no chance at all. In many of these places, local hospitals no longer deliver babies, leaving families to make long drives into urban centres for obstetricians’ services.

Creating positions for midwives in rural and remote areas would mean a higher quality of care for families and decrease hospital overcrowding in urban centres.

Because midwifery is fully regulated by the province, we are at the mercy of politicians to prioritize creating and funding positions. Our numbers are shockingly low: the Canadian Association of Midwives reports that as of 2016, Saskatchewan had just 14 midwives, compared to 77 in Manitoba, 111 in Alberta, 313 in B.C., and 817 in Ontario.

The challenge is partly one of funding, but it is also one of recruitment and education. The national demand for midwives outpaces supply, and Saskatchewan does not yet offer a training program (the Canadian standard is a four-year baccalaureate degree). We are left to recruit from other provinces and countries or to send students away for their education and hope they come back to us.

Friday, May 5 was International Day of the Midwife, and I am writing in part to advocate for midwifery. We need more midwives across the province and a degree program at our university. We also need more midwives globally, especially in communities without prenatal care, in which nearly 300,000 women and three million infants die annually of preventable complications. But I am also writing to honour the small group of midwives we do have in the province. Working tirelessly, they mingle professionalism with humour and tenderness. They have helped me bring two beautiful humans into this world, and in their care I have felt listened-to, safe, and empowered. Would that all women were so lucky. Cynthia Wallace, a published author, is an assistant professor of English at St. Thomas More College, University of Saskatchewan.

The challenge is partly one of funding, but it is also one of recruitment and education.