Mid­wifery de­mands span the prov­ince


As an On­tario stu­dent of mid­wifery cur­rently on place­ment at Planned Par­ent­hood in St. John’s, I want to thank ev­ery­one for their kind­ness and wel­com­ing hos­pi­tal­ity. While shar­ing in­for­ma­tion about my pro­gram and fu­ture pro­fes­sion, few peo­ple seem to know about mid­wifery. Those who are fa­mil­iar with mid­wifery seem very en­thu­si­as­tic about the model of care, and how it could ben­e­fit women in St. John’s and across New­found­land and Labrador.

There­fore, I am writ­ing this let­ter to share in­for­ma­tion about a ter­rific al­ter­na­tive model to ma­ter­nity care.

It is with great in­ter­est that I have been fol­low­ing the ma­ter­nity care cri­sis in Labrador West. Many ru­ral women with low risk preg­nan­cies are re­quired to travel away from home for birth, de­spite the fi­nan­cial and psy­cho­log­i­cal stress that this places on the mother and fam­ily. A wo­man who needs to leave her fam­ily for birth will not have the con­tin­u­ous sup­port dur­ing birth which has been shown to im­prove labour out­comes.

Also, the bro­ken fam­ily unit places a need to find ad­e­quate child­care dur­ing the mother’s ab­sence. Mid­wives have been work­ing un­reg­u­lated in Happy Val­ley- Goose Bay, but the de­mand for reg­is­tered au­ton­o­mous mid­wives spans the prov­ince. More­over, with an im­por­tant need for cul­tur­ally sen­si­tive and lo­cally ac­ces­si­ble ser­vices to abo­rig­i­nal com­mu­ni­ties, Labrador will ben­e­fit from the ex­pan­sion of a mid­wifery model of care.

In many prov­inces across the coun­try, mid­wifery has demon­strated its abil­ity to pro­vide safe ma­ter­nity care to low risk women, im­prove women’s choice in birth op­tions, and re­duce gov­ern­men­tal costs as­so­ci­ated to ma­ter­nity ser­vices. Since start­ing my place­ment in this prov­ince, I am pleased to find that many peo­ple who ask what I am tak­ing in school are fas­ci­nated by the model of care and ques­tion why New­found­land and Labrador do not have mid­wives.

Mid­wifery care is an al­lied pro­fes­sion based on three philoso­phies. First, a wo­man has the right to con­ti­nu­ity of care. In On­tario, mid­wifery care is funded through the Min­istry of Health and Long Term Care. As a client, you are given am­ple time dur­ing ap­point­ments and a trust­ing re­la­tion­ship forms.

Your birth is con­tin­u­ously at­tended to by your mid­wife, who stays with you from the time that you are in ac­tive labour, un­til the time that you have been re­cov­ered post de­liv­ery. A sec­ond mid­wife or birth at­ten­dant is present for the birth to en­sure ad­e­quate as­sis­tance should an emer­gency arise.

Con­ti­nu­ity of care con­tin­ues through­out the first six weeks post­par­tum and in­cludes mul­ti­ple home vis­its.

Sec­ond, a wo­man has the right to in­formed choice re­gard­ing use of in­ter­ven­tions and birthing style. Our ap­point­ments are funded to be long enough to pro­vide in­for­ma­tion to women so that they can make per­sonal choices about their health­care.

Third, a wo­man has the right to choose their place of birth. Mid­wives are reg­is­tered un­der the Col­lege of Mid­wives of On­tario as independent pri­mary care­givers and main­tain independent hos­pi­tal priv­i­leges. This gives clients the free­dom to choose be­tween birthing at home or in a hos­pi­tal.

Re­search com­pleted over the last decade has con­sis­tently demon­strated that planned home­births for low risk preg­nan­cies re­sults in care that is as safe as women birthing in hos­pi­tal, but has less risk of un­nec­es­sary in­ter­ven­tions. More­over, mid­wives come to a homebirth pre­pared to han­dle emer­gen­cies with the same abil­ity as a Level 1 hos­pi­tal (drugs, IVS, and re­sus­ci­ta­tive equip­ment).

Mid­wives have worked hard to es­tab­lish their pro­fes­sion as independent pri­mary care­givers for low risk preg­nant women, and of­fer an al­ter­na­tive to women who are un­able to find a fam­ily doc­tor or ob­ste­tri­cian, or who want care un­der an al­ter­na­tive model.

New­found­land and Labrador has only re­cently started the process of leg­is­lat­ing mid­wifery. In June, 2010 Bill 17 re­ceived as­sent and cur­rently plans are be­ing de­vel­oped to frame the lo­gis­tics of mid­wifery in New­found­land and Labrador, such as where will they be ed­u­cated, reg­u­lated, prac­tice and how will it be funded.

As a stu­dent at Ry­er­son in Toronto, my class size is 31 and there are stu­dents who wish to re­turn to this prov­ince to prac­tice. I look for­ward to watch­ing New­found­land and Labrador de­velop and im­ple­ment mid­wifery as a means to pro­vid­ing and pro­mot­ing more op­tions for nor­mal birth, close to home, at lower costs.

With warm re­gards to all whom I have con­versed with over the last few weeks,

Carolyn Begg-reid writes from St. John’s

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