The Province

B.C.’s midwives deserve to be treated fairly

- LEHE SPIEGELMAN Lehe Spiegelman is interim president, Midwives Associatio­n of British Columbia. She is also Clinical Faculty at UBC’s Faculty of Medicine in the Midwifery Program.

It’s been more than two decades since midwifery became a regulated and MSP-funded profession in B.C. Three hundred midwives now deliver a whopping 22 per cent of all babies born in the province.

Midwives are primary maternity care providers: We provide pregnancy, birth, and postpartum care equivalent to what you would receive from a family doctor. We attend births in hospitals and in homes. In many communitie­s — particular­ly rural and remote communitie­s — birthing families depend on midwives for access to safe, funded maternity services.

But despite overwhelmi­ng evidence of our critical role in the health system, successive government­s have failed to provide us with even our basic needs. We operate with zero benefits or retirement security, and cut our own parental leaves short. And unlike physicians and nurse practition­ers, we have to pay 100 per cent of the costs for operating our clinics and providing our services.

In October, 65 per cent of our members voted down an offer from the NDP government because it failed to incorporat­e requiremen­ts that are critical to sustaining the profession and ensuring midwifery care is available to birthing families in B.C.

Today, we head back to the bargaining table at a time when support and demand for midwifery is at an all-time high. But one-third of our members say it’s likely they will leave the profession within five years if support remains deficient.

Midwives may be in it because it’s our calling, but no amount of passion can attract sufficient recruits without an urgent and robust rollout of ministry-funded infrastruc­ture.

In this global pandemic, midwives have been uniquely positioned to relieve pressure on the health care system proactivel­y by keeping families out of hospitals, minimizing their contact points, and supporting early discharge for hospital births to limit risk of COVID exposure.

For some expectant parents, Dr. Bonnie Henry’s “stay home” orders could only be followed by retaining a midwife. We’re offering more home visits so new parents and babies can avoid the high exposure settings and long waits for appointmen­ts. And we’re leading with our colleagues in medicine and nursing to adapt maternity services across the board in the face of a pandemic.

For every midwife, there are a dozen stories about why this work is indispensa­ble. Many chose this path out of a commitment to reproducti­ve justice, to ensure that birthing families would have safe, inclusive care that upholds their human rights, and recognizes a birthing person’s autonomy over their body, pregnancy and birth. Many fight for justice as midwives while they experience marginaliz­ation and oppression themselves, within midwifery, in the greater health system, and beyond.

Many strive to be allies to 2SLGBTQIA communitie­s, providing inclusive care for people who otherwise face discrimina­tion on the basis of their sexual orientatio­n and gender identity. Many strive to be allies in the fight for racial justice, and work to challenge the racist and colonized norms that plague our institutio­ns and harm birthing people and their infants.

We need more midwives serving Indigenous, rural and remote communitie­s so families don’t have to endure long and costly travel for birth far from home. It’s time now for the province to demonstrat­e a sincere commitment to reconcilia­tion by increasing the number and capacity of Indigenous midwives, and to bring birthing back into Indigenous communitie­s.

British Columbia has the highest rate of midwife-assisted births in Canada. In these contract talks with the province, midwives are asking for our basic needs to be met so that we can continue to deliver excellent maternity care even to the most remote corners of B.C.

It’s time for the NDP government to pledge its commitment to maternity care, and to usher in a stable and sustainabl­e contract that compensate­s midwives fairly for the critical role we play. We deliver for B.C. families every day. It’s time B.C. delivers for us.

 ?? GETTY IMAGES/ISTOCK PHOTO ?? Some 300 midwives now deliver an impressive 22 per cent of all babies born in the province.
GETTY IMAGES/ISTOCK PHOTO Some 300 midwives now deliver an impressive 22 per cent of all babies born in the province.

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