Manitoba needs more midwives

Opinion

Hey there, time traveller!
This article was published 04/05/2015 (3799 days ago), so information in it may no longer be current.

Midwives and birthing families in Manitoba are celebrating 15 years of regulated midwifery in the province. Over these years, midwives have provided safe, quality care to thousands of women and their families.

But what exactly do midwives do?

Midwives are primary health care providers who provide support, care and advice to women during pregnancy, labour and the postpartum period, facilitate births and provide care for the newborn.

Midwives understand, promote and protect the physiological processes of the child-bearing year. Midwifery practice involves informing and preparing the woman and her family for pregnancy, birth, breastfeeding and parenthood and includes certain aspects of women’s health, family planning and infant well-being.

When someone knows “normal” well, they can recognize the “abnormal.”

Midwives identify complications that may arise in mother and baby, make recommendations to promote a return to health, access appropriate medical assistance, and implement emergency measures as necessary. When women require a referral, midwives work in collaboration with other health professionals.

Some of the philosophical foundations of midwifery care are informed choice, choice of birthplace and continuity of care.

Midwives work in partnership with their clients to enable them to make choices that are appropriate for their family. One of these choices includes where the women plan to give birth, whether this is at home, at the Women’s Health Clinic Birth Centre in Winnipeg, or in hospital.

Midwives generally work in teams in order to provide continuity of care. It is both a philosophy and a process that enables midwives to provide holistic care and to establish an ongoing partnership with the client in order to build understanding, support and trust. There is always a midwife available to a woman in care, should questions or concerns arise.

Midwives have an important role in promoting health and wellness.

Expertise in breastfeeding positions midwives well in protecting the present and future health of women and their babies. There exists a wealth of research about the beneficial long-term health impacts of breastfeeding, both for mother and baby. Midwifery clients boast a 90 per cent rate of exclusive breastfeeding.

Additionally, in a province with a Type 2 diabetes epidemic where each new case costs $473,000 in health-care spending over a lifetime, breastfeeding has clearly demonstrated a decrease in the development of the disease when compared to formula-feeding.

Midwives connect women and their families with community programs as needed, such as counselling services, the Women’s Health Clinic mothers’ program and the provincial healthy baby program. Half of midwifery clients are women who would otherwise be underserved in the general obstetric population.

Midwives provide support to those who are disadvantaged, disempowered and who would most benefit from the increased knowledge, time and the resources midwives provide.

Midwifery care is not a luxury service. It is recommended worldwide as the basic, quality care that each pregnant woman should receive. Thousands of women in Manitoba are wondering where their own promised midwives are.

There are currently 49 midwives practicing in Manitoba. Midwives are employed by their regional health authorities (RHAs). There are midwives employed in several RHAs, including Winnipeg, southern (Steinbach/St-Pierre and Winkler/Morden areas), Brandon and northern (Thompson/The Pas/ Norway House). Often, the number of midwives is limited and well short of the demand.

Most regions continue to decline midwifery care to well over 50 per cent of the women who request this service. Since the number of midwives in Manitoba is so small, a midwife leaving practice due to retirement, maternity leave or to seek opportunities in another province can quickly make a big change to the overall midwifery workforce.

Though most midwives are in permanent positions, some are still in term positions. There are several vacant positions available in various RHAs. Further, not all midwifery positions are being posted by the regions, in spite of provincial funding designated for these positions. Brandon RHA, however, has prioritized midwifery care for their region and found funding for a position from within their own budget.

Other regions have not implemented midwifery services at all. One woman from the Interlake, Selkirk, Pine Falls, Beausejour area, known as the Interlake Eastern Region, is granted midwifery care in Winnipeg each month. Otherwise there are no midwifery services available.

Portage La Prairie, a larger urban centre, does not have any midwives.

When Manitoba evaluates the goal it set in 2000 of increasing funded positions by four or five each year, we are about 150 positions short of the mark. When Manitoba compares itself to Ontario, B.C. and Alberta, the rate of increase is also lagging.

Though, for a time, there were not enough midwives to fill job vacancies, the tide has turned in recent years due to our own homegrown midwifery education program and to an influx of midwives educated elsewhere in Canada or the world. The Manitoba-based education program has been modified and strengthened. An annual student intake is expected to produce new graduates at regular intervals, which both boost the number of midwives and improve strategic workforce planning.

As midwifery looks back over the past 15 years, we see the families that have benefitted from midwifery care. As the profession looks forward, it envisions a time when every woman will be offered her choice of care provider.

The Midwives Association of Manitoba, the professional organization representing midwives, is inviting everyone to come celebrate with us the International Day of the Midwife on May 5.

In Winnipeg, celebrations will take place at the WHC Birth Centre, at 603 St Mary’s Rd, from 2 p.m. to 6 p.m. Information and tours of parts of the birth centre will be provided. We will also have food and face painting available.

For families in Brandon, rural and northern regions, contact your local midwives for information on local International Day of the Midwife celebrations.

Let’s celebrate the value of midwifery in Manitoba, and continue growing this invaluable health service.

 

Geralyn Reimer is president of the Manitoba Association of Midwives.