promoting midwifery care for all saskatchewan women

guest article by Midwifery for All 

May 5th is the International Day of the Midwife, a day that is recognized around the world as an opportunity to celebrate midwifery and to promote awareness of the care that midwives provide.

On March 14, 2008, midwifery became a regulated profession in Saskatchewan, joining seven other provinces and territories to offer a safe alternative to traditional physician care. Two years later, many people still do not understand the role of a midwife and are not aware that midwifery care is an available option for some women.

1. Midwives are specialists in normal birth, providing primary care for women and babies throughout pregnancy, labour, childbirth, and first six weeks postpartum.

2. Midwives are able to do deliveries in hospitals or at home, and they are trained to provide immediate emergency care to the mother and newborn.

3. Midwives provide women with information and options regarding their care, encouraging informed consent, and follow guidelines that determine whether a medical condition or complication indicates a need for physician consult or transfer of care.

4. Midwives are able to order diagnostic tests and assessments, prescribe and administer many drugs commonly used in pregnancy, childbirth, and immediate postpartum period.

5. Midwifery care reduces the rates of intervention including cesarean section, result in shorter hospital stays, increased success rates of breastfeeding, and reduce health care costs.

There are currently over 800 registered midwives throughout Canada, with over half of those in Ontario alone. Despite having the most registered midwives in Canada, the demand for midwifery services is so great that more than 40 percent of women seeking midwifery care in Ontario are turned away due to a full case load. Across Canada, almost all other provinces are experiencing the same difficulties with meeting the demand for midwifery services.

Despite the goal of Saskatchewan Health to make midwifery care accessible to all women in the province, full scope of midwifery services is only available to women who live within the Saskatoon city limits. The Saskatoon Health Region has only five registered midwives and due to the demand for services, these midwives are not able to accept clients outside of Saskatoon which leaves women in other communities and rural areas without access to midwifery care. Regina Qu’Appelle and Cypress health regions are in the process of recruiting midwives but services will be limited until more midwives are hired. Until the Saskatchewan government provides funding for independent midwifery services, rural women will continue to have insufficient access to midwifery care.

In order for midwifery care be accessible to all women in Saskatchewan, funded independent practice is an option that must be considered. Although independent midwifery practice is a legal option in Saskatchewan, the midwife must first obtain liability insurance in order to be eligible for registration (legally allowing her to practice). Liability insurance costs $25,000 to $50,000 each year, in addition to all other business expenses such as emergency training courses, supplies, and equipment; a prohibitive amount of money for a midwife in independent practice. As well, until the Saskatchewan government provides funding for independent practice, clients must pay the midwife “out of pocket” for independent midwifery services, a service that is free for Saskatoon (urban) women. Midwifery service fees range from $2,500 to $3,100 per course of care. For those health regions that employ midwives, expenses such as liability insurance, supplies, equipment, emergency training courses, and office and clinic space are all paid for by the health region. These health regions also pay the midwives’ salaries so midwifery care is “free” to women in that area.

Obstacles to having midwifery care accessible to all women in Saskatchewan:

1. Only four provinces in Canada offer university midwifery education programs, and Saskatchewan does not have one.

2. A full range of midwifery care is only available to women within the city limits of Saskatoon at this time.

3. Two other health regions are in the process of hiring midwives who will be limited in the care they can provide, such as providing care only to women who choose to birth in a hospital.

4. Home birth with a registered midwife is not an option for women outside of Saskatoon.

5. Rural women in Saskatchewan have no access to midwifery care and most women have to travel long distances to receive prenatal care and give birth in hospitals.

6. The costs required for midwives to set up independent practice are prohibitive.

7. Although Saskatchewan Health has provided funding for midwifery services, it is not known when ten of the 13 regional health authorities in Saskatchewan are planning to implement midwifery care. While the Cypress Health Region has started the process there is still no definite date for when midwifery will be implemented.

Midwifery For All is a consumer group for the advancement of midwifery services in Saskatchewan. For more information contact Amy at amycassonis@gmail.com or midwiferyforall@yahoogroups.ca.



2 comments


Anonymous said...

I find it ridiclous that "Saskatoon" is the only city in Saskatchewan allowed to have home births. Its unfair to all woman who lives outside of the city to have a
home birth. I feel ripped off and so many other feelings of something I feel we ALL have a Wright to have!! Its OUR bodies, Our babies, and OUR lives. I feel the most comfortable in MY home with someone I choose, not some discusting hospital with snotty people I have no time to get to know with NO care in the world. These "doctors" dont give 2 pineapples about us woman, they should be giving surgerys. All they want is to get these births over and done with using medicine that arent even healthy. taking away our moments were suppose to enjoy and one day have as a wonderful memory. But no! We have to be pushed around like some kind of animal with the no wrights and no say in things. Home births are WAY safer than hospital delivers. Who lays down to push out a baby when we know that puts more preasure on us so its harder for baby to come out? I 100% believe in water births the MOST normal way for a baby to be delivered in! Im 18 years old and I know so much about this horrible stuff and how we are treated int hose hospiatls. If I was able to have my home birth like i have always wanted I know for a fact I would NOT have needed to be cut open for the 2 births of my children I FEEL ROBBED 100 Million% ROBBED of my most precious moments of my life. Will I ever get any of it back NOPE NEVER! How lovely. Births shouldnt even be allowed in hospitals, only for severe births that really need it. Corruption I tell you. They make everyone believe this is normal. Where are our wrights to chose.

Anonymous said...

Well written! If the ' medical community would start to see that birth is not a disease then we would all be so much further ahead! The lack of midwives is only pushing women who want home births to do so 'under' the table!! Is this what the medical community wants? How did our society take so many steps in the wrong direction... Oh right everyone is so worried about money instead of the Heath and general well being of women and their babies!!!

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