Annapolis Valley push for midwifery

Jennifer
Jennifer Hoegg
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Local families fight for more choices

BY JENNIFER HOEGG

Kings County Advertiser/Register

Olin was ushered into the world by his mother, father and a midwife on a stormy winter night.

His baby brother or sister will be born soon, but not in the same cozy house overlooking the Minas Basin. Midwives can no longer practice in the Annapolis Valley.

Olin’s mother, Erica de Sousa, is part of Valley Families for Midwifery (VFM), a local group advocating for midwives’ return. After 30 or more years of continuous services, regulations of the profession two years ago put an end to midwifery here in March 2009.

Before, midwives operated in a legal grey area and could not order ultrasounds, blood work, write prescriptions or attend hospital births. Clients paid midwives directly.

Regulation was supposed to be a step forward. A midwifery regulation council was established and a prior learning and education assessment program adopted between the legislation’s announcement and eventual adoption. Seven midwives were hired to provide publicly-funded care at three pilot sites: Guysborough Antigonish Strait Health Authority, South Shore Health and the IWK Health Centre in Halifax.

Midwifery advocates had been arguing for regulation for a long time and government working groups had been in place since the mid-1990s,  but when their work came to fruition, there were some unpleasant surprises.

“The gap between the passage and the proclamation of the legislation was to get things up and running,” Jan Catano of the Midwifery Coalition of Nova Scotia (MCNS) says.

“Once the act was proclaimed, it would have been illegal to practice midwifery in Nova Scotia without a license.”

Legal midwifery “has been a double-edged sword,” she says.

“It was not ill intended but, as it played out, we never envisioned it would be two years between proclamation and midwifery being available outside of those model sites. We thought they would start rolling it out elsewhere.”

Things haven’t gone well at the IWK site. Home births were delayed, women were turned away, midwives were fired and others quit. In December, the Halifax program was suspended. An evaluation report commissioned by the Department of Health showed tensions between midwives and other care providers was stressing mothers, and there weren’t enough midwives to meet demand.

We need a champion within the system. Midwifery is working. It does work. It’s working all across the world. This is not a new thing. Dawn Hare

In late-January, a rally at the Legislature drew around 200 people.

“I never thought that I'd still be writing letters and planning to go to demonstrations at Province House in 2011,” Wolfville’s Mercedes Brien says. She was at a rally 27 years ago, with a baby in a sling. 

“My granddaughter was born in the Valley five years ago. That wouldn’t even be possible now. I never thought my home-born children would have to leave the province to have their birth choices honoured.”

“Implementation has been very dissatisfying,” de Sousa says. “It assumed midwifery didn’t exist.”

“That’s what the kicker is,” Dawn Hare says. “We are trying to regain something.”

Waiting for care

Hare’s two children were born at home with a midwife. 

“It was beautiful. It was empowering. I was surrounded by my family, my daughter was there right after her brother was born.”

She and her husband would rather wait for midwifery than have another baby now.

Melissa Dimock is waiting, too - until her family is complete or midwives return - before moving back to Kings County from Ottawa.

“My experiences with midwives as care providers were wonderful, particularly with our third child, who was born at home. The lack of adequate midwifery services in the Annapolis Valley is a significant deterrent for me.”

De Sousa’s baby won’t wait. He or she will be born in the hospital, hopefully attended by the general practitioner she has chosen. Although pleased with her medical care so far, she feels, for an uncomplicated birth, she doesn’t need to be in the hospital. 

“My husband and I would rather have a homebirth. We are both distressed. The choice has been taken away from us in the middle of our family planning.

“It’s a waste of resources. It costs less to have a homebirth.”

It isn’t just the opportunity to birth at home de Sousa misses, but the continuity of care midwives offer, from early in pregnancy until six weeks postpartum.

“We spent energy building a relationship with the person who thought would help deliver our family.”

 

Continued on next page..

 

Organizations: IWK Health Centre, Midwifery Coalition of Nova Scotia, Guysborough Antigonish Strait Health Authority Department of Health Province House Annapolis Valley Health District Health Authority Valley Regional Hospital Ontario Association of Midwives Wolfville Library

Geographic location: Annapolis Valley, Halifax, Minas Basin Nova Scotia Wolfville Kings South Shore Ottawa Ontario

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