Integrating midwives more fully into the health-care system can help relieve pressure on rural physicians, improve health outcomes and save health-care dollars.
In countries such as Britain, Norway and the Netherlands, more than 70 per cent of births are attended by midwives. The Midwives Association of B.C. and the provincial government have made significant strides to make midwifery services available in B.C.
In Greater Victoria, 30 per cent of births are attended by a midwife, while the provincial average is only 17 per cent.
Too many expectant mothers are not able to receive the maternity care they need in their communities. Women and families in remote, northern and First Nations communities often travel hundreds of kilometres to obtain maternity care, resulting in elevated health risks, poorer outcomes for mothers and newborns and unnecessarily higher costs all around.
To close the maternity-care gap, MABC has put forward a new vision for midwifery and maternity care. This vision is about fully integrating midwifery into our health-care system and hospitals, and supporting midwives to assist in the delivery of 35 per cent of the births in B.C. by 2020 in order to increase access to maternity care, improve health outcomes and reduce health care costs.
Our vision involves providing women greater choice in their maternity-care provider, reducing the rate of caesarean sections and improving access to First Nations maternity care.
At the same time, our vision is to reduce pressure on family physicians in rural communities, while making better use of health-care dollars.
While awareness of midwifery as a safe and recognized maternity-care choice has increased, the profession’s growth has not kept pace with demand. More and more women are recognizing that B.C.’s registered midwives are highly trained, educated and regulated professionals who are experts in pregnancy, low-risk birth and post-natal care.
Midwives are covered by the B.C. Medical Services Plan, and practise in clinics, hospitals and homes, offering a full range of prenatal tests, screening and diagnosis options, ultrasound imaging and access to a variety of comfort and pain-relief options during labour.
B.C.’s registered midwives often work collaboratively with family physicians and with obstetricians, pediatricians, nurses and nurse practitioners to ensure that all of a mother’s or baby’s medical needs are met.
The MABC’s recommendations include increasing the number of midwives in B.C. by 16 per year, enabling internationally trained midwives to practise in B.C., new supports for midwives in rural and northern communities and new policies to enable midwives to work to their full capacity.
Our recommendations build on the positive steps taken by the provincial government, which has provided resources to support home births and funding to double the number of graduating midwives at the University of B.C. to 20 from 10 by 2017.
We hope our vision will begin a new dialogue to foster collaborative action between the provincial government, its agencies and other health-care providers so together we can bridge the gap in maternity-care services.
Ganga Jolicoeur is executive director of the Midwives Association of B.C.