It’s been more than two decades since midwifery became a regulated and MSP-funded profession in B.C. Three hundred midwives are involved in 22 per cent of all births in the province each year.
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 by 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.
This Monday, 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 is 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.
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.