Women and families in British Columbia’s rural, northern and first nations communities are experiencing a widening gap in maternity care services due to a growing shortage of maternity care providers.
The number of family physicians who include maternity care in their practice is declining and a significant number of obstetricians will soon retire. Twenty rural maternity care services have closed in B.C. since 2000.
Women and families often travel hundreds of kilometres to access care, resulting in elevated health risks, poorer outcomes for mothers and newborns, and unnecessarily higher costs all around.
While B.C. isn’t the only province facing a growing maternity-care gap, it is all the more challenged because our birthrate is projected to increase by 17 per cent to over 50,000 by 2020.
To close this gap, the Midwives Association of British Columbia has put forward a new vision for midwifery and maternity care in B.C.
Our new 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 to increase access to maternity care in rural communities, improve health outcomes, and reduce health care costs.
Our vision involves providing women greater choice in their maternity care provider, reducing the rate of caesareans and improving access to first nations maternity care.
Most important, increasing access to quality maternity care will lead to healthier babies, healthier women and healthier families, which all British Columbians can support.
At the same time, our vision aims to reduce pressure on family physicians in rural communities, while making better use of British Columbian’s health care dollars.
Independent analysis shows achieving our vision will reduce costs by about $60 million by 2020, money that could be put toward other health care priorities.
Registered midwives are able to decrease health-care costs by reducing the number of c-sections and other invasive procedures, reducing preterm births, reducing hospital readmissions and the over-all length of hospital stays, or eliminating them altogether through home births.
While awareness of midwifery as a safe and recognized maternity care choice has increased, the profession’s growth has not kept pace with demand.
Most practices have waiting lists and many communities have no access to midwifery care at all.
Women appreciate that B.C.’s registered midwives are highly trained, educated and regulated professionals who are experts in low-risk pregnancy, birth and post natal care.
Midwives are covered by MSP and practice in clinics, hospitals and homes and offer 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 vision recognizes that a high level of inter-professional collaboration among B.C.’s maternity care providers will deliver the best outcomes for B.C.’s women, newborns and families.
It provides a series of recommendations that involve B.C.’s midwives working with the provincial government, regional health authorities, hospitals, other maternity care providers and the First Nations Health Authority to better serve women and families in rural, northern and first nations communities and close the maternity care gap.
The MABC recommendations include increasing the number of midwives by 16 per year, funding a credentials program that enables internationally-trained midwives to practice in B.C., new supports for midwives in rural and underserved communities, and the introduction of supportive policies to enable midwives to work to their full capacity.