News > The case for midwives

The case for midwives

posted on August 6, 2014
Source: The Prince George Citizen - Judy DeFreitas and Karin Gerlach

We are writing to follow up to the July 25, 2014, article "Midwives start job action" to provide your readers with additional information and local context regarding the recent actions we have taken in our discussions with the provincial government for a new sensible agreement for BC's registered midwives.
 
Our first measure was to immediately withdraw clinical education services for students in any health discipline across the province, including midwifery, nursing, medical students and family practice and obstetrical residents. It is important to note that we receive no compensation for providing these services.
 
Registered midwives have taken these actions with great reluctance, but with the overwhelming support of our members who voted 94 per cent in favour of terminating our agreement with the province.
 
Many midwives working in northern communities are on call 24/7. We are not asking for the Ministry to take over the pilot locum program, we are looking to expand it to allow rural midwives access to the program. Without an adequate locum program, we are unable to step away from our demanding schedule to attend to personal medical care needs or take part in ongoing professional education which will benefit our future clients. It is not simply about providing coverage during vacations as was inferred in the article, it is about building a sustainable model of care.
 
We are pleased to note that Prince George is ahead of most communities in Northern Health in integrating midwifery into the health care system. However, the demand for our services is growing, especially in First Nations and other northern communities, where expectant mothers and their families must often travel hundreds of kilometres to access maternity care.
 
What your readers might not be aware of, in some rural communities in other parts of the province midwives are still being denied hospital privileges where there is a high demand for services. This is not sensible. It is impossible for a midwife to establish a practice in these communities without access to the medical facility. We need to find ways to increase maternity options and services, not limit them.
 
Moreover, the maternity care gap BC's north is expected to increase, not diminish. As the economy grows and more people move here, coupled with fewer physicians choosing to provide obstetrical services, the challenges ahead will only increase.
 
British Columbia's registered midwives are already an integral part of the maternity care system and assist in the delivery in one in five births. Yet, the total annual budget for midwifery is less than $26 million per year.
 
The province's total health budget is over $14 billion and growing. Studies show that investing in midwifery results in cost savings - makes fiscal sense to us. A nominal investment today will result in savings of approximately $60 million by 2020 and $20 million annually after that, thereby freeing up savings for other health care priorities.
 
The article incorrectly stated that midwives were seeking a wage increase for professionals who have been practicing for more than five years. In fact, we have requested a modest wage increase, following five years with no increase, for all registered midwives and this increase would be spread out over five years of our new contract.
 
The bottom-line for residents in Prince George - including the expansion of the locum program, better integration with the health system, increasing the number of midwives practicing in rural and northern BC and wage adjustments - our proposal would cost the province approximately $3 million per year over five years for a total of $15 million. That sounds sensible to us.
 
This is why we are asking people in Prince George and throughout northern BC to contact their MLA to urge the Ministry of Health to deliver for women and families by reaching a sensible deal with registered midwives.
 
Judy DeFreitas and Karin Gerlach are both registered midwives who practice in Prince George.

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