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The Midwifery Group - Team 1

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Laurie-Ann Cheng, Tracy Kemp, Stephanie McDonnell, Caitlin Frame, Katie McCallum, and Andrea Brett

What are the challenges you’re facing as a midwife practicing during the pandemic?

Midwifery is an intimate profession. We are accustomed to building close relationships with our clients, relationships that are known to improve outcomes. In order to reduce contact we are limiting our in person visits, only doing the clinical aspects in person and then carrying on our discussion by phone or video conference. We are covering the same material but we are missing the difference in physical closeness that makes our care special.

Additionally, we are very fortunate to have protective equipment but wearing a mask at all client encounters also puts up a barrier in getting to know us.

We are missing the intimacy of the care we provide.

Another challenge we face is the increased risk we face of exposure everyday. We are putting ourselves, each other, our families and our other clients at risk every time we see someone or do a home visit. We are following strict contact precautions; wearing PPE and sanitizing our equipment but the risk is real and these methods of protection are not perfect.

As a team we have also had some personal struggles during this already extra stressful time. Our heart goes out to one of our teammates who sadly very recently lost her father, another was supporting her husband through a major surgery and recovery, others had to pick up more shifts, some are home schooling and providing care for children at home while tag-teaming with their spouses who are also working full time, etc.

Our team (as with every other team and midwifery practice) have had to quickly adapt and implement new protocols for how we practice during the COVID-19 pandemic. This required many extra work hours and meetings, writing regular bulletins to send to our clients, being resourceful in procuring supplies for sanitizing (which were very expensive hard to find) ex. Sanitizing products and surgical masks and DIY PPE. Thankfully the generous donations of clients, friends, students and the hard work of our leaders at the BCWH Midwifery Department helped us fill in the gaps to create a full set of PPE for each midwife so we could continue to provide home births and protect ourselves and our clients.

How has your midwifery practice changed since the pandemic?

In sooooo many ways! Here are a few...

  1. New protocols for sanitizing thoroughly between each client interaction.
  2. New equipment and organization of home birth and home visit equipment that is easier to sanitize.
  3. More client counselling regarding decisions around: their employment, contact with others, concerns about decreased support options in labour and postpartum.
  4. Screening all clients over the phone (for any COVID-19 symptoms) before seeing them in person.
  5. Changing the way we conduct visits and working collegially with other midwives to do their postpartum visits and vice versa to reduce traffic in and out of the hospital.
  6. Getting used to surviving under all the PPE. It’s pretty uncomfortable to wear all day long!

Can you please describe a snapshot of a recent workday?

24-hour call shift for Andrea recently (18:00-18:00):
17:50 Checking in with a client who just started an induction at BC Women's
21:50 Phone check in re: inpatient induction process so far and see how the client is doing
03:57 Page from a different client in early labour
06:50 Call to hospital to check in on induction process for client #1
07:30 Head to the hospital to visit with client #1
07:45 Arrived at the hospital. While making use of the free parking (thank you!!). Page with Active labour of client #2
08:00 Quick trip to the change room to get into scrubs, mask, goggles.
08:10 Visit with client #1 who’s getting close to active labour and provide support answer questions
08:30 Hospital assessment and admission of client #2
09:00 Two PP visits while waiting for a nurse to bring the patient to a room. (1 visit for Team 3 to minimize extra personnel in hospital).
10:45 Client number 2 moved to a room
11:00 Labour support for client #2 and visits with Client #1 down the hall. Constantly donning and doffing gloves, hand sanitizing after each thing I touch (computer keyboard, phone, the chart, the door).
15:44 Client #2 gives birth to a healthy vigorous baby girl
16:30 Checking in with client #1 who is now in active labour
17:00 Answering a call from an anxious client regarding social distancing concerns re: COVID-19
17:30 Another hospital visit - Postpartum Day 1
18:15 Handover with oncoming RM Busy shift! (no time for lunch!)
18:30 Calling clients back who left messages for the on call midwife during the day
19:00 Heading home :)
19:30 More phone calls to clients who have urgent questions or needed a phone check in.
20:00 Dinner
00:00 Finally finished charting/documentation for all the client interactions from the day - time for bed!

What, if anything, is helping you get through this crisis?

Knowing that midwives and the greater healthcare provider community are all in this together and doing the best we can to support each other!

The midwives at TMG have really come together in the true essence of "teamwork" to create new systems and practices to keep our clients, ourselves and the community safe. We are so proud of each other, our hard working clinic staff (and our greater community of midwives in Vancouver) and of what we have accomplished to change and adapt to in such a short period of time. We also thank our clients for their graciousness and understanding and going with the flow with all the changes.

Slow deep breaths! Hard to do under a mask, but we’re learning ;)

Is there anything else you’d like to add?

Midwives are working hard towards pay equity for the profession. However, this pandemic and it's challenges and the extra work involved drives home the pay inequity even more. It's a labour of love! We are beyond committed and dedicated to our profession because we see firsthand the difference we make in our clients’ lives each and every day! Providing care at all stages of the pregnancy, during labour and birth and helping newborns, clients and families get off to the best start at caring for a newborn is satisfying work but it's HARD work too. We want to keep doing the good work we do and still be able to take care of our own families. Midwives need to be able to earn enough to cover our student loan debts, high professional dues, rent of clinic space and just simply to keep up with inflation and the cost of living.

We thank you for your support as we continue to work with the government to secure fair compensation for our work.

Submitted with love & gratitude to each and every midwife and the hard working individuals in our Midwifery Dept, at the MABC and the CMBC for supporting us so well along the way!