Midwifery Funded in Alberta

The rumors are true. I've gotten phone calls. I've heard the news. I've read online reports but I didn't believe it until I called the Director of the Albertan Midwives. She confirmed it!

Read this article.

As of April 2009 all women who choose to have a midwife can do so without the worry of financial strain. I'm so happy! We've rallied and we've carried on after women have gone to the government for years and it's finally happened.

If you're looking for a midwife for a current or future pregnancy there is lots of relevant information in the right sidebar.

Political Rally across Alberta

The rallies in Calgary, Edmonton, Medicine Hat and Red Deer all went exceptionally well and the people involved have been amazing in their generous support over the past couple months.

I will have pictures up soon from the rally but for now I will attach links to different news articles that followed after the rally. The news coverage was outstanding and the turn out surprised me. Hopefully we'll be celebrating next year instead of rallying!

CBC
Edmonton Sun
Alberta Local News
Calgary Herald

IMBCO

I saw this article referred to on a blog called Birth Notes (linked on the right under Natural Birth Bloggers).

The International MotherBaby Childbirth Organization created this Initiative after a survey of birth and breast-feeding organizations in 163 countries and on input from a Technical Advisory Group made up of birth experts from around the world who all helped in the construction of the Initiative.

The purpose of this 10 step Initiative is to improve care, save lives, prevent illness and promote health for both mothers and babies around the world.

You can read the Initiative in its entirety here or you can continue to read my break down of what I found important.

The 10 Steps:

1. Treat every women with respect and dignity.

2. Possess and routinely apply midwifery knowledge and skills that optimize the normal physiology of birth and breastfeeding.

3. Inform the mother of the benefits of continuous support during labour and birth, and affirm her right to receive such support from companions of her choice.

4. Provide drug-free comfort and pain relief methods during labour, explaining their benefits for facilitating normal birth.

5. Provide evidence-based practices proven to be beneficial.

6. Avoid potentially harmful procedures and practices.

7. Implement measures that enhance wellness and prevent illness and emergencies.

8. Provide access to evidence-based skilled emergency treatment.

9. Provide a continuum of collaborative care with all the relevant health care providers, institutions and organizations.

10. Strive to achieve the BFHI 10 Steps to Successful Breastfeeding. (I'll write about those steps later.)

The basic principles of the IMBC Initiative are the women's and children's rights and access to humane and effective health care. Pregnancy, birth and postpartum/newborn care should be individualized. The needs of the MotherBaby should take precedence over the needs of caregivers, institutions and the medical industry. Women should receive full, accurate and unbiased information based on best available evidence about harms, benefits and alternatives so that they can make informed decisions about their care and their babies' care.

There are many more principles of the IMBC and I suggest reading the Initiative. It's a life saving resource to have organizations like this one putting time and education together to create standards that make care providers (of all types) more accountable and aware. It's a life altering experience and I'm so glad there are organizations that recognize the seriousness of the experience. I hope that the care providers here in Canada are aware or can be made aware of this document.

Is Natural Childbirth Dead? A great overview of natural childbirth.

Have you listened to many women talk about childbirth? Have you heard them say how horrible and difficult it was? It may give you the impression that no one is having natural childbirth anymore. And if they are, they have a screw loose...

Actually, quite the contrary, natural childbirth is becoming more and more popular as people realize the benefits to the woman, the family and the baby, and as they realize that there are risks to medication used frequently in birth.

Natural childbirth has different meanings to everyone. Some would describe it as a vaginal birth, others as no medications for pain, and yet others would say no intervention or pain relief medications. For the purposes of this article we will define natural childbirth as birth without pain relieving medications (Demerol, Nubain, Stadol, epidural, spinal, etc.).

Natural childbirth takes place with different practitioners (midwives, nurse midwives, obstetrician, family practitioners, perinatologists, etc.), and in different settings (hospital, birth center and home).

Although it is becoming harder to have a natural childbirth as they add more and more machines to the birth process. That is why many women who believe in natural childbirth will tell you to have a birth plan to help you clarify what you need and want with your practitioner.

"Read as much as you can about childbirth, preferably before you become pregnant. Take childbirth classes that teach natural birth, preferably independent classes, not in the hospital. Get a doula. Prepare a birth plan. Make sure that your health care provider knows your wishes before the birth," says one mother who has experienced the joys of natural birth.

Does this mean that natural childbirth and medical intervention are mutually exclusive? No. High risk pregnancies also benefit from have an unmedicated birth.

"Both of my daughters were born in the hospital," one mother explains. "I was at a very high risk of complications, but had no medications at all."

And another offers, "Be realistic that there are times when medical intervention is the right thing to do. Make sure your birth support not only understands your wants and needs, but that they respect and support your decisions."

You can read the remainder of this article by clicking on the link to the right.

A letter from the SOGC

In a letter sent to the Minister of Health and Wellness in 2007 from the SOGC (Society of

Obstetricians and Gynaecologists of Canada) it stated that a study was done in 2006 with the following findings;

"Last year, the Ministry completed a program evaluation of midwifery. Program evaluation showed that midwifery is very cost effective compared to the care provided by obstetricians and family physicians.

According to Ministry estimates, the cost to the health care system of a midwife-attended birth in a hospital is about $800 less than with a family physician. If a midwifery client gives birth at home, the cost is about $1,800 less. (Savings are due to a c-section rate for midwifery clients that are 30% lower than for family doctors, an episiotomy rate that is less than half, a re-admission rate to hospital that is 65% lower than other providers, and shorter hospital stays including over double the rate of early discharge of low-risk patients.) There are broader savings to the health care system resulting from midwifery care not captured in the savings shown above, including reduced nursing staff time, reduced emergency room visits, and reduced use of walk-in clinics.

As well, the focus of midwives on health promotion can yield other long-term savings.

Midwifery produces direct savings for hospitals. According to a report in The Ottawa Citizen, the Ottawa Hospital estimates that a midwife-assisted birth costs the hospital about $450 while a physician-assisted birth costs $1,400. Home births increase savings for the health care sector by an even greater amount."

Addressing the issue referred to as the Care Crisis, the SOGC had this to say;

"A generation ago, about half of family doctors still delivered babies. Today, that figure has dropped to less than 10%, according to the Ministry. Just in the past three years, more than 300 family doctors have left the practice of obstetrics. Family doctors now deliver about 20% of babies.

The number of obstetricians doing deliveries is declining slightly, but those who remain are doing an increasing number of births each. In 2001/02, 466 obstetricians were delivering babies, 15 fewer than 3 years before according to a study by the Institute for Clinical Evaluative Services. In the absence of other obstetrical care providers, these doctors were doing on average 221 births per year, 7% more than 3 years before. At the same time, the percentage of births by c-section increased by 17.5%, which results in increased costs to the health care system."

The SOGC ended with this warning;

"Responding to the maternity care crisis depends on addressing the sustainability of midwifery.

Midwifery is the only obstetrical care profession that is growing, particularly in areas that are

under served for maternity care. There are currently over 300 midwives practicing in Ontario, and the number of women they have cared for has increased by more than 80% over the past five years. Midwives look after healthy women with normal pregnancies in their communities, thereby freeing up obstetricians and other specialists to handle more complicated pregnancies.

However, many of the same pressures pushing doctors out of obstetrical care are also impacting midwives, including job-related stress resulting from long and irregular hours, and substantial amounts of time on call. As a result, action is needed by the province to support both the growth and the sustainability of midwifery.

Calgary and Area Press Release

Demonstration in Calgary on May 5, 2008 at the McDougall Centre from noon to 1pm.

Community members from Banff, Canmore, Didsbury and Cochrane will join Calgary supporters in demonstrating for publicly funded midwifery under Alberta Health and Wellness. At the same time, sister-rallies are held in Edmonton, Medicine Hat and Lethbridge.

Alberta does not to date fund midwife services, and thus is the last province or territory in Canada to not publicly fund or publicly commit to fund midwife services in the future.

The price to hire a midwife is $3450.

Research shows, outcomes of low-risk pregnancies assisted by midwife are as safe or safer as MD assisted births (Hafner-Eaton & Pearce, 1994; Janssen, Holt & Myers, 1994, MacDorman & Singh 1998)

• Improve outcomes of hard to reach and low income women

• Reduce: c-sections, drug-use and medical interventions

• Increase infant birth weight

• Costs less than MD fees, fewer interventions and often shorter stays

• Births at home or in birth centres ease the shortage of hospital beds and staff.

If you're interested in seeing the full press release leave a comment and I will get a copy to you.

Press Release

This is a press release that ran in the local newspapers in both Airdrie and Cochrane. Bonnie Bent and Sarah Deveau have been putting in countless hours helping Ulrike Kimbley-Nicolai put together what will hopefully be a successful rally. Press releases like this one are a huge help in getting the word out.

Airdrie, Alberta. March 27, 2008. Airdrie business owner Sarah Deveau of Cater Tot Consignment and Bonnie Bend of Great Things in Store in Cochrane are working together to support action to encourage the Alberta government to provide funding for midwifery care in this province.

Alberta is the last province or territory in Canada to not publicly fund or publicly commit to fund midwife services in the future. “I had my second child this past Christmas at home with the support of a midwife,” says Bend. “Everything about the midwifery care model is so valuable to mothers, from hour-long appointments to post-partum care, and I feel that by not covering the cost of midwives in Alberta, our government is doing mothers a great disservice.”

The average price to hire a midwife is $3,450 and many believe the fee discriminates against low-income women, especially those who might benefit best from the more in-depth care provided by a midwife.

“All of the research shows outcomes of low-risk pregnancies assisted by midwife are as safe or safer as doctor assisted births,” says Deveau. “I considered a home birth for my second child, born this February, but the cost was simply out of my reach this time. I'm hoping it will be covered by Alberta Health when I'm ready to have another child.”

A petition to the Alberta government requesting that midwifery services be publicly funded is available for signing at Cater Tot Consignment in Airdrie ad Great Things in Store in Cochrane until April 30.

Bend and Deveau will be attending a demonstration on May 5, 2008 in Calgary at McDougall Centre from noon to 1pm on the International Day of the Midwife. Community members from Airdrie, Banff, Canmore, Didsbury and Cochrane will join Calgary supporters in demonstrating for publicly funded midwifery under Alberta Health and Wellness.

Some Facts about Midwife Assisted Births

• Improve outcomes of hard to reach and low income women

• Reduces c-sections, drug-use and medical interventions

• Increases infant birth weight

• Costs less

• Births at home or in birth centres ease the shortage of hospital beds and staff

Contacts:

Bonnie Bend

info@greatthingsinstore.ca

Sarah Deveau

sarah@catertot.ca

Ulrike Kimbley-Nicolai
Event Organizer

udkimble@ucalgary.ca