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.