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Midwifery demands spans the province

Dear editor, As an Ontario student of midwifery currently on placement at Planned Parenthood in St. John's, I want to thank everyone for their kindness and welcoming hospitality while sharing information about my program and future profession, few people seem to know about midwifery. Those who are familiar with midwifery seem very enthusiastic about the model of care, and how it could benefit women in St. John's and across Newfoundland and Labrador.

Therefore, I am writing this letter to share information about a terrific alternative model to maternity care. 

It is with great interest that I have been following the maternity care crisis in Labrador West.

Many rural women with low risk pregnancies are required to travel away from home for birth, despite the financial and psychological stress that this places on the mother and family. A woman who needs to leave her family for birth will not have the continuous support during birth which has been shown to improve labour outcomes. 

Also, the broken family unit places a need to find adequate childcare during the mother's absence.

Midwives have been working unregulated in Happy Valley-Goose Bay, but the demand for registered autonomous midwives spans the province. Moreover, with an important need for culturally sensitive and locally accessible services to aboriginal communities, Labrador will benefit from the expansion of a midwifery model of care. 

In many provinces across the country, midwifery has demonstrated its ability to provide safe maternity care to low risk women, improve women's choice in birth options, and reduce governmental costs associated to maternity services.

Since starting my placement in this province, I am pleased to find that many people who ask what I am taking in school are fascinated by the model of care and question why Newfoundland and Labrador does not have midwives. 

Midwifery care is an allied profession based on three philosophies. First, a woman has the right to continuity of care. In Ontario, midwifery care is funded through the Ministry of Health and Long Term Care. As a client, you are given ample time during appointments and a trusting relationship forms. 

Your birth is continuously attended to by your midwife, who stays with you from the time that you are in active labour, until the time that you have been recovered post delivery. A second midwife or birth attendant is present for the birth to ensure adequate assistance should an emergency arise. 

Continuity of care continues throughout the first six weeks postpartum and includes multiple home visits. 

Second, a woman has the right to informed choice regarding use of

interventions and birthing style. Our appointments are funded to be long enough to provide information to women so that they can make personal choices about their healthcare. 

Third, a woman has the right to choose their place of birth. Midwives are registered under the College of Midwives of Ontario as independent primary caregivers and maintain independent hospital privileges. This gives clients the freedom to choose between birthing at home or in a hospital. 

Research completed over the last decade has consistently demonstrated that planned homebirths for low risk pregnancies results in care that is as safe as women birthing in hospital, but has less risk of unnecessary interventions.

Moreover, midwives come to a homebirth prepared to handle

emergencies with the same ability as a Level 1 hospital (drugs, IVS, and resuscitative equipment). 

Midwives have worked hard to establish their profession as independent primary caregivers for low risk pregnant women, and offer an alternative to women who are unable to find a family doctor or obstetrician, or who want care under an alternative model. 

Newfoundland and Labrador has only recently started the process of legislating midwifery. In June 2010, Bill 17 received assent and currently plans are being developed to frame the logistics of midwifery in Newfoundland and Labrador, such as where will they be educated, regulated, practice and how will it be funded. 

As a student at Ryerson in Toronto, my class size is 31, and there are students who wish to return to this province to practice.

I look forward to watching Newfoundland and Labrador develop and implement midwifery as a means to providing and promoting more options for normal birth, close to home, at lower costs. 

With warm regards to all whom I have conversed with over the last few weeks.


Carolyn Begg-Reid

St. John's

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