Came across this interesting post put out by the Midwifery Coalition of Nova Scotia.
Only one midwife left standing in the IWK midwifery program
HALIFAX, NS – The Midwifery Coalition of Nova Scotia (MCNS) is very concerned about changes occurring in the IWK Midwifery Program. In just one year, the IWK midwifery program has gone from employing four midwives to employing one. The attrition of midwives and the numerous interruptions in services makes it clear that a community-based midwifery program cannot function under the management of a tertiary care hospital whose expertise lies in high-risk hospital-based clients and not in primary health care.
There is presently only one full-time midwife still employed at the IWK Clinic, Kelly Chisholm. The other full-time midwife, Theresa Pickart, tendered her resignation on December 15. As Erin Hemmens, Co-Chair of the MCNS said: “With only one midwife still employed we are not certain what this means for midwifery clients. It is possible for them to still receive care from the remaining midwife, but given the caseload and demands, it is likely that some clients will not be able to remain under midwifery care and most clients will not know whether part of their care including delivery will be handed over to physicians.”
This is only the last of a string of occurrences in the program in this week that have us very concerned. Previous to the resignation of Theresa Pickart, the IWK had told midwifery clients that a registered nurse (Lorraine Jarvie) will now provide care in the midwifery clinic to midwifery clients. She does not have a license for clinical midwifery practice and she has never practiced midwifery in Canada. As a registered nurse, she is required to work under the direction of a midwife or other primary care provider. Moreover, as a member of the IWK midwifery management team, she will need to be ‘supervised’ by her employees (the midwife).
Also, previous to this resignation, the IWK had already informed midwifery clients that they would no longer be allowed to plan homebirths for the foreseeable future. The IWK advised clients that home birth services could not be offered when there are only two midwives employed. However, the South Shore midwifery practice of two midwives have been providing homebirth services all along.
According to Hemmens, “For women under care at the IWK midwifery program it means no end of stress and anxiety. It means, should the last midwife continue to practice, these clients will no longer have the choice to give birth outside of the hospital. Clients will also now receive fragmented care from various providers including nurses and family physicians. We are concerned that this could compromise the quality and safety of care provided.”
There has to be an alternative to this program being managed by the IWK. The alternative must allow midwives to work according to their full scope of practice within a model that provides the best care possible to women and their families. It must allow midwives to be able to use their unique skills and training, in a way that responds to the needs of women and families across this province, who value the different model of care provided by midwives. It must allow midwives to continue to collaborate with other care providers as necessary to ensure that a woman receives the safest care.
A couple of alternatives to the hospital-based program are possible. The Department of Health could allow publicly-funded midwives to practice autonomously. In addition, according to Jane Moloney, Executive Director of the North End Community Health Centre, “the centre has already expressed interest to the Department of Health to be considered as part of the future for midwifery in the province to offer culturally specific, collaborative care that meets the needs of vulnerable and marginalized populations. The Centre now has the space available to work together with midwives, consumers, and the province to consider how to implement that opportunity”.
Women who want to access midwifery care in Halifax deserve answers and they deserve to know what is being done to ensure that they can receive the care they expected to receive under the care of midwives.
For more information and to arrange a media interview, contact Erin Hemmens 422-6429.
Evaluation
MCNS Evaluation report available
Download your own copy of the Midwifery Coaltion of Nova Scotia’s evaluation report:
Uncomfortable Positions: Consumer Comments on Midwifery Implementation in Nova Scotia
and the Appendix of Letters
Position Statement
In response to some issues raised at the Forum, as well as for our own use when speaking with politicians and media, the Midwifery Coalition of Nova Scotia has created a new position statement. It outlines our thoughts and wishes for midwifery in Nova Scotia and we will be using it as the foundation for our lobby efforts in the coming year. Please feel free to cut and paste/draw from for your letters to government officials.
Download it here.
Forum: Finding our Common Voice
We had an amazing turnout for our Forum. Wonderful people with positive energy discussed their personal experiences with and without midwifery. From here we strategize and throw our efforts behind making midiwfery available to all.
If you have some lobbying ideas, ideas about what kind of political action you’d like to see or to take, give us a jingle. mcns at chebucto.org
Also consider coming out to our annual general meeting. We’ll talk about next moves, about what the Coaliton needs to do in order to forward our goals.
Implementation
When the Midwifery Act became effective in March 2009, several things happened:
• Midwifery became a legal, regulated, publicly funded service.
• It became illegal to practice midwifery without a license.
• Midwifery services became available in three model sites—the IWK in HRM; the South Shore DHA; and GASHA (Guysborough, Antigonish, Strait Health Authority.
What this means for women is that some of us have access to publicly funded midwifery care, but many more don’t.
Right now, the Department of Health is evaluating the process of implementing midwifery in the province. Along with this evaluation, the Midwifery Coalition of Nova Scotia (MCNS) has been asked to collect the stories of women and families who live in parts of NS where midwifery services are not available. We have collected these stories and written an analysis which will be available soon here on our website.
We are also meeting to look at the evaluation and consider recommendations.
Our Vision
The Midwifery Coalition believes that midwifery provides the highest standard of care for mothers, babies and families. We believe it is an important part of maternity care and is a choice that should be available to families in Nova Scotia.
We are working to have midwifery accepted as part of Nova Scotia’s health system and to have midwifery care covered by MSI.
The original post can be found at http://mcns.chebucto.org/
