B.C. midwives say they can help improve health-care system, want more support

Midwives in B.C. say their profession could be doing more to help solve the health-care crisis and want more support from the province, as some patients wait months for maternity care.

“The demand is definitely growing,” says Midwives Association of B.C. board member Tobi Reid.

“I’ve been speaking with people who are five, six months along and still haven’t been able to get in with a primary care provider and that’s a huge safety issue," adds Reid. “One of them told me that she had to present to the emergency room just to get basic pre-natal bloodwork done."

The midwife has been practicing in Victoria since February 2022. She and others working on her team are on call seven days a week, at all hours of the day, excluding every other weekend.

“It’s definitely a hard job,” says Reid. “Midwives and physicians are burning out and leaving clinical practice for many of the same reasons.”

The Midwives Association of B.C. says the struggle some families are facing finding and accessing maternity care is reflective of the primary care crisis on a larger scale.

“We’re working for more midwives, increased training opportunities for midwives. We believe they play a central role in health care,” says Health Minister Adrian Dix.

Midwives say they would like to be seen as a more equal partner in helping solve the problem – and bring ideas to the table.

'A FEW POSSIBLE SOLUTIONS'

Reid, along with MABC’s Indigenous advisor Melanie Mason, says changes to the payment and funding model are needed.

For example, they think midwives should also be eligible for the province’s interim stabilization funding. The $75-million program was launched in support of family doctors to help them with overhead costs and prevent clinics from closing.

“Unfortunately, midwives were left out of that investment, and that’s an equity issue,” says Reid. “And it’s not going to solve this shortage.”

She says if midwives get sick or injured, there’s no option for paid time off. And if they need a colleague to cover for them due to the physical demands of the job, they pay out of pocket.

“That’s one of the reasons I would say that midwives are burning out is just the lack of support from government and from the ministry in really making sure that we have the resources that we need to sustainably stay in clinical practice,” she says.

Mason has been practicing midwifery care for five years. The clinic she’s operating out of has plans to close in September, and she’s hoping to move on by setting up an Indigenous-focused practice that reinstates midwives' traditional role in the community.

“We did that whole kind of lifespan of reproductive health and sexual health,” says Mason. “We also looked at bonding within community and family structures.”

The pitch is for a multi-disciplinary, team-based practice, which could include GPs, nurse practitioners and doulas.

“It’s kind of in its infancy. So we really need to pull our stakeholders together,” says Mason.

Mason and Reid think expanding the scope of midwifery practice would address primary care gaps.

“Midwives regularly offer pap tests. We can treat sexually transmitted infections. We can prescribe hormonal contraceptives. We can give vaccines. But current regulations prohibit us from offering those services to the broader population,” says Reid. “I think that’s a missed opportunity.”

CTV News asked Dix if the province would commit to offering stabilization funding, similar to the family doctors. He says the place to discuss it is at the bargaining table.

Those talks have been underway since September.

FIRST-HAND EXPERIENCE

MABC says midwives in the Island Health region are involved in over 40 per cent of births.

Anyone learning they’re pregnant is encouraged to look for a primary care provider as soon as they find out, which is exactly what Nicole and Wesley Baker did, prior to the arrival of their son, who was born on Feb. 8.

They have a newer sense of appreciation for having found out Nicole was pregnant early.

“I called right away,” she says. “To the point where they’re like, 'OK we have space, but we don’t need to see you for awhile.'”

“It seems everyone we know right now that’s a couple weeks behind us is having big problems,” says her husband Wesley.

The couple says having access to talk to and see a maternity care specialist, especially in the early weeks, was important to them.

“I can’t imagine not having someone to have checked in with and get information from,” says Nicole. “I think it would’ve been just a little bit more nerve-wracking.”

Their midwife Tobi Reid says it's heartbreaking when midwives have to turn people away.

“There’s so much evidence to indicate that minimal prenatal care is associated with poorer health outcomes for parents and their babies,” she says.

If you’re pregnant, you can self-register to be on a waitlist for a midwife through Midwives in Victoria and/or call the Victoria General Hospital’s antenatal assessment unit.