Report highlights burnout, attrition among Ontario’s midwives

A new report has found that the province’s midwives are suffering from high rates of burnout, with tough working conditions causing many to leave the profession

A new report has found that the province’s midwives are suffering from high rates of burnout, as difficult working conditions are causing many to leave the profession.

Midwives provide prenatal care, as well as care during labour, delivery and six weeks after a birth. But labour is unpredictable, so they’re also regularly on-call.

“We don’t get paid vacation, we don’t get established time off,” said Buffy Fulton-Breathat, a partner and midwife at Sudbury Community Midwives.

“You’re negotiating with another partner or another team member to cover your caseload.”

Midwives have lost income in the past few years due to the one-per cent public sector salary cap. Now the Association of Ontario Midwives is negotiating with the provincial government to compensate midwives for that three-year gap, in line with other health professionals.

Equal treatment

“When everybody is willing to come to the table and have a conversation to treat the profession the same as they have treated physicians, nurses and firefighters,” Fulton-Breathat said.

“That respect, I think, is essential, as well, to sort of assist in recruiting the best people back into this profession.”

In an email to CTV News, the Ministry of Health said the province is a strong partner to Ontario midwives.

The government has spent “an additional $40 million over the last two years to increase compensation and expand access to care while giving them additional tools, which they requested, to deliver more convenient care by expanding their scope of practice to prescribe and administer medications and perform additional minor procedures,” said the statement from spokesperson Jackson Jacobs.

“While the Ministry of Health has negotiated in good faith throughout this process, the Association of Ontario Midwives, current demands are well beyond recently negotiated outcomes for other primary care providers.”

“We remain willing to continue discussions on a fair, sustainable path forward that protects patients and strengthens primary care for Ontario families, in every corner of the province.”

Recruitment, retention crisis

In support of their demands is a report from independent third-party mediator Beverly Mathers. The report, which was tabled as part of a mediation process between the ministry and the AOM, said the loss of income has led to a recruitment and retention crisis.

It found key factors are burnout and attrition, where midwives are leaving Ontario for better-paying provinces. There are also not enough new midwives entering the profession.

It translates to fewer midwives, particularly in northern Ontario after the Midwifery Education Program was shuttered at Laurentian University in 2021.

“We do not have a northern site for midwifery education, which is certainly having an impact,” Fulton-Breathat said.

“We’re providing student placements for southern midwives but they’re returning to other locations. They’re not staying with us.”

Help 30,000 families a year

The report said that “while compensation alone will not resolve the crisis, the ministry can work with the AOM to correct the other drivers of recruitment and retention.”

The association is calling on the Ministry of Health to implement recommendations in the mediator’s report.

There are 1,050 midwives working in 250 communities across Ontario. The AOM said that each year, 30,000 families access care from a midwife, with 6,600 unable to find one.

“Ontarians know the value of midwifery care, but government continually denies midwives these fundamental rights, and midwives are suffering from the effects,” said Elizabeth Brandeis, a midwife and AOM negotiator.

“Midwives are tired of being disrespected and devalued by government when demand for our services continues to grow. Midwives provide primary care that Ontarians want -- a unique model of care that is not interchangeable with care from other providers in the system. And midwives would be able to contribute even more to the health system if their work was respected and valued by government.”