Midwifery-Canada

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Introduction

  • Most Canadian provinces do not have hospital-based midwifery as it is known in the UK.
  • In most cases, Canadian women give birth in hospital. Nurses monitor their progress for most of the time that they’re in labour. Doctors preside over deliveries.
  • In the majority of Canadian provinces and territories, midwives practice as private, independent practitioners, outside of the provincial health care insurance plans.
  • Except for residents of a couple of provinces, women who avail themselves of midwifery services have to pay for them themselves.

Working Conditions

  • In most provinces, a midwife is on call 24 hours a day, 7 days a week.
  • It’s common for a Canadian midwife to work for 10 months of the year, providing all the antenatal, labour, and postnatal care for the women she has booked. She then has 2 months off. But the 10 months that she does work are intense.
  • It can be tricky for a midwife to schedule her work. If she has a certain number of deliveries booked, thinking that they’re due to take place at staggered intervals, they may happen one after the other, and she may be in for a stretch of sleep deprivation.
  • Some British midwives who move to Canada find that the way midwifery is practised in Canada is incompatible with family life, especially if they themselves have children.
  • In British Columbia there are some group practices. That means that the individual midwives who belong to those groups can take turns being on call on weekends and holidays. Manitoba midwives also have group practices.

Advantages

  • One of the good things about midwifery in Canada, though, is that the pay is good.
  • Also, people who choose to be midwives in Canada like the one-on-one care they’re able to provide for their patients.

Disadvantages

  • A British midwife has to jump through hoops to be recognized in Canada. Either she pays for a 3 - 12 month placement with a group of midwives, or she does a course. Either way, it’s costly and time consuming.
  • It costs $10,000 - $15,000 for interviews, assessment, placement, etc.
  • A midwife pays a lot of money to provide evidence that she is a safe practitioner and that her knowledge is up to date. Costs of ongoing training and education all come out of her own pocket.
  • The cost of malpractice insurance also comes out of the midwife's pocket.
  • In most provinces, a midwife is a businessperson. She has to do the administrative functions of her business (accept payment from patients, do the banking, complete tax returns, etc.).

British nurses

  • If a British nurse has DOESNT NEED qualifications as a nurse and midwife, it would be easier for her to be licensed as a registered nurse in Canada.
  • A nurse in a maternity ward handles everything but the delivery.
  • A nurse has shift work and regular pay.
  • A nurse working in a hospital doesn’t have to run her own business and the bureaucracy that goes with it.

Information Resources

Please contact the following organizations to find out about midwifery in provinces and/or territories that are of interest to you, and to find out the requirements for registration.

Across Canada

The provincial and territorial midwives’ associations belong to an umbrella association called Canadian Association of Midwives.

Alberta

  • Midwives in Alberta are registered by the Midwifery Health Disciplines Committee, which falls under the jurisdiction of Alberta Health and Wellness.
  • In 2005, there were 23 registered midwives in Alberta.
  • Midwifery services in Alberta are not covered by the provincial health care insurance plan.
  • Consumers who choose to use the services of midwives have to pay for them.
  • Midwives have to collect and remit to the government 6% Goods and Services Tax.
  • There is only one hospital in the province, in Stony Plain (near Edmonton), in which doctors, midwives and nurses work alongside each other and in which costs are covered by the Alberta Health Care Insurance Plan.
  • At this time, there is no program for the education of midwives in Alberta.
  • For more information, see Alberta Association of Midwives.

British Columbia

  • BC has 92 registered, practising midwives.
  • By Canadian standards, BC is receptive to midwifery.
  • The University of British Columbia in Vancouver offers a 4-year degree in midwifery.
  • In BC the Ministry of Health pays for the services of Registered Midwives.
  • For more information, please see the Midwives Association of BC, also College of Midwives of BC

Manitoba

  • The Manitoba Ministry of Health funds the midwifery services that are provided through Regional Health Authorities.
  • Manitoba legislation permits registered midwives to work outside of the health care insurance plan.
  • However, the 28 midwives who currently are registered in Manitoba all choose to work as unionized, salaried employees of Regional Health Authorities.
  • Most midwives work in groups of 4.
  • They earn $65,000 - $82,000 for a 40-hour work week.
  • For more information, see College of Midwives of Manitoba.

New Brunswick

  • New Brunswick does not have a system for registering midwives, and they are not officially recognized in that province.
  • Residents of NB who favour midwifery are lobbying the provincial government to establish the profession of midwifery in that province.

Newfoundland and Labrador

  • Newfoundland and Labrador does not recognize midwives as a distinct profession.
  • There are half a dozen or so hospital-based midwives in Newfoundland, but they are permitted to work by virtue of the fact that they are registered nurses.

Nova Scotia

  • Interest in midwifery is increasing in NS. There is talk of legislation that will recognize midwives as professionals and that will set out registration standards. There also is talk of midwives being integrated into the IWK Health Centre in Halifax.
  • So far, that’s all it is – talk. However, there are quite a few people in Nova Scotia who would like to see publicly funded, regulated midwifery introduce to the province.
  • At present, there are 5 midwives who work as private practitioners in the province.
  • For more information, see Midwifery Coalition of Nova Scotia.

North West Territories

  • The Midwives Association of NWT has 9 members.
  • Midwives in the NWT are unionized workers.
  • But keep in mind that the NWT is a vast, sparsely populated area. When people there discuss travelling time, they’re referring to flying time, not driving time.

Nunavut

  • The government of Nunavut employs 2 midwives.
  • Nonetheless, most women choose to fly to southern cities to give birth.
  • Nunavut has the same logistical issues as the NWT – small pockets of population separated by enormous distances.

Ontario

  • In Ontario, midwifery services are publicly funded.
  • Ryerson University in Toronto offers a 4-year degree in midwifery.
  • Around 2005 – 2006, there were 356 midwives in Ontario.
  • Midwives are available to their patients 24 hours a day, 7 days a week.
  • The body that regulates midwifery in Ontario is the College of Midwives of Ontario. See also Association of Ontario Midwives.

Prince Edward Island

  • There are no midwives in PEI.
  • The only way that a woman in PEI can obtain the services of a midwife is to persuade an out of province midwife to travel to her. (Nova Scotia midwives occasionally attend to patients in PEI.)

Quebec

  • Quebec provides public funding for midwifery.
  • The province has 84 licensed midwives.
  • Université du Québec à Trois Rivières offers a midwifery program.
  • Three Quebec hospitals permit midwives to work in them.
  • However, most Quebec residents who opt for midwifery services choose to give birth at home.
  • Midwives provide prenatal care to pregnant women in the far northern parts of Quebec. However, the midwives who work in the far north are stretched rather thinly.

Saskatchewan

  • Saskatchewan currently has 6 midwives.
  • It is anticipated that legislation to provide public funding of midwifery services will be passed in 2008.
  • For more information, please contact Midwives Association of Saskatchewan.

Yukon

  • The Yukon has two practising midwives.
  • They are frustrated by the fact that they cannot obtain malpractice insurance coverage.
  • As in most provinces and territories, midwifery services are not publicly funded.
  • The Yukon has no framework for assessing midwives’ competence and registering them.