Lehe Spiegelman: Midwives can help close the care gap for BC’s families

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Many people in BC encounter difficulty accessing primary maternity care and sexual and reproductive health services, especially in the province’s rural, remote and Indigenous communities. These challenges have been compounded by the ongoing pandemic which has placed additional strain on the health-care system.

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On Thursday, May 5, the International Day of the Midwife will be celebrated worldwide. The Midwives Association of BC is proud to celebrate with midwives and midwife-allies from around the world. The global midwife community will come together to celebrate and advocate for investment in quality midwifery care around the world, improving sexual, reproductive, maternal, newborn, child and adolescent health in the process.

BC’s midwives play an important role in ensuring that birthing people, expectant parents and families have access to care. As the provincial government seeks to address critical issues affecting health-care delivery and bringing access to care closer to home, midwifery can provide solutions to address inequities, foster reconciliation, and support anti-racism initiatives in the health-care system.

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In recent years, BC has experienced the highest rate of midwifery-involved maternity care in Canada (27 per cent), assisting in more than one quarter of pregnancies each year. What is evident is the critical role midwives play in delivering accessible, culturally safe, and effective health care to over 10,000 families in BC annually.

As primary care leaders accredited through the BC College of Nurses and Midwives, we specialize in all types of pregnancies, normalizing birth and caring for pregnant people with a span of diverse needs. We work within acute care settings such as hospitals as well as in community clinics and in homes to support the physical and mental wellbeing of expectant parents and babies. In many communities, midwives are the backbone of maternity care as the only care providers in the area, keeping birthing options close to home.

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Midwives are committed to providing culturally safe and relevant care that supports and promotes Indigenous Midwifery in BC to meet our commitments to truth and reconciliation. Recently, the Midwives Association of BC secured funding to enhance programs for Indigenous midwives.

Midwives also bring leadership skills outside of the birthing room to resource planning and facility developments to ensure families have access to evidence-based, person-centered health care.

There are currently just over 400 registered midwives in BC, which isn’t enough to meet the growing demand for our services. With the pressures on our profession and the pandemic there is a risk of those numbers getting even smaller. In response to a survey conducted in 2017, one-third of BC’s midwives said they planned to leave the profession for reasons other than retirement.

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Recently, the Midwives Association of BC secured support for our members including parental leave, disability insurance, retirement savings, and funding to acknowledge the important cultural work for Indigenous midwives. Twenty-five years after first becoming a regulated health-care profession in BC, this is the first time BC midwives will have access to these essential programs. We applaud the government for recognizing the significant impact these programs will have on our profession’s sustainability and primary maternity care in our province.

That said, we still have work to address shortages in resources, heavy workloads, high operating costs, access to training and the gender pay gap, so that we can attract and retain midwives in the future.

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Midwives are a key to the future of primary maternity care in BC We greatly appreciate your support in promoting International Day of the Midwife, and recognizing their continued hard work and dedication to continue to provide access to the care newborns and families need.

To secure this competent and skilled workforce for years to come, it is imperative that we work collaboratively with health-care partners, particularly family physicians as they experience shortages and are urgently needed.

Today, nearly one million people across the province do not have a family physician, and as midwives who provide primary maternity care, we can continue to support BC families seeking essential maternity services. Working collectively with the government and growing our services will allow us to increase access to the care newborns and families need across the province.

Lehe Spiegelman is president of the Midwives Association of British Columbia. She is also a clinical faculty at UBC’s Faculty of Medicine in the midwifery program.

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