Citizen groups highlight need for better access to midwifery services in Quebec

A number of citizen groups from around the province met in Montreal Saturday to discuss ways to make midwifery care more accessible in Quebec.

Midwifery has been legal in the province for 20 years, but access to services is lagging according to Lorraine Fontaine, a coordinator for Coalition pour la pratique sage-femme.

Lafontaine said the government has fallen short of its own objectives set back in 2010.

“The Quebec government — the ministry of health — had objectives of 10 per cent  of women getting access to midwifery,” Lafontaine said, “but actually there is only four per cent now.”

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For Lafontaine, it’s not about meeting government targets, but about filling a need.

“Of the 80,000 or more women that give birth, 20,000 would like access to midwifery and they don’t get it,” she said.

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One of the reasons why demand isn’t being met is that there aren’t enough midwives.

“There are 202 midwives registered at the order of midwives now, but there are only 150 of them that are actually attending births,” Lafontaine said, adding that the others are otherwise occupied — either teaching at university, trying to set up points of service or starting new programs.

Lafontaine believes a few persistent myths surrounding midwifery are also hurting the practice and stopping it from gaining wider acceptance.

“Some people think that home births are dangerous,” Lafontaine said.  “But, the minute you go into an institution and the bright lights are on and many people are coming in and all kinds of people are checking you and all kinds of interventions are happening…it slows the birth process down, so then we have to medicalize it.”

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Lafontaine argues the government needs to step up its efforts, pointing to a 2011 recommendation by the Commission on health and social services.

“It recommended an awareness campaign to inform the public of the safety record of midwifery practice and its benefits for pregnant women and their newborns,” she said, adding that it has yet to happen.

“Over the last 100 years, we have created a social paradigm that birth is a risky thing, a dangerous thing, that we need to have it in institutions, that we need to have experts and yet humanity has existed for a lot longer than that,” she said. “All over the world there are midwives; all over the world people are giving birth and they are doing it well.”

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Lafontaine was clear that Saturday’s meeting wasn’t about creating a divide, but rather about reaching a balance.

“Yes we want safety and when something happens we are happy to have the system there, but it’s a question of balance,” she said. “We want to work so that the system, the healthcare system that is in place, sees midwives as the first-line providers for birth.”

While some see implementing a new system as a financial drain, Lafontaine argues its the opposite.

“It costs less, because a midwife follows the whole pregnancy — the birth and up to six weeks after,” she said. “Think of all the people in the healthcare system who are mobilized to give care to women who are going in the hospital — that’s nurses, doctors, technicians and anesthetists — and midwives are covering all of that.”

The various groups meeting in Montreal are trying to hammer out a specific list of demands and recommendations they hope will help midwifery care move forward in the province.