~pics from CBC.ca
On April 1st, 2009, Alberta Health Services and Alberta Association of Midwives announced that they came to an agreement regarding funding for midwifery services. From that day on, women were given the option to have a midwife attend their birth (at the hospital or at home) and they would not have to pay out-of-pocket. This was a huge gain for consumers, birth activists and Midwives all over Alberta. Up until then, midwifery services costed roughly $2000 out-of-pocket.
My first midwife assisted birth in 2006, with baby number three, cost me $2000, plus $500 for the birth centre in Calgary. With baby number four, I had to hire a travelling midwife, as there were no midwives in Lethbridge at the time. That birth cost me around $1800, although the quality of care was not nearly as consistent as my first team of midwives (she travelled from the U.S.). I organized a rally in Lethbridge on May 5th, 2008, simultaneously with 4 other Alberta cities, demanding funding for Alberta midwifery services. A few months later, our cries were answered and we were assured that funding was on it`s way. This was a huge win for midwives, birth activists, future birthing women and their families.
Here are some slightly outdated midwifery facts and figures, taken from the Alberta Association of Midwives website:
“Alberta Midwifery Facts and Figures
- Registered Midwives in Alberta deliver proximately [sic] 4% of the babies in the province. Midwives in Canada deliver 2% of the country’s babies.
- The number of babies delivered by midwives in the province has more than doubled from 975 in 2009 to 1,984 in 2012.
- The number of Midwives in Alberta has increased by 17% year-over-year since public funding in 2009.
- Midwives have been registered in Alberta since 1992
- In 2009 there were 31 midwives and this has grown to 80 in 2013.
- There are 45 Midwives in Calgary, 16 in Edmonton, 3 in Red Deer, and 16 Rural.
- Publicly funded midwifery care is available in B.C., Alberta, Saskatchewan, Manitoba, Ontario, Quebec, Nunavut, Nova Scotia, and the NWT.
- Women can choose to deliver their babies either at home, a birth centre, or in the hospital with an Alberta Registered Midwife. On average, 50% of midwife-attended births in Alberta occur at home or in a birth centres – this number varies by practice and community.
- There are currently 36 students enrolled in the 4 year Mount Royal University Bachelor of Midwifery program which started September 2011.
- Alberta Registered Midwives are able to care for up to 40 clients per midwife per year.
- Midwives are independent contractors and paid by Alberta Health Services based on the Course of Care for each client.
- The full amount for a Course of Care that an Alberta Registered midwife can bill for includes a provision for 39-55% for overhead, registration and insurance fees.
- Canada was the last developed country to legally recognize the practice and profession of midwifery.” ~ taken from Alberta Association of Midwives
It is not surprising that the number of midwives and midwife assisted births went up dramatically since 2009, considering that is when funding came in. Unfortunately though, the demand for midwives far out numbers the supply. To hire a midwife, you basically need to call either before or immediately when you conceive. DO NOT wait for the positive pregnancy test. Every midwifery practice in Calgary has a wait list, and I’m willing to bet it’s the same in every large centre. That said, even though the demand is huge and growing, the funding that AHS will provide is not.
When the contract renewed in 2013, not all midwives were able to use the full 40 courses of care they were given in the original agreement. This has to do with the growing number of midwives, the higher demand of services, and the insufficient growth of funding. Some of the midwives who were granted 40 courses of care gave some to other newer midwives, so they took a hit and the new midwives were able to do a few births a year. Hardly enough to call a living really, and with the new registration, midwives cannot work privately and accept payment from their clients once funding has maxed out.
Negotiations for funding are currently happening again in Alberta, and we are anxiously awaiting the final numbers. From what we’ve been told though, it’s been an uphill battle for our long-standing midwives as well as the soon-to-be newly graduated midwives from Mount Royal University (“The little college that could” has been a University for 6 years! what what?!). This year the first cohort to take the MRU midwifery program will be graduating, and there are no confirmed courses of care for them to practice. Some are working as doulas, some are leaving the province, but none are guaranteed to be working full-time in the field they went to school and worked so hard towards here in Alberta.
Click the picture above to watch a recent video addressing the Midwife/funding issue
Personally, I think it’s ridiculous to think that midwifery is a dormant profession, and that there would never be growth. Midwives are in huge demand now, and were in huge demand even when we had to pay out-of-pocket for their services. It confuses me how a huge government body like AHS could not foresee the growth in midwifery service usage and demand (even when they were being advised by AAM), and therefore plan to grow with it. Instead, we are still having to fight for coverage, for equal maternity care for all birthing families, and for acknowledgement of the value of midwifery.
So I guess now is the time to rally? Maybe send a letter or start a petition? I suppose now is the time to stand up and defend our student midwives and their future, along with the current midwives who have been serving us for years. Now may just be the time to stand up for birthing mothers and their rights to choice and access. Or not… Your call. But I encourage you to summon the activist within and get involved. A good place to start is MCAN (MaternityCare Consumers of Alberta Network), you can find them on Facebook, and just jump on in. You can also write a letter to your MLA sharing your concerns. If you don’t know who your MLA is, you can find out here. Lastly, please keep talking. Talk with your family members, with your friends, and with anyone who will listen. Numbers speak volumes, and the more people we have fighting for our midwives and our families, the more likely we will see successes. You gotta FIGHT! For your RIGHT! To par… um, I mean to have equal access and choice when it comes to your maternity care.
pic from http://www.birthwithoutfearblog.com