Midwifery coalition lobbying province to improve access

When Amber Tapley went into labour with her first child, she jumped in a car and drove two and a half hours west.

The Sydney, N.S., woman was determined to have a midwife deliver her baby and throughout her pregnancy had travelled to Antigonish,the closest town withregistered midwives.

With just three areas of Nova Scotia providing the service, Tapley's experience isn't unique, despite repeated calls from moms who want to access the service where they live.

"It seems ridiculous that I would have to be in a car for two and a half hours to access services that could be offered here," Tapley told CBC's Information Morning.

"There's a lot of people I talk to and they would love to have a midwife but it's not an option, and for most people their lives don't allow them to travel."

By the timeTapleyarrived at the hospital inAntigonish, the two midwives were no longer workingso a doctor delivered her baby.

'Big concern' for rural areas

That was six years ago, and the Midwifery Coalition of Nova Scotia says little has changed in terms of access.

The group is urging people to mailpurple postcards to the provincial government to lobby for provincewide access. Midwives currentlyoperate out of Antigonish, the South Shore and Halifax.

Beforemidwifery became regulated in Nova Scotia, womenhad to pay out of pocket for the service. In 2009, midwives began working from hospitals and had access to blood work and ultrasounds.

But there were negative consequencestoo, said Renee MeuseBishara, a member of the coalition's board.

"Seven years ago, more women actually had access than they do now," she said."The Annapolis Valley had a very lively midwifery practice and culture and they've had zero access ... so it's a big concern for that area."

In 2011, a team of consultants was tasked by the province to research the challenges of regulating midwifery care. Their report recommended increasing the complement of midwives to 20 from nine.But changes to the Nova Scotia Health Authorityand a strapped health-care budgetmean that still hasn't happened.

"But the dust is settling a bit so we feel like it's a good time to look at this again," said Meuse Bishara.

According to the Canadian Association of Midwives, in 2016midwives attended an average of 2.8per cent of all births in Nova Scotia, compared with more than 20 per cent in B.C. and about 15per cent in Ontario.

Cultural shift

The fight to regulate the profession began in the early '90s when midwifery was seen as "very much of an alternative, fringe movement," said longtime midwife MarenDietze.

Dietze, who recently ended her career on the South Shore,saysmidwives are now seen as an important aspect of maternal health, especially for marginalized populations and women in rural regions.

"People are ready now for it on the government, health authority side, midwives and nurses side and I'm not quite sure what's holding it up now," she said.

Provincial planning underway

The Nova Scotia Healthy Authority says it's working on a health services plan, which includes midwifery,that will result in recommendations to the province by the end of the year.

Sally Loring,senior director of maternal and child health, says examples like Tapley'sare good to hear because it lets the health authority know where the needs are.

But expanding the service willrequire more money. Each midwife employed by the Nova Scotia Health Authoritycosts the province about$100,000 a year including salary, benefits and pension, but there's alsotravel and set-up costs to consider, said Loring.

"It's not just midwifery," she said."We have to be fiscally responsible and thereare other top-ticket items that will be required across the province to assist with health care."