Midwifery in Canada - New Brunswick

Report submitted September 2008

Midwifery Act
On June 18th, 2008, the Midwifery Act received Royal Assent in the NB Legislative Assembly, and progress continues towards publicly funded midwifery services. The act includes provision for midwife attended home births, with yearly auditing. Midwives will be employees of the Regional Health Authorities, and nurses will be second attendants at all hospital births.

Integration and Expansion Current plans are for two integration sites from June 2009, with a team of four midwives working from a community clinic in Fredericton, and a team of four in the Peninsule. It is anticipated that midwifery teams will be added in third and fourth regions in 2010 and 2011 with a view to integration in all areas by 2015.

Education
The province is aware of the need for an education program east of Trois-Rivieres.

Regulation
From October 2008 to February 2009 the Midwifery Regulations Advisory Committee will provide advice to DOH regarding the development of regulations under the Midwifery Act. This committee will report on Standards of Midwifery Practice, Therapeutics Committee Terms of Reference, entry to practice and continuing registration requirements, Professional Liability Insurance, and the powers, duties, and qualifications of the Registrar of the Midwifery Council of NB. Membership will include 2 midwives from CAM, and one representative each from the SOGC, the NBMS, the NBPS, the NANB, a maternal child care clinician, two DOH consultants and a project coordinator.

Proposal for Provincial Reproductive Care Program
The multi-disciplinary work of the Midwifery Stakeholder Committee and the Midwifery Model of Care Working Group in 2007-2008 has acted as a catalyst for the proposal of a Reproductive Care Program “to coordinate programs and services and support caregivers in the provision of quality care with the aim of optimal health for all maternal/newborn patients and their families”. A comprehensive perinatal database has also been recommended.

Association
There is currently no midwifery association in NB, as there are no practicing professional midwives. The midwifery advocacy group, Birth Matters, continues to be active, accessible at http://birthmattersnb.com/introE.htm

Research
One midwifery research study during the past year examined the issue of informed choice within the existing maternity care system. The conclusion reached was that women’s legal right of access to informed decision making was not assured in NB. Women accepting epidurals and caesarean sections are unaware of the potential short and long term sequelae. Despite this lack of awareness, women are under the illusion that they are well informed. Associations were uncovered between the distance involved for access to postnatal breastfeeding information and support, and breastfeeding duration, and also between persistent breastfeeding problems, premature cessation of breastfeeding, and postnatal depression. The fragmentation of care was found to inhibit access to information throughout the continuum of care, and this in turn was associated with adverse health outcomes.

No contact information at this time.