Midwifery in Canada - New Brunswick

Report submitted September 2007

Joint Presentation to New Health Minister
Last September midwifery advocates in New Brunswick were disappointed by the change of government, as Minister Green had been supportive of the midwifery agenda, and was actively initiating some of the groundwork required. Contact was made early with the new Health Minister, and in February a joint presentation was offered on the potential contribution of midwifery to maternity care in the province. Those presenting included a pregnant member of Birth Matters, the midwifery advocacy group, a representative from the Aboriginal Women’s Health community, a midwife, and a physician who had not only worked with midwives, but whose children were born at home with midwifery care.

Women requesting midwifery care were encouraged to write to the Minister at this time, and letters of support were obtained from the Canadian Association of Midwives, and the Society of Obstetricians and Gynaecologists of Canada. The N.B. Advisory Council for the Status of Women has been continually supportive in helping to raise the profile of midwifery, and publishing data on areas of maternity care which need improvement.

May 16th Announcement in the Legislature
In May, midwives in the province were summoned to the legislature to hear ‘an announcement’. Minister Murphy formally recognized the profession of midwifery, and introduced all five midwives to the House. He announced his government’s intention to introduce regulated and publicly funded midwives into the health care system. A working group would deliberate over the summer and advise the government in the fall, with a view to developing legislation over the winter months. Minister Murphy expected to see midwives practicing by the spring of 2008. However the issue of home birth was evaded at the time. Midwives made it clear to the media that the Canadian model of care included an informed choice of birth place.

Midwifery Stakeholder Committee
A committee was struck, composed of nurses, physicians, administrators, legal advisers, a pharmacist, a health human resource specialist, a mother, and one solitary midwife. The committee’s purpose was to advise the Department of Health with regard to the legislation, regulation, implementation, recruitment and retention of midwives. To date, the committee has met three times, and the major unresolved issue at this stage is that of home birth. Teleconferences with key professionals and administrators in Quebec, Ontario and Manitoba, have made it clear that home birth is an accepted component of midwifery practice in other provinces. However, the N.B. Medical Society supports the concept of midwifery, as long as home birth is not offered. The new R.C.O.G./R.C.M. statement promoting home birth in the U.K., and the new H.I.R.O.C. Joint Statement with regard to midwifery-physician collaboration have been very useful, and are currently being considered by the N.B.M.S. A draft report to the Minister is now available, and this will be revised at an October meeting prior to submission.

Growth of the Midwifery Profession
Four of the five midwives currently living in the province have trained outside Canada, and require access to a P.L.E.A. or I.M.P.P. program. One of these is currently attending the I.M.P.P. Concern has been expressed in the report to the Minister regarding the need for midwifery education and assessment programs locally. It is anticipated that three to four Canadian registered midwives will be available to practice in N.B. in 2008/2009, and Fredericton is likely to be the first midwifery practice site. New Brunswick has benefitted from the work completed in Nova Scotia with regard to plans for an inter-disciplinary regulatory committee as an interim measure for a small but growing profession. While delighted with the progress being made, mothers and midwives in N.B., as well as those midwives intending to return to N.B. to practice, remain concerned at the lack of acceptance for home birth. It is hoped that the position of the N.B.M.S. may be revised in the near future, to ensure that women who choose home birth may be safely cared for by professional midwives in a publicly funded system.