Midwifery in Canada – Provinces/Territories

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Report submitted September 2009 by the Alberta Association of Midwives

Government funding for midwifery services was announced by Alberta Health and Wellness on October 16, 2008. This was a history making day for the mothers and midwives of Alberta. Full funding came into effect for the fiscal year starting April 1, 2009 with a budget of four million dollars to implement a funded midwifery model of practice. In the next two years there will be additional coverage for more courses of care and yearly remuneration increases. The current commitment for ongoing funding will cover a total of three years. The course of care payment is based on an average of 48 hours per client with the understanding that full time midwives will carry a caseload of 40 clients per year. Under the remuneration agreement midwives are responsible for all their own expenses including equipment, supplies, office and clinic space, and continuing education. Malpractice insurance will continue to be subsidized by the government.

There are currently 43 registered midwives and 25 student midwives throughout the province. The majority of midwives work in autonomous practice settings in solo practices, or teams of 2 to 4 midwives within larger practices. 1,025 courses of care will have been provided in 2009-2010 with more than half of the births anticipated to occur in an out-of-hospital setting. There are currently not enough midwives to handle client demand and every practice has a long waiting list of women hoping to obtain the services of a midwife.

Challenges for the AAM over the next three years will be a sustainable funding model, education programs for future midwives, establishment of an independent college and growing the profession.

Alberta currently does not have a provincial education program for midwives. Mount Royal University in Calgary has developed a proposal for a four year baccalaureate program leading to a Bachelor of Science in Midwifery. The proposal will be presented to Alberta Advanced Education and Technology for funding approval in the very near future.

Midwives register through the Midwifery Health Disciplines Committee. Midwives educated in Canadian programs and registered in other provinces have reciprocal registration in Alberta. Internationally educated registrants must go through a prior learning assessment program and are required to submit a detailed portfolio, have current experience and pass written, oral and practical exams before they can be registered to practice in Alberta.