Midwifery in Canada – Provinces/Territories

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Alberta Association of Midwives - Report submitted November 2011

Things are going fairly well in Alberta.  We are into our third year of public funding and we continue to grow with new midwives coming from the Multi Jurisdictional Bridging Project and other provinces.  We currently have 62 registered midwives, 14 are restricted.  Interestingly, 48 midwives are in the south half of the province and the majority of the midwives practice in the two major urban centres, Calgary and Edmonton.  We have increased our numbers by about 30% in the three years since funding was announced.  There has been some growth in rural areas in Central Alberta and a new practice is being supported in Southern rural Alberta.  Alberta Health Services is very interested in investigating how midwifery can help the province deal with the lack of obstetrical care providers in rural and remote areas.  Our challenge as an association is to participate in that goal while keeping the pillars of the Canadian Midwifery Care model intact. 

In 2008 we signed a three year Memorandum of Understanding with Alberta Health Services which was designed to provide for controlled growth.  Our model of remuneration is a Course of Care (COC) fee which includes provision of overhead and midwifery fees.  For the province we were allotted 2025 COCs for year three.  Full time midwifery is based on 40 COC per midwife. 

A source of frustration has been the lack of access to Alberta Health Services (AHS) when it comes to developing operational infrastructure.  Because of the restructuring of the Alberta Health Services which saw 17 regional health authorities become one super board with zonal representation, some of the day to day detail has been put aside as the province deals with higher level policy and program development. To a certain extent that has left us to develop systems that work well for the midwives without a lot of bureaucratic interference but on the flip side some of the practical expertise has not been available to us.  One of the down sides is a lack of cohesion throughout the province when in comes to integration and collaboration. We now have a Midwifery Advisory Steering Committee with AHS so hopefully we will see some balance in terms of high level development planning that comes with implementation and operational support.

Our association has seen tremendous growth as we have moved from an operational board.  We have worked on structure and policy development this past year.  We hired an executive assistant who we can see very shortly moving into an executive director role with administrative support required.  Our board is also working with an advisor to help us navigate the ever changing and morphing political landscape in our quest for a signed contract. 

We have been working over the last few years on a statistics gathering website for the province that is on line and very user friendly.  It is our hope that this tool can also be used for COC payment reconciliation and quality assurance reporting as well.

 We have received support from Alberta Health and Wellness to move forward in our pursuit of an independent college.  We currently operate under the Health Disciplines Board of Alberta Health and Wellness with a Midwifery Health Disciplines Committee.  This committee has had the onerous task of continuing to administer the registration process of our growing membership without an increase in resources or support.  The Health Disciplines Board is requesting that we continue to offer a PLEA program which definitely has its challenges for our small under-resourced committee.  Our association has put their continued support behind the MMBP program and has requested that the government do likewise. 

 Finally, the first year of Mount Royal University’s Bachelor of Midwifery is well underway with 14 students, two of which are aboriginal students.  The students are from many areas across Alberta.  We have seen some very bright and eager faces in our clinics for their initial clinical observation.  Applications for the 2012/2013 academic year will be accepted starting December first at www.mtroyal.ca.