Yukoners for Funded Midwifery

Walk for Midwifery, April 30--Join Us on the Millenium Trail!

2011-04-24T10:40:00.001-07:00

International Day of the Midwife
Journée Internationale des Sages-Femmes

SATURDAY APRIL 30th 11am-1pm
SAMEDI LE 30 AVRIL de 11h a 13h

GLOBAL WALK
MARCHE MONDIALE

WHITEHORSE EVENTS:
ÉVÈNEMENT A WHITEHORSE:

WALK THE MILLENIUM TRAIL
BEGINNING AT THE S.S. KLONDIKE
SPEECHES AND SNACKS TO FOLLOW AT THE GAZEBO IN THE ROTARY PARK

MARCHEZ LE SENTIER DU MILLENIUM
DÉPART DU S.S. KLONDIKE
DISCOURS ET COLLATIONS SUIVRONT AU GAZEBO DU PARC ROTARY

Why walk? Because you feel concerned about midwifery regulation issues, because you would like to see this service offered equally to ALL women and families of the Yukon, because birth needs to be humanised and women need to be empowered in their birthing capacities, because too many unnecessary obstetrical interventions are being done, because it is important for the future of your family and children, to finally give the choice to women now and of future generations to birth supported by midwives.

Pourquoi Marcher? Parce que la cause des sages-femmes vous tient a coeur, parce que vous aimeriez voir ce service accessible a TOUTES les femmes et familles du Yukon, parce que c'est important d'humaniser la naissance et de redonner le pouvoir d'accoucher aux femmes, parce que trop d'interventions obstétricales sont non nécessaires, parce que c'est important pour le futur de vos familles et de vos enfants, pour enfin donner le choix aux femmes de maintenant et des générations futures d'accoucher avec des sages-femmes.

Contact: Karine 456-4728 and/et Kathleen 335-3836

Childbirth Education--Weekend Workshop, April 8-10

2011-03-30T17:43:00.000-07:00

Pregnant and want to prepare for childbirth and parenthood?

I am considering offering a weekend workshop here in Whitehorse of the Connected Childbirth course content.

The course would run Friday evening, Saturday, and Sunday April 8-10, 2011.

I have one interested expectant couple, and need at least 2 more to offer the course (maximum 6 expectant women).

Cost is $199, and includes a partner. Location to be announced (we are hoping that one of the course participants will be willing to open their home for the weekend).

Please contact me immediately if you are interested. Pass the word to your pregnant friends!

Asheya Hennessey, B. Ed.

Founder & Executive Director, Mothers of Change for Maternity Care

Founder, Yukoners for Funded Midwifery

867.456.7711

info@connectedchildbirth.com

Doula Services in Whitehorse

2011-02-04T18:07:00.001-08:00

In the absence of funded midwifery in the Yukon, midwives are only available in their full professional capacity for homebirths.

For some women, this is exactly what they want and they are willing to pay for it. For others, the lack of funding or homebirth-only option, or both, prevent them from hiring one of the excellent midwives who work here in the Yukon.

Doulas are a good compromise for those looking for one-on-one care supporting natural birth, like that provided by a midwife, but planning a hospital birth. Doulas are birthing support professionals, who offer emotional and physical care for the mother and her partner. Doulas are not health care providers, and do not offer medical services or advice. Doula services are less expensive than midwifery services, which may be more affordable for some families.
Research has shown that using a privately hired doula (not a doula or nurse employed by the hospital) has many benefits, including:

reducing the mother's experience of pain
reducing the use of epidurals
reducing interventions and Cesarean births
shortening the length of the birthing process
increasing the mother's satisfaction with her experience.

A doula will typically come to the mother's home at the beginning of the birthing process and support her at home until the mother is ready to travel to the hospital. The doula will continue to support the mother and her partner at the hospital, providing one-on-one care and natural pain relief methods, such as massage, position suggestions, aromatherapy, encouraging breathing for relaxation, positive messages, visualization, and emotional support.

I maintain a list on this website of doulas currently offering services in Whitehorse, and I am now also taking clients.

I am available to support women who are planning to birth at the Whitehorse hospital and who are hoping for a natural birth with minimal interventions.
If you are interested in finding out more about my services, please contact me, Asheya Hennessey, at 867.456.7711 or info@yffm.ca.

Mother-to-Mother Milk Sharing

2010-11-12T10:26:00.000-08:00

Breastmilk is nature's normal, optimal food for infants. Exclusive breastfeeding is the healthiest way to feed a baby until at least six months of age, and breastfeeding until at least two years of age and beyond provides children with immune protection and nutrition.

But what to do if a parent can't produce milk or can't produce enough milk? In the case of a woman who is attempting to breastfeed after giving birth, the first answer should be to seek help from a lactation consultant, as it is extremely rare that women cannot produce enough milk for their babies. However, there are certain conditions that make it difficult for women to breastfeed, and of course there are also situations where the biological mother is absent.

The answer that first comes to mind in these situations for many people is commercial formula, which comes with many health risks.

A new initiative, Eats on Feets, which is a take 'Meals on Wheels,' started by Emma Kwasnica, a Canadian mom, is trying to make breastmilk available to all babies through woman-to-woman milk sharing networks. The idea is simple, but radical, with the potential to revolutionize feeding of infants who cannot get breastmilk or enough breastmilk from their parents.

Create facebook pages. Invite women to join. Use the facebook page as a platform for this network of women to communicate about the need for donated breastmilk for a particular infant, so that women who have breastmilk to donate can connect with the parents who need the breastmilk. That's it. No intermediaries. No money. Just the community of women supporting each other.

To find out more about Eats on Feets Yukon and to join the network of Yukon women, go to the facebook page: www.facebook.com/eatsonfeetsyukon.

Doula Training in Whitehorse

2010-09-10T11:18:00.000-07:00

Doula Training
October 15-17, 2010

For anyone interested in supporting women and their families
during late pregnancy, childbirth & early postpartum.This is an intensive workshop that explores the emotional, social, physical, mental and spiritual aspects of birth and the immediate postpartum period. The training focuses on current practice, evidence-based care and supporting a Yukon community of Doulas. The cost of the workshop is $375.00, including manual, snacks and lunch.

For more information, please call Heather Ashthorn, CPM 633-6770

YFFM Membership

2010-08-20T21:57:00.000-07:00

YFFM now has two types of membership: supporting membership and voting membership.

Supporting Membership
Supporting members receive e-mail updates on midwifery in the Yukon but are not part of any decisions YFFM makes. Supporting members have no responsibilities.

Voting Membership
Anyone who directly indicates they would like to be a voting member may become one. Voting members are involved in the decision making of YFFM. Voting members are responsible to stay involved in any discussions, and to attend meetings if they are able. If they are not able to attend meetings, voting members should participate in discussions through e-mail and phone conversations. Voting members are also expected to help with any activities YFFM undertakes. Professionals (midwives, nurses, doctors etc.) may be voting members, as long as they ensure there is no conflict of interest between their participation in their professional organization and the purposes of YFFM. If a conflict of interest arises, professionals are expected to remove themselves from the decision making process.

If you would like to become a member of YFFM, please e-mail info@yffm.ca and indicate which type of membership you would like.

Upcoming YFFM decisions may include working on regulations, depending on whether the government decides to regulate midwifery in the Yukon or not.

Addendum to YFFM Midwifery Regulation Consultation Response

2010-05-21T23:39:00.000-07:00

Addendum to Midwifery Regulation Consultation Response
on behalf of
Yukoners for Funded Midwifery
May 14, 2010

In the last few weeks of consultation, there has been discussion among members and supporters of Yukoners for Funded Midwifery regarding what regulations would look like. The consumer response to whether to regulate is not unanimous, with some consumers thinking it is better to integrate midwifery into the health care system as quickly as possible in order to obtain funding, and others concerned about the potential costs to the profession and to women if a careful, considered, consumer-centered approach is not taken, especially in light of the Yukon Medical Association President Dr. Tadepalli’s position on the exclusion of homebirth and the unknown overall position of the Yukon Medical Association.

Women who have used and paid for midwifery services in the territory are aware of the high caliber of those services and highly value their experiences of informed choice, continuity of care, and the optimal environment created for physiological birth without unnecessary interventions. These are the true consumers of midwifery services, and the consumers who are truly informed about the benefits of midwifery the way it is currently practiced in the Yukon and the potential disadvantages of regulation.

We are concerned that members of the public who have not used midwifery services, including childbearing women, do not currently have enough information about the advantages and disadvantages of regulation to make an informed decision. We are also concerned that all of the public, including consumers of midwifery services, do not have enough information regarding what regulations would actually look like to make an informed decision on the question of whether midwifery should be regulated. Our initial consultation response reflects this lack of information.

We are also very concerned that if midwifery should be regulated that consumers and midwives will not be at the center of all discussions, planning, and final decisions. This concern is highlighted by Health & Social Services neglect to inform YFFM that we were in consultation beginning on April 1, 2010. YFFM only found out that we were in consultation from a Yukon News reporter on April 12, 2010. This raises grave concerns as to the importance the government places on consumer input. Regulations that are not consumer and midwife designed put the public at risk for harm, acting in opposition to the very public safety they are supposed to create.

In light of these concerns we request that the Yukon government delay a decision about whether to regulate or not until after more information has been gathered on what regulations would look like.

We propose a public information campaign created and led by consumers and midwives, with support from the government for networking with stakeholders and the provision of funding for the campaign from the government. YFFM is currently preparing a survey to begin the process of gathering information regarding what regulations the different stakeholder groups would like to see. We would need to explore possible models of regulation and funding of midwifery services, and their impact on Whitehorse and the communities.

It is also important that the First Nations be included in any stakeholder discussions, and their exclusion from the process so far is a severe oversight on the part of Health & Social Services, and in fact in many ways significantly negates the process so far, as the voices of the First Nations have not been heard.

The health of mothers and babies in the Yukon is of utmost importance, both now and for the future. We will not sacrifice ourselves or our babies on the altar of government procedure or doctor’s uninformed opinions. Birth belongs to mothers, midwifery belongs to mothers, and we will not be satisfied with a process that does not put our concerns, our choices, and our leadership as the directive for all decisions.

Please respond to our request for a delay in the decision on whether midwifery should be regulated and the proposed information campaign by Friday, May 21, 2010.

YFFM Midwifery Regulation Consultation Response

2010-05-21T23:34:00.000-07:00

Midwifery Regulation Consultation Response
on behalf of
Yukoners for Funded Midwifery
May 2010

Yukoners for Funded Midwifery does not think regulations are necessary for public safety for the following reasons. First, the midwifery model places high value on the informed choice of the woman and shared responsibility for decision making. This differs from the medical model, upon which most other health professions are based. Midwives place high value on disclosure to their clients, and foster an approach that invites the woman to ask questions about individual midwives’ qualifications and credentials. Ultimately, the burden of responsibility and choice for her maternity care rests with each individual woman.

Secondly, the Yukon is a unique jurisdiction, as the population is quite small and concentrated in Whitehorse. Because of the small population, word of mouth and reputation are important in establishing and maintaining a profession. Unlike large provinces such as Ontario or British Columbia, it is possible to personally know every midwife who would be practicing in the Yukon, as the population could only support four to eight midwives, assuming that about half to three quarters of the births in the territory would be attended by midwives if midwifery were funded. There are currently only two midwives practicing in the territory, both of whom are well known in the community and competent in their profession. Neither of the midwives currently practicing in the Yukon pose any public safety concerns, and we anticipate that if new midwives were to begin practicing in the Yukon their qualifications would very quickly become known and assessed in and by the community.

Third, the midwifery model of care is inherently less risky than the medical model of care, as the midwifery model recognizes pregnancy and birth as normal life processes that for ninety percent of women require no intervention. The main principle behind midwifery is ‘First, do not interfere.’ The midwifery model encourages midwives to intervene only when it is absolutely necessary, and to engage the woman in decision making for any interventions that might be considered medically necessary. The midwifery model also protects the environments in which women give birth most easily, particularly the home birth setting, reducing risk of problems in birth that are caused by the release of stress hormones due to unfamiliar environments with unfamiliar people. The midwifery model by its very nature provides supportive, continuous care by a trained labour support person, a measure that has been shown to be extremely effective in reducing stress, fear, and pain in birthing women, which in turn makes birth easier and the birth process most effective, reducing the need for interventions.1 Midwifery is not about treating pathology but about optimizing physiological, normal birth and recognizing pathology when it arises, in order to collaborate on care with medically trained professionals. Midwives obtain their education either through an apprenticeship or through a university education program, and either of these routes teach them how to recognize and respond to emergency situations, in order to protect the mother and the baby.

We recognize the possible advantages of regulating midwifery. We would like to see midwives have status as primary health care providers in the health care system of the Yukon. We would like midwives to be able to order diagnostic tests and prescriptions when indicated for women and babies, and to have hospital privileges. We would like there to be more collaborative care between midwives and other health care professionals, when it is in the best interest of the mother and baby. We would like midwifery to be funded, to make midwifery accessible to all mothers in the territory. We would like to see a free standing, government funded birth center, with living/birthing suites for families from the communities, staffed entirely by midwives. We would like mothers in the communities to have access to publicly funded midwifery services and the option of birthing in their own homes. We would like to see the choices for women expanded, so that every mother receives optimal, evidence-based prenatal, birth, and postpartum care that emphasizes informed choice and puts birth where it belongs—in the hands of the mother.

We are concerned that regulations could limit the choices currently available to mothers. Right now, pregnant women have no restrictions on their informed choices. If the midwife feels comfortable providing care for a woman, whatever her circumstances, and the woman has been informed of the risks and benefits and desires care, the woman and the midwife enter into an agreement of care. Historically, some jurisdictions have limited the choices available to women by limiting midwives in what they are allowed to do and to whom they are allowed to provide care. This has led to harms for women, one example being the case of breech births in Ontario, where midwives were required to consult with an obstetrician. Because of regulatory guidelines, women were restricted to a hospital birth with a breech baby, and because of the climate due to regulations, if a woman had a breech baby she was forced into a cesarean section, even if the midwife had the skills to assist in delivering a breech baby vaginally and the mother preferred that option.2, 3 Vaginal breech birth has been shown to be as safe as birth by cesarean section.4 Cesarean sections carry high risks for both mothers and babies, and when the benefits of performing them do not outweigh the risks, harm is done. There are restrictions in other jurisdictions for other circumstances a mother might encounter, such as twin births, that limit choice for women. The reason the woman’s choice ends up being limited is because midwives who go against guidelines set out by regulation are often concerned about being disciplined by their regulatory body and having their license revoked as a result of remaining with a woman who chooses a form of care that the midwife is not supposed to provide.

We do not want to see women’s choices limited, and are concerned that regulations could end up causing more harm than good, acting in opposition to public safety. While midwives and consumers would be part of drafting regulations and would create regulations that provide the most choice for women, our concern is that the doctors would also be involved in drafting the regulations. Because the majority of doctors in the Yukon are not familiar with the midwifery model of care and instead approach pregnancy and birth from a medical model of care, we are concerned that they would want to put in place restrictive regulations, based on their own experiences rather than on the evidence-based practice of midwifery. We are aware that the doctors have a strong voice and are very important to the government, and that the government has a strong interest in accommodating the Yukon Medical Association and individual doctors, as indicated in our meeting on January 26, 2007 with the former Minister of Health Brad Cathers. We feel that the tension between providing women choice and the doctors’ belief of what is best for women, with the government favouring doctors, could lead to regulations that are unfavourable and not what women want or in the best interest of women. We do not want our voices to be overpowered by perceived medical authority.

We are also concerned that regulations would limit choice for women by restricting who is allowed to provide maternity care to women, as has happened in other jurisdictions. If midwifery were regulated, we would want women to be able to choose from a registered, publicly funded midwife or a non-registered, private-fee-for-service midwife, if one was practicing in the Yukon. We would want the term ‘midwife’ to be usable by both registered and non-registered midwives alike, with the exclusive use of ‘registered midwife’ reserved for those midwives who are registered and whose practice is governed by regulations.

An alternate solution to regulation would be for the government to reimburse women who use the services of midwives who have passed a midwifery competency exam administered by the Canadian Midwifery Regulators Consortium. This would make midwifery services accessible to all women in the territory, expanding their choices.

The vision of Yukoners for Funded Midwifery is that in order to enable informed choice for all women in the Yukon regarding their pregnancy, birth, and post-partum care, we envision women retaining all the choices that midwifery services in the Yukon currently offer, and the extension of those choices through government funding.

If a guarantee could be put in place to give midwives and consumers the authority in what regulations are finalized, with the opinions of doctors, other health professionals, and government being given due consideration but not final determination, then under these conditions Yukoners for Funded Midwifery would be supportive of regulating midwifery.

1. DONA International. Research Shows Doulas Make a Difference. http://www.dona.org/resources/research.php (April 2010)
2. Coalition for Breech Birth. Miriam Hannah’s Birth Story. http://www.breechbirth.ca/Birth%20Stories/Birth%20Story%20Miriam%20Hannah.html (April 2010)
3. Coalition for Breech Birth. I Have Carried Two Breech Babies. http://www.breechbirth.ca/Birth%20Stories/Birth%20Story%20Jen.html (April 2010)
4. Society of Obstetricians and Gynecologists. SOGC Clinical Practice Guideline: Vaginal Delivery of Breech Presentaion, No. 226, June 2009. http://www.sogc.org/guidelines/documents/gui226CPG0906.pdf (April 2010)

Midwifery Regulation Consultation

2010-04-14T06:48:00.001-07:00

The government of the Yukon has now completed the document to inform the question of whether midwifery should be regulated. The document is available online, and the government is collecting feedback from stakeholders and the public on the question of whether midwifery should be regulated. The consultation process will end on April 30, 2010, so if you are interested in being part of the process, take a moment before then to read the information about midwifery (it's not too long) and provide your opinion.

All the information and opportunity to provide feedback is on the government's website here.

Globe and Mail ~ June 19, 2009

2009-06-19T10:03:00.000-07:00

C-section not best option for breech birth

The Society of Obstetricians and Gynecologists of Canada will launch program to teach physicians breech vaginal delivery

Carla Wintersgill

Friday, Jun. 19, 2009

Physicians should no longer automatically opt to perform a cesarean section in the case of a breech birth, according to new guidelines by the Society of Obstetricians and Gynecologists of Canada.

Released yesterday, the guidelines are a response to new evidence that shows many women are safely able to vaginally deliver babies who enter the birth canal with the buttocks or feet first. Normally, the infant descends head first.

“Our primary purpose is to offer choice to women,” said André Lalonde, executive vice-president of the SOGC.

“More women are feeling disappointed when there is no one who is trained to assist in breech vaginal delivery,” he adds.

Since 2000, C-sections have been the preferred method of delivery in breech births. Studies suggested that breached births were associated with an increased rate of complication when performed vaginally.

As a result, many medical schools have stopped training their physicians in breech vaginal delivery.

The problem now, according to Dr. Lalonde, is that there is a serious shortage of doctors to teach and perform these deliveries.

With the release of the new guidelines, the SOGC will launch a nationwide training program to ensure that doctors will be adequately prepared to offer vaginal breech births .

The new approach was prompted by a reassessment of earlier trials. It now appears that there is no difference in complication rates between vaginal and cesarean section deliveries in the case of breech births.

News of the change is a boon for the Ottawa-based Coalition for Breech Birth.

“We're really, really pleased,” said Robin Guy, co-founder of the coalition.

Ms. Guy started the group after the birth of her second child in the fall of 2006. Although she had given birth to her first child at home with a midwife, Ms. Guy delivered her daughter in the hospital because of the baby's breech position.

“I was cornered into an unneeded and unwanted C-section because the obstetrician that I had didn't have the experience to catch her,” said Ms. Guy.

The aim of the coalition is to ensure that women know what their options are when it comes to breech birth. Ms. Guy believes that many women don't realize that vaginal breech births are even possible.

“Educating women is our primary goal because it takes more than just a guideline change,” she said.

The SOGC stresses that because of complications that may arise, many breech deliveries will still require a cesarean section.

Breech presentations occur in 3-4 per cent of pregnant women who reach term. That translates to approximately 11,000 to 14,500 breech deliveries a year in Canada.

The new decision to offer vaginal breech birth aligns with the SOGC promotion of normal childbirth – spontaneous labour, followed by a delivery that is not assisted by forceps, vacuum or cesarean section. In December of 2008, the society release a policy statement that included its recommendation for a development of national practice guidelines on normal childbirth.

“The safest way to deliver has always been the natural way,” said Dr. Lalonde.

“Vaginal birth is the preferred method of having a baby because a C-section in itself has complications.”

Cesarean sections, in which incisions are made through a mother's abdomen and uterus to deliver the baby, can lead to increased chance of bleeding and infections and can cause further complications for pregnancies later on.

“There's the idea out there in the public sometimes that having a C-section today with modern anesthesia and modern hospitals is as safe as having a normal childbirth, but we don't think so,” said Dr. Lalonde.

“It is the general principle in medicine to not make having a cesarean section trivial.”

The SOGC believes that if a woman is well-prepared during pregnancy, she has the innate ability to deliver vaginally.

The national average for babies delivered via cesarean section in Canada is 25 per cent.

Film Night ~ A Must See for Every Parent to Be

2008-10-15T13:49:00.000-07:00

Yukoners for Funded Midwifery
invites you to a special showing of
Ricki Lake's film

The Business of Being Born
Saturday, October 18, 2008
7 pm @ Alpine Bakery
(Admission by Donation)

A must see for every parent to be.
You will never look at giving birth the same way.

Hosted by Yukoners for Funded Midwifery
Sponsored by Alpine Bakery, Due North Delivery, and Copy Copy

Los Angeles Times ~ July 9, 2008

2008-09-14T19:05:00.000-07:00

Big Medicine's blowback on home births

Why do U.S. doctors strong-arm women into our standard maternity care system?

By Jennifer Block
July 9, 2008

You'd think the healthcare establishment would have bigger fish to fry than Ricki Lake. (The 47 million uninsured, maybe?) But Lake's recent documentary, "The Business of Being Born," which includes footage of her own delivery of her second child at home, was on the agenda at the American Medical Assn.'s annual meeting in mid-June. Lake was personally name-checked in a "Resolution on Home Deliveries" introduced by the American College of Obstetricians and Gynecologists: "Whereas, there has been much attention in the media by celebrities having home deliveries, with recent 'Today Show' headings such as 'Ricki Lake takes on baby birthing industry.' " The AMA ultimately passed the resolution without the Lake citation, but not before the Hollywood media got wind of it and, overnight, home birth was thrust into the mainstream light.

It's about time.

Last year I flew to Britain to be with a good friend for the birth of her first child. She's American but married into Britain's National Health Service, lucky duck. The differences in the prenatal care she got there were striking. First and foremost, she never saw a doctor. As a healthy woman with a normal pregnancy, she saw midwives. And one of their first questions to her was, "So, would you like to give birth in the hospital maternity ward or at home?"

Planning a home birth with a midwife may sound old-fashioned -- maybe you think it sounds crazy -- but a solid body of research shows that for healthy women who seek a normal, nonsurgical birth, there are several benefits. At home, a woman can get one-on-one care and monitoring from a midwife trained to support the normal labor process. The mother-to-be is free to move about, eat and drink, sit in a birth tub -- Britain's national health guidelines call water the safest, most effective form of pain relief. A woman will be helped to give birth in positions that are effective and protective: sitting, squatting, on hands and knees, even standing.

The physiological birth process is automatic: hormones fire, the cervix gradually opens, the uterus contracts, the baby descends, muscles engage. An optimal birth, one in which mother and child emerge as healthy as can be, is one that begins spontaneously, progresses on its own and concludes with the least amount of intervention necessary.

But hospital maternity care in the U.S. is typically not supportive of this process. More than half of women are induced into labor, or it is sped up with artificial hormones; the vast majority of women labor and push in the desultory flat-on-the-back or leaning-back position; and (perhaps not surprisingly) nearly one-third of women end up giving birth through major surgery, the caesarean section.

This has led to an epidemic of pre-term births in the United States. A 2006 survey showed that the majority of babies are now born before the spontaneous onset of labor, which leaves them more prone to breathing and feeding difficulties. Caesareans are also contributing to a rising maternal death rate, announced by the Centers for Disease Control and Prevention last year.

Which is why some women, such as those in the film Lake produced, choose to give birth somewhere other than a hospital. Their choice is backed by sound science. Studies of "low-risk" women in North America planning out-of-hospital births with midwives have found that 95% give birth vaginally with hardly any medical intervention. The largest and most rigorous study to date, published in the British Medical Journal, found that in North America, babies were born at home just as safely as in the hospital.

Organized medicine can't believe this. Dismissing the research evidence, the AMA resolution states that "the safest setting for labor, delivery and the immediate postpartum period is in the hospital" or an accredited birth center. In its own statement earlier this year, the American College of Ob/Gyns went even further, implying that women who choose home birth are selfish and irresponsible: "choosing to deliver a baby at home ... is to place the process of giving birth over the goal of having a healthy baby."

Compare that to this information in Britain's NHS-issued handout my friend was given at her first prenatal appointment: "There is no evidence to support the common assertion that home birth is a less safe option for women experiencing uncomplicated pregnancies." In a joint statement last year, the Royal College of Obstetricians and Gynecologists and the Royal College of Midwives said, "There is no reason why home birth should not be offered to women at low risk of complications, and it may confer considerable benefits for them and their families."

The AMA's statement calls for legislation that could be used against women who choose home birth, possibly resulting in criminal child-abuse or neglect charges. The group says this is about safety, but with no credible research to back up its claim, this argument falls flat. Women are simply caught in a turf war over the maternity market, and it would appear that the physicians' groups are perfectly willing to trample the modern medical ethic of patient autonomy -- grounded in our legal rights to self-determination, to liberty and to privacy -- in their grab for control.

If these groups were truly making maternal and child health a priority, they'd be reforming standard maternity care, not strong-arming women into it.

Jennifer Block is the author of "Pushed: The Painful Truth About Childbirth and Modern Maternity Care."

Midwifery Update

2008-08-20T19:59:00.000-07:00

This update is long overdue, as I have been extremely busy with a new baby and a new business. You can read Eowyn's birth story (at home with midwife Christina) in the previous post. My husband and I have started Due North Delivery, a baby and maternity store that offers customers 5% of their purchases as a credit towards doula and midwifery services. We decided to start this business in large part because the government has been slow in funding midwifery services in the Yukon. You can access the store at www.duenorthdelivery.com

The last midwifery working group was held in June, at which time a new policy analyst from Health and Social Services was introduced. I have not yet received any reports or documentation from our meetings, although Health and Social Services should be preparing a document.

I personally feel that Yukoners for Funded Midwifery is at a bit of a crossroads. Having been through the working group meetings and discussing the idea of regulation at length with the midwives, government personnel, medical workers, and other consumers, I do not believe it is in the best interests of women who wish to use midwifery services in the Yukon for midwifery to be regulated. This is mostly because regulation of midwifery in Canada has a history of limiting women's choices surrounding birth with a midwife, which in many cases is contrary to the safety and well-being of the woman and/or her child. However, I would like to see midwifery services become a more accessible choice for women in the Yukon through funding and for midwives to have status at the hospital to better meet the needs of women who either choose a hospital birth or require transport to the hospital.

The government has said repeatedly that the only way to funding is through regulation, but I am wondering if perhaps we should challenge this. What I would ideally like to see is a government program of reimbursement, where the women who receive midwifery services are reimbursed for their bill, rather than the government dealing with the midwives. Does anyone know of any program that would set a precedent for this? I would like to propose to the government that they have a list of midwives (which right now would be the two practicing midwives in the Yukon, Christina and Heather) whose services they will reimburse women for. The Canadian Midwifery Regulators Consortium has a standardized Canadian Midwifery Registration Examination, and the government of the Yukon could require midwives who would like to be on the list to pass this examination. The hospital could establish a set of guidelines or protocol for the interactions between midwives, doctors, nurses, and hospital staff when a midwife is attending a woman at the hospital. Does this seem really outside the realm of possibility? I've always liked to dream big! If you think this would best serve the needs and enable the choices of women in the Yukon please email me back! And come to a meeting! The government takes action in response to what we, the consumers, want and the more the better. We need to figure out a way to really get our voices heard and get the message through that this is what we want. We can discuss ideas at the next meeting.

The next meeting will be on August 26 at 7pm at my house, 17 Redwood St. in Porter Creek. Please feel free to email me at info at yffm dot ca or call me at 456-7711 for directions. We need to hear your voice!

Eowyn's Birth Story

2008-08-05T18:52:00.000-07:00

This is Eowyn's birth story, submitted by Asheya Hennessey, the founder of Yukoner's for Funded Midwifery. It's long and detailed!

I am writing Eowyn’s birth story on April 2, 2008, and she is right here with me sleeping in the sling. Eowyn’s birth story starts with the choices I made about my prenatal care and where I wanted to give birth. I chose to have a home birth with a midwife as my health care professional, Christina Kaiser.

I had mildly painful contractions on Wednesday night, and during the morning on Thursday, March 20. I let Eric know. At about 11 am I started nursing Elias, as he had hurt himself and needed comforting. While he was breastfeeding I had some more strongly painful contractions, but they were manageable lying down, and I decided to let him continue nursing. He nursed for about twenty to thirty minutes. As soon as I stood up from nursing him I felt a gush, and went straight to the bathroom. There on my underwear was a huge blob of bloody something, and I had a lot of blood that was going into the toilet. I felt calm but excited – this was definitely happening! I called out to Eric, who was working from home, “I think my water broke!” He came in to look, and of course Elias was there too. Eric brought me the phone and I called Christina. I didn’t remember what my mucus plug had looked like with Elias, but I thought this was rather bloody. When I told her that the blood was bright red, she told me she would be there in an hour, and that I should feel for the baby moving and watch for any gushes of bright red blood. If the baby moved I should call her, and if I started bleeding I should call her. At this point I could blot up blood on the toilet paper, but I wasn’t actually bleeding into the toilet.

I spent an anxious twenty minutes lying on the couch waiting for the baby to move. Finally, I felt something! Just a gentle movement low in my belly, but definitely a movement. I called Christina, and a few moments later felt a little more activity. Having felt the baby move helped me to be calm while I waited for Christina to arrive. I felt anxious about the blood, but knew Christina was on her way.

By the time Christina arrived the fluid I could wipe on toilet paper was pink, not red. I had saved the bloody blob in a jar, and Christina confirmed that it was my mucus plug. She said it was the bloodiest mucus plug she had ever seen. There was a lot of blood in the toilet, but I was not still actively bleeding, and Christina’s presence helped me to feel reassured. She also confirmed that my water had broken, and smelled the fluid on a pad, telling me it had a somewhat sweet smell. I couldn’t smell it, really, but I was glad she could. At this point I was having some mild contractions, which I couldn’t feel at all unless I was lying down. Christina stayed for about an hour, asking questions, taking my blood pressure, listening to the baby’s heartbeat, and giving instructions and information. She also brought in all of her equipment for the home birth and showed us what was in her kit, which included all of her emergency supplies (such as pitocin and oxygen masks for mom and baby) as well as basics for the birth (such as sterile scissors and clamps for the cord).

I remember when she asked me how I felt, I told her that I felt pretty normal, which I thought was strange since my water had broken. She told us that after the water breaks labour usually starts within 24 hours, but it can be as long as three days. She said I should only dab, not wipe, when I went to the bathroom, to try to keep as sterile an environment around my vagina as possible, to prevent infection.

I called my mom to let her know that my water had broken and that labour could start anytime, since she would be coming over to look after Elias during the labour and birth. She dropped by later in the afternoon with some more sheets from the Thrift Store and some grocery items, such as green grapes. She also brought me a dozen red tulips, which were absolutely gorgeous! I kept in touch with Christina by phone, and let her know that nothing had changed.

All day Thursday I tried to rest and eat as much as I could, since I knew I would need energy for the birth. The contractions were still mild, but even though I didn’t feel much pain I still felt a little worn out from them. What does that song say? “Waiting is the hardest part.” At one point on Thursday evening I remember I was lying down, trying to rest, and I just felt so lost. Birth is an uncontrollable event, and I didn’t know what was going to happen when. We went for a walk as a family at about 9:30pm, and I hoped that this might help speed up contractions and get things going. In fact, the opposite happened! My contractions slowed down to about every 10 minutes. My sister Emily came over and brought the movie “Enchanted,” which she had just bought and which I hadn’t seen yet. I sat on the birthing ball, and we only watched part of the movie as we were all getting tired. I went to bed at around 11:30 pm, and woke up every half hour to an hour to go the bathroom. I could feel the contractions, but was able to get back to sleep.

At 3 am on what was now the morning of Friday, March 21, I woke up with contractions that were more intense and I knew I couldn’t sleep through. I got up, had a bowel movement, poured myself a big glass of apple juice, got a bowl of chocolate chip mint ice cream, and went downstairs to see if I could watch some of a movie. I turned on the little white Christmas lights that we had set up in the rec room, and put the tulips on top of the dryer. I watched all of 30 seconds of “Enchanted” and realized that it was only making things worse. I decided to wake up Eric, since I wanted some company. I went back upstairs, and at this point had to stop and breathe through contractions while I was leaning against the wall. I woke Eric up around 3:30 am, and called Christina to ask her to come around 3:45 am. At this point my contractions were about 3 minutes apart, lasting about 45 seconds, and I had to stop and breathe through them.

Eric put the plastic on the futon, and made the bed with the sheets I had bought at the thrift store. When I had a contraction he would stop and put his hand on my shoulder. With the presence of his hand on my shoulder I would feel myself relax. I tried to sit on the birthing ball, but it wasn’t working for me the way it had with Elias’ birth, probably because my water had broken so there was more pressure. Eric started pumping up the birthing pool (an inflatable kiddie pool from Canadian Tire!).

Christina arrived around 4:15 am. I was managing a lot of my contractions by leaning against the washing machine, making low moaning noises, and trying to breathe deeply and relax. I would also move my hips and bend my knees during a contraction. Christina started helping to pump up the tub. *** Stopped writing and am now starting again on June 22, 2008. I am referring to Christina’s record of events now as well as my own memory as I write this.*** Either Eric or Christina would pause what they were doing to come over to me during a contraction, and lay a hand on my shoulder. I was trying to notice when the baby moved, as Christina had told me that movement is an indicator that the baby is doing well, and if the baby is moving there is no need to check for a heartbeat. I hadn’t paid any attention to movement during my first labour, but now that I was trying to feel it I definitely noticed when the baby moved. The baby moved before Christina arrived, and I let her know. I felt the baby move again at 4:53 am.

I had been feeling like throwing up since eating that chocolate chip mint ice cream, and at 4:55 I threw up. I never throw up, so this was an uncommon and unpleasant experience for me. I threw up until I was dry heaving; luckily Christina had brought a bucket out from the bathroom and it was on the floor at my feet. I had been leaning on Christina with my arms around her neck during a contraction when I started throwing up, and she brought the bucket up to me. Then we went over the sink in the bathroom. At some point after this I asked Christina how far along she thought I was. I didn’t want an internal, and she didn’t want to give me false information based on her guesses of how far along I was, so at that time she didn’t tell me. Later she said that many women throw up as they are entering transition, and that I was probably about 8cm dilated at that time. But, some women throw up at 3cm, 5 cm, and 8 cm, so the throwing up was not necessarily a sure indicator.

My contractions were getting pretty intense at this point. It was sometime after this that I remember thinking, “Why did I think this was going to be so great?” I had been so excited about having a home birth, and I knew it was going to still be painful, but time erases the memory of the pain I had felt during Elias’ birth. I just wanted to lie down and go to sleep. I knew lying down would only make things worse, but I decided to try it anyway. I lay down on the futon in between contractions, and instead of trying to get up as a contraction was starting I just stayed there. That one really hurt! I didn’t stay lying down during a contraction again, although I would lie down between and then get up so I could cope with the pain during the contraction.

I drank quite a bit of water and apple juice while I was in labour, and I tried to eat some grapes. Christina had thoughtfully bought me some frozen grapes (I really liked eating frozen things during the pregnancy!). At 5:23 am I went pee on the toilet. Sitting on the toilet during contractions has never worked for me, so I didn’t stay there but got back up and went back to leaning on the washing machine. I really appreciated having the tulips there that my mom had brought; they helped to remind me of beauty in the midst of my pain.

I started to feel a bit like pushing soon after this, around 5:30 am. Christina asked me if I felt “pushy at the peak,” which is a good way to describe it. I didn’t feel like pushing during the whole contraction, but I had the urge to bear down in the middle of the contraction. I followed my body and just did what felt right. I started to really, really want to get in the tub, and if the tub wasn’t ready I wanted to get into the shower.

There had been some difficulty in hooking the hose up to the faucet in the sink in the bathroom, which I didn’t pay attention to, but Christina and Eric had both been busy trying to get the tub filled with water. One of them would always come back to me during a contraction, and I would instantly feel more relaxed as soon as I felt a hand on my shoulder.

I asked Eric to call my mom and ask her to come, as things were getting pretty intense and if Elias woke up I wanted her to be there to look after him.

At 5:35 I got into the tub, and it was instant, warm relief! Of course not all the pain was taken away, but that first minute was intensely soothing. I thought I felt the baby move at around 5:36, but I couldn’t be sure. At 5:46 Christina asked if she could listen for the heartbeat, and used the fetoscope. She heard the heartbeat and it was around 120bpm – 130bpm, totally normal. At this point I was starting to really feel more like pushing, and there was a lot of pressure. I was hoping the bath would help to take the pressure away, but being in the tub during labour is not the same as relaxing in the tub when you’re not in labour! At one point I said, “It hurts,” and whimpered a bit. Christina said, “You’re doing so well.” Christina asked me if the contractions still hurt in front, and by 6:00 am they didn’t and I was fully pushing. Again, I just followed my body and did what felt right, without outside direction. I tried different positions in the tub, like kneeling and squatting. I was trying to find a position that would take advantage of the buoyancy of the water and help relieve the pressure. Christina suggested I lean back against the tub and squat, and this ended up being a good position for me.

I started wondering where my mom was, and asked Eric to call her again, which he did. She said she was just leaving the house.

Elias woke up sometime around 6:00 am, and Eric went upstairs to attend to him. We had the monitor on. Eric came back down and said Elias was back in bed. I told Eric to go get him, as I thought we were getting pretty close the baby being born. Elias came down, and was quite enchanted by the fish on the tub! Soon after this my mom arrived, and started talking to Elias. I asked them both to be quiet – I didn’t want any noise interrupting my concentration on coping with pushing.

To cope with the pushing contractions I vocalized strongly, in a higher pitch than when I was having dilating contractions. In between I would rest and ask for water to drink. Eric was in the tub with me at this point.

I put my hands down near my vagina so I could feel if the baby’s head came out. I felt the baby’s head, and then it went back in. Eric asked if he could touch the head, but I said no, since there was no head there to touch. With a few more pushes the baby’s head came again, and I told Eric he could feel it.

At 6:22 am I had a contraction and pushed and could feel the baby’s head coming out! Christina advised me to slow down, so I tried to hold back on the pushing so I wouldn’t tear, although it was very hard and I just wanted the baby out! I didn’t know if I had slowed down or not, as the baby’s body was born into Eric’s hands! He scooped the baby up out of the water and placed her on my chest. I felt pure joy, a moment of pure emotion, and I started crying as I looked at my sweet, beautiful baby! In that moment I was totally in the moment, totally myself, fully vulnerable and overcome with intense feelings of joy, delight, and relief.

A few moments later we looked and found out that we had a girl, a daughter! She was so peaceful, and just lay on my chest. I thought she was breathing, but she wasn’t crying, so I asked Christina just to be sure. Christina reassured me that our girl was fine. She let out a few little cries a couple of minutes after she was born. Eric was so happy too, and we both talked sweetly to our precious new daughter.

I invited Elias over to touch her, and he was very gentle with his new baby sister. I wanted a few photos of her when she was first born, so Christina and my mom took a few pictures. About twenty minutes after she was born, Eowyn started leaning toward my left side. I made sure my breast was out of the water, and supported her neck. She found my nipple, latched on, and started nursing!

Very soon after she started nursing (about three minutes) the placenta was born. I had wanted to stay in the water until the placenta was born. Christina told me she would like me to get out of the water soon so that she could see how much I was bleeding, so at 6:48 I got out of the tub, with Eowyn still nursing and still attached by the umbilical cord to the birthed placenta, which we put into a bucket. I went over to the futon and lay down on my side, with Eowyn still nursing. We snuggled in bed as a family for a bit, and Elias got to kiss and hug his new baby sister! Then my mom took Elias upstairs to get him some breakfast and give us some time to settle with Eowyn.

Eric cut the umbilical cord at 7 am, and Christina inspected the placenta. The placenta was a little bit small and had some calcification, but it wasn’t too small. Calcification is an indicator that the placenta was wearing out, which would explain why Eowyn was born two and half weeks early. The amniotic sac was broken right next to the placenta, where there were also some blood clots. This is unusual, as the sac usually breaks on the opposite side of where it is attached to the placenta. This shed some light on the bloody mucus plug when my water broke and the early delivery. Implantation had probably occurred very low in my uterus, close to my cervix, so that the placenta grew into the mucus plug. If this is what happened, then I would have had placenta previa marginalis, but not full placenta previa as the placenta was not covering my cervix. Eowyn had been head down for some time, and her head was probably against the placenta preventing more growth, which would account for the calcification. She was very engaged when my water broke, and so her head acted as a plug stopping any bleeding that might have happened from the torn vessels that were part of the mucus plug.

If I had had a routine ultrasound, which I didn’t want, the doctor who viewed it may have been concerned about a vaginal birth given the placement of the placenta, and recommended a c-section. I am so glad that I did not have an ultrasound! And I am so glad that I had Christina to assess me when I was in labour. If I had been actively bleeding she would have recommended we go to the hospital, but everything was fine and there were no symptoms that would cause alarm. I am glad that I had a healthy vaginal delivery without interventions, and that I had a health care professional I trusted to assist me. I have realized that I cannot have a doctor as my primary care giver for any of my subsequent pregnancies because I simply do not trust their recommendations for what they might consider necessary interventions.

It’s interesting that I had Braxton-Hicks contractions early in my pregnancy when I would do simple things like carry a relatively light basket of laundry down the stairs. I think my body was telling me to take it easy, possibly because of the placement of the placenta. I listened, and stopped doing things that gave me Braxton-Hicks or that made me feel uncomfortable.

I had some pretty severe afterpains while Eowyn was nursing, which I always find really annoying because they are just as bad as labour contractions but I am lying down nursing through them , so they are difficult to cope with. I have to breathe deep and slowly, but it’s still really painful. I took some cramp bark tincture, but that didn’t seem to have any effect so I took some ibuprofen.

I wanted Eowyn to stay right with me for at least an hour after she was born, so we didn’t weigh and measure her until 9:00 am! She was 7lbs 5 oz and 19 ¾ inches long. Even though she was born a little early she had no signs of prematurity. She was healthy, pink, and fast asleep after nursing for about half an hour, which is why we waited until she woke up to weigh and measure her.

I had a small one degree tear just inside my vagina, which I opted not to get stitched. I guess I did a pretty good job of slowing down, considering I had a third degree tear almost to my anus with Elias’ birth! Because I decided not get stitched I had to mostly lie down with my legs together for a week, which I thought was a good thing anyway to make sure I rested and bonded with Eowyn. Those first few days are so fleeting, and so precious.

I am overjoyed with the way Eowyn’s labour and birth went, and I feel empowered and confident in myself as a women through the experience. I feel satisfied that I was able to bring her into the world in the best environment possible, with dim lighting, gentle sounds, people that I knew and trusted, the loving hands of her daddy to catch her, and the comfort of my skin and my breast in the first hours of her life.

SOGC makes changes to guidelines for vaginal birth of breech babies

2008-07-22T12:28:00.000-07:00

This is not strictly midwifery related, but it is an interesting development in the world of maternity care. My friend Robin has been working hard in the last few years to make vaginal birth a viable option for women with breech babies. (C-sections still have their place, of course, but there are some breech presentations that are suited to normal vaginal delivery, but many women are never given the information let alone the choice. You can learn more about it at the Coalition for Breech Birth website.)

Last week, Robin got this great response from the Society of Obstetricians and Gynaecologists of Canada.

Dear Ms. Guy:

Thank you very much for your letter dated June 25th, 2008 regarding Breech Birth in Canada. Your letter was perfectly timed as the Society of Obstetricians and Gynaecologists of Canada’s (SOGC) Council Committee has just discussed and approved new guidelines that will offer choices to women who want to have a vaginal birth when there is a breech presentation. The breech guideline is now being copy-edited and will be published in the fall in the JOG. At that time, it will become official SOGC policy. A full press release will be prepared and we would be happy to have you, or someone from your group, participate.

The SOGC had a guideline in 1994. In 2000, given the results and the publicity surrounding breech delivery, we felt it was necessary to warn our members about the study and suggested they discuss it with their patients. At no time did the SOGC ever recommend cesarean sections for all breech presentation. I regret these comments reported by physicians and we will certainly work hard to correct these impressions.

The SOGC will also collaborate with the Association of Professors of Obstetrics and Gynaecology (APOG) to make sure that Breech Vaginal Delivery is taught properly in all medical schools in Canada.

Thank you very much for sending this information to me, I will circulate this information to SOGC Council. I will also put you on the mailing list for our guidelines, which are printed in the JOGC as well as being available on our website.

Yours Sincerely,

André B. Lalonde, MD, FRCSC, FSOGC, FACS, MSc
Executive Vice-President

Veronika from Dawson - Birth Stories

2008-03-31T20:15:00.000-07:00

Thank you to Veronika, from Dawson, Yukon, for sharing the birth stories of her two daughters with us!

In Prague, Czech Republic, I spent most of my working life in marketing business. The closest I ever got to the “birthing” was while working for Procter & Gamble, Pampers being my main brand. I visited lots of hospitals and even picked one for my own delivery. It amazed me with all its services – there was big hot tub, jumbo bouncing balls, single rooms with beds not only for mum and the baby, but for dad too.

Then I came to Yukon, met Tom, got pregnant and started to ask about Whitehorse Hospital. All the information I had got was pretty much positive – except for the rate of c-sections. That figure shocked me – for European it was unheard of. In spite of being pregnant for the first time I knew that I was built to bring my baby to this world in a natural way… and then I heard of midwives – midwives that were in Czech banished when communists took over and never established their practice again. That settled it.

I met Christina Kaiser in seventh month of my pregnancy. We spent whole day, we talked, she loaded me with advice and delicious brownies, checked on the baby, helped with leg-cramps by applying acupuncture. All felt very natural.

The day we arrived to Whitehorse next time, my labour started. It was at 9 am, August 18^th 2005, and I honestly did not realize what had been happening until about 3 pm. We called Christina and headed for Mendenhall, where she lived. When we arrived, “our” little cabin was ready, kids swimming pool was ready, and so was my midwife. I plopped myself into a soothing warm bath that took most of the initial pain away and enjoyed the peaceful atmosphere ( so peaceful that my husband actually fell asleep :o). When the bad pain came, Tom held my hand when I needed and Christina was massaging my lower back making the pain go away, talking me into breathing and, above all, telling me over and over again that I was doing a great job. At 1:51 am, August 19^th, Sofia was born. Pink, beautiful, those big dark eyes starring at me, perfect. Tom cut the cord.

Most of the necessary checking then went without us noticing – uninterrupted in our joy we spent hours with our new baby before we all hit the bed. It took us almost a month to leave Christina’s little cabin – month full of advice and practical help. Thanks to Christina I turned from literally all-that-everyday-baby-stuff illiterate into quite a confident mum.

… and so when Eva let us know she was there, we did not hesitate about where this one was to be born. But how different two pregnancies can be! While I hardly noticed with Sofia, Eva was giving me a really hard time. Problems culminated in the eight month with hemorrhoids so bad that after unsuccessful treatment with the only two ointments available and heavy painkillers, I ended up with a letter from one of the Dawson Medical Clinic’s doctors pleading Whitehorse Hospital staff to do a surgery on me. I called Christina instead. She gave me a shopping list and since very little could be purchased in Dawson, she went shopping in Whitehorse and found a way how to deliver that big box full of goodies (herbs, ointments, barks and lots more) to me. In two days I was able to operate again! (All the shopping, driving and phoning was part of the $2500 fee!)

Just like with Sofia, Eva decided that the dreadful trip from Dawson to Whitehorse was enough. The labour started at about 1 pm, December 8^th 2007.We went to Christina’s and again – my little pool was ready :o) Kids and daddies got together and ladies started to work. Eva was born at 8:17 pm, December 9^th.

It was a long and painful journey completed fully naturally only thanks to Christina. To each of mine “I can’t anymore!” she replied “Yes, you can.” and she would never let go of my hand or stop saying something about a great job :o) After teas, acupuncture and a brisk walk outside, we used an up-and-down the stairs method to enhance the contractions that subsided every time I went for the soothing bath. Eventually, we walked our way back to the pool and after quite a bit of pushing, Eva finally decided to come out. Tom ran in to see her coming, Sofia joined us right after.

Unfortunately, as exhausted as I was, I could not take care of Eva right away but there was somebody who did it for me: my midwife. Thank you, Christina, from all my heart!

Whitehorse Daily Star Article - March 17, 2008

2008-03-18T22:44:00.000-07:00

Women Look for Midwifery Reimbursement

by Stephanie Waddell

Two local women have submitted invoices to the Yukon government for a reimbursement of the money they paid to have a midwife oversee their childrens’ birth, rather than a doctor.

“It should be funded,” Asheya Hennessy, who last year formed the Yukoners for Funded Mid-wifery group, said in an interview this morning. “It is a primary health care service.”

Hennessy has chosen to use a mid-wife for the birth of her second child, while Desiree Pinkerton went to a mid-wife for the birth of her first baby.

Both sent letters and invoices in to Health and Social Services Minster Brad Cathers on Friday requesting reimbursements for the bills this year.

Hennessy said she requested reimbursement for the $2,500 service because it is an important part of health care in the country with numerous other regions, including Ontario, B.C., Manitoba, Saskatchewan, Nunavut and the Northwest Territories funding it as part of the health care system.

“It is so good for women,” she said.

While the government is looking at regulating mid-wifery in the territory, it is not funded.

Hennessy expects the territorial government will argue against funding until regulations are in place, which could take a couple of years.

As she noted though, Nunavut is devising regulations, but is also funding mid-wife care as part of the health care system.

She, Pinkerton and local mid-wife Christina Kaiser all stressed in separate interviews the mid-wife approach to births is based on informed choice, with the mid-wife pointing to the options and the risks and consequences associated.

One of the biggest differences Hennessy has noticed in dealing with a mid-wife compared to a doctor is that her mid-wife comes to her house for appointments instead of having to go to an office.

“I don’t have to wait,” Hennessy said.

Once the mid-wife is there, Hennessy is able to go over anything on her mind and ask questions, with her mid-wife taking the time to answer and point to Hennessy’s choices in various matters such as what tests to have and so on.

“A woman feels cared for,” she said.

With Hennessy just sending out the letter and invoice on Friday, she noted a week or two for Cathers to reply is fairly reasonable.

Pinkerton chose to go with a mid-wife’s care over a doctor for the birth of her daughter after speaking to a number of women who praised the care they received from midwives during their pregnancies.

Originally from Ontario, where it’s covered by health care, she soon learned it was not the same case in the Yukon.

“I was initially shocked that it wasn’t funded,” Pinkerton said.

That prompted discussions with her husband about whether they would pay for the services of a mid-wife.

After meeting local mid-wife Heather Ashthorn, Pinkerton said she put her “foot down.” She decided to pay for the birthing services that would enable her to make choices that worked best for her, such as giving birth in a hot tub at home, and make her feel confident in those choices.

Sending her invoice into Cathers was an opportunity to make a point that funding should be provided regardless of whether there are regulations in place and that process should be speeding up.

Kaiser has seen some women consider using a mid-wife for the birth of their child, only to opt out once they learn they must pay for it themselves.

“Of course it’s an issue,” she said, before noting that women who are determined to use a mid-wife’s services usually find a way to do so.

Hennessy and Kaiser argued there are flexible payment plans established for each patient, but it still remains a barrier for some women, especially Canadians who are accustomed to primary health care being funded by government.

Patients from Haines, Alaska, for example, are usually more willing to pay for Kaiser’s services, and it is usually cheaper to use a mid-wife than a doctor if a patient isn’t covered.

Kaiser would like to see her services available to all women, but with funding comes the issue of regulations.

If funding was to be provided without regulations, Kaiser would like to see it funded immediately.

Kaiser is part of the committee looking at regulations with the Yukon government, but that process is only at the first step of questioning whether regulations are needed.

Though becoming regulated could have advantages in terms of the industry being able to get insurance, Kaiser noted there could also be disadvantages in that with regulations, there are often restrictions.

“(Right now) we can do whatever we want,” she said of providing options for clients. “We do what our clients want.”

In other regions, however, there are restrictions such as no home births for women who have had Caesarian sections in the past.

In the Yukon’s case, Kaiser can tell her clients who have had Caesarian sections the risks involved in a home birth, leaving that choice up to the client, she noted.

“Mid-wifery is about informed choice,” she reiterated.

Cathers did not respond to the Star’s request for an interview on the subject this morning.

CBC Radio One, March 12, 2008

2008-03-13T10:35:00.000-07:00

Here's a transcript of the news stories about midwifery that CBC Radio One aired the morning of March 12. I also did an interview for the afternoon show at 5:10 pm on March 11. We will be continuing with media exposure, including contacting the newspapers, after we have submitted our invoices for midwifery services to the government and potentially received a response from them.

1. Saskatchewan midwives had a reason to celebrate last Monday. The proclamation of the Midwife Act made them a provincially recognized self regulating and publicly funded profession. Midwives in the Yukon are not so lucky. Their fees are not covered by Yukon medicare and the debate over whether they should be regulated is ongoing. Asheya Hennessey is the president of the Yukoners For Funded Midwifery. Her group is meeting with the department of Health and Social Services to discuss midwife regulations since last fall. Her organization is primarily concerned with ensuring midwifery is government funded but a lack of regulations could delay that goal. (Hennessey) "The department of Health and Social Services has definitely been very willing to work with us towards looking at midwifery services being integrated into the health care system and they do seem quite optimistic about it happening but we are going through this process where there will be a decision around whether it should be regulated and that may affect the length of time that it takes for midwifery services to be come fully integrated." The NWT has already passed legislation and Nunavut has draft legislation in place.

2. (6:30 a.m.) Saskatchewan has made midwifery a publicly funded profession on Monday. The president of the Yukoners For Funded Midwifery hopes that the territory will follow the lead. (Keitha Clark) Asheya Hennessey had her first baby in the Yukon two years ago. She wanted a midwife to help with the delivery but says it was too expensive. (Hennessey) "I think as Canadians we're just not used to paying for health care." Hennessey is due to have her second child in April and plans to have a midwife present to deliver her baby. She says it remains expensive but it's something she wants to do. Currently Yukon doesn't fund midwife services. When Hennessey founded Yukoners For Funded Midwifery in 2006 she hoped to change that but first the debate over whether to regulate the service must be wrapped up. She says if midwifery is not regulated it may become more challenging to obtain government funding. Her group has been meeting with the department of Health and Social Services since last fall to discuss this issues. (Hennessey) "This process where there will be decision around whether it should be regulated or not may affect the length of time that it takes for midwifery services to become fully integrated." The meetings wrap up next month which Hennessey says will be followed by public consultation on the issue. Hennessey is optimistic about the process, however, even if the regulation debate is wrapped up and funding is legislated she says that doesn't provide a financial solution for women like herself who are paying for a midwife right now. Hennessey hopes to submit a bill for her midwife services to the Yukon government later this week. (Hennessey) "It's hard to say. I mean it's worth a shot. I think it just demonstrates that we need the midwifery services now." NWT has already regulated midwifery and Nunavut has draft legislation in place.

*note, I changed the spelling of my name in these transcripts so it is correct - Asheya Hennessey

Evolution of childbirth practices

2008-03-11T12:07:00.000-07:00

Those of us who are involved in birth advocacy issues are very concerned about the medicalization of pregnancy and chidbirth, unnecessary medical interventions, rising Cesarean rates. It can be somewhat encouraging to consider how much better the whole child-bearing experience is for most women in Canada compared to 50 years ago.

I just read a great story about Norman Morris, a professor and obstetrician in the UK, who apparently had a huge impact on attitudes and practices surrounding childbirth. He died last month, so his career was chronicled briefly in the Telegraph.

Here's a taste:

Throughout his life Morris was guided by a deep humanism. He felt that the way in which women were traditionally treated by the health service was inhumane, and that the psychological stress involved often militated against the best possible outcomes and tended to increase demand for artificial pain relief.

Thanks to Kimberly from The Trial of Labor for the link.

Natural Birth and Homebirth Thoughts by Michel Odent

2008-02-19T21:06:00.000-08:00

This is a post by Michel Odent relating to natural birth and homebirth which I found at http://www.mothering.com/sections/experts/odent-archive1.html#natural-birth

My sister and I were discussing childbirth. She is very influenced by her friend, a nurse, to have an intrusive, medicalized birth. What kind of resources can I share with her to show her that a natural childbirth is a wonderful and safe birth choice?

Michel Odent: You might first explain to your sister and her friend that a natural childbirth is not a choice. This term can only be used in retrospect, when a woman has given birth without any drug and without any intervention. The environment where you give birth is the real choice. You must explain that your main objective is safety and that according to common sense an easy birth is safer than a difficult birth. So your priority is to make the birth as easy as possible thanks to an environment that can satisfy your basic needs when you are in labor.

Your basic needs are easy to explain in the current scientific context. Physiologists, scientists who study the body functions, tell us that adrenaline (the emergency hormone we release in particular when we are scared or when we are cold) makes difficult the release of oxytocin, the hormone necessary for effective uterine contractions. You can explain that you release a lot of adrenaline when you are in an unfamiliar and clinical environment. You can add that, in contrast, you can imagine yourself giving birth in a familiar environment, with - for example - nobody else around than an experienced, motherly, low profile and silent midwife knitting in a corner. It is probable that in such an environment your body will work well.

The second aspect of the safety preoccupation is: what to do if there is something wrong? In the age of the safe c-section and widespread cell-phones, there is usually an easy answer to this question, which should always be the second one.

Many health professionals need to learn to think in terms of 'ratio of benefits to risks'. Where out of hospital births are concerned, they immediately ask: 'what will you do if…' instead of asking first: 'how to make the birth as easy as possible'.

You are asking what kind of resources you can share. You might share data about the Dutch birth statistics. In Holland, where 82% of the midwives are independent primary care givers, about 31% of the births occur at home, and an autonomous midwife attends many of the hospital births. The rates of c-sections are around 10% for the whole country and more than 90% of the laboring women do not need an epidural anesthesia. The birth outcomes are much better than in the USA (number of babies alive and healthy at birth).

Do not recommend books about 'natural childbirth' because they are usually written for the converted. Instead you might suggest updated books focusing on one of the main aspects of industrialized childbirth, such as 'The Caesarean. Free Association Books 2004'. In order to help your sister and friend to learn to think long term, you might indicate the 'Primal Health Research Data Base' that is specialized in studies exploring the long term consequences of what happened at the beginning of our life. It appears that the way we are born has life long consequences and that, today, in spite of the safe caesarean, we have good reasons to try to rediscover the basic needs of women in labor and of newborn babies.

YFFM Meeting, Saturday, March 1

2008-02-18T12:18:00.000-08:00

Come out and have a voice in what happens with midwifery in the Yukon! Babies & children are welcome – since we are meeting in the library, I would suggest bringing toys for them to play with.

When: Saturday, March 1, 2008 @ 10:30 am
Where: Whitehorse Public Library, Meeting Room 1

My Prenatal Experiences with a Yukon Midwife

2008-02-15T09:49:00.000-08:00

***by Asheya Hennessey***

When a home pregnancy test confirmed my pregnancy with my second child this past summer, one of the first people I called with the good news was Christina Kaiser. Christina is one of two practicing midwives in the Yukon, where midwifery services are currently not funded by the government and not integrated into the health care system. Christina was happy to hear my news, and we booked an appointment for a few weeks later. She has been my primary health care provider during this pregnancy ever since.

I am now seven months pregnant, and I thought it was about time that I shared my experiences. There are so many things I enjoy about having a midwife for my prenatal care, it's hard to know where to begin! I think this will end up being a bit of a compare and contrast, as a doctor was my primary health care provider for my first pregnancy, and I can't help but see the differences. I think my previous experience with a doctor has also helped me to appreciate Christina's care all the more.

One of the first things that struck me as being different from the prenatal care I received from a doctor is that Christina comes to my home for appointments! I can remember waiting over an hour in the doctor's office for a fifteen minute appointment, but Christina sits in my living room and we usually talk for over an hour. I love having the time to tell her how I am feeling, both physically and emotionally, and to ask tons of questions about different pregnancy and birth related options, such as what remedies I can use for heartburn, or what the pros and cons of a water birth are. There are different things to discuss at each stage of the pregnancy, such as whether or not I want to get an ultrasound, or if I want to get tested for Strep B, or if I prefer an active or passive approach to the third stage of labour, and as each topic comes up I can ask Christina for information and then I get to make the decisions without pressure from her. With the doctor it was quite different: it was more of a 'this is the way things are done' and if I wanted something different I felt I had to argue my case.

I also really appreciate how Christina remembers what I've said in previous appointments. For instance, I knew I didn't want to listen to the baby's heartbeat with the Doppler, which is an ultrasound device. I was okay with waiting to hear the baby's heartbeat until it could be heard with a fetoscope. When I was pregnant the first time, I told my doctor right away that I didn't want to use the Doppler, but she kept forgetting and I had to keep saying 'no thanks,' which felt a bit awkward. Once I told Christina that I didn't want to use the Doppler it was never an issue, and I still felt that if I changed my mind I could always ask for it.

A typical appointment starts with Christina asking how I am feeling, so I share my different pregnancy related woes, such as nausea, heartburn, backache, fatigue, mild cramping, cravings or whatever else I have been experiencing. It's great having someone listen to you complain, and you know that it's actually part of what you are supposed to be doing! My sense is that asking how the woman is feeling is an important part of how a midwife takes care of her client, because not only does it make the woman feel cared for, but what the woman is feeling may reveal something that is a symptom of a problem, which will allow the midwife to catch it and be able to address the problem. My pregnancy is perfectly healthy and normal, but it's reassuring to know that I'm being listened to in case there is a problem.

After we discuss how I am feeling, we usually discuss some informational sort of topic that has to do with my options, such as remedies to treat my complaints, or tests in pregnancy, or options in childbirth.

Christina takes my blood pressure and my pulse at every visit, and she gives me the choice of whether or not I would like to be weighed. I always opt to be weighed because I like knowing how much weight I've gained in the pregnancy. Similar to how it's done at the doctor's, I pee in a jar and she checks my urine with one of those little strips of paper that gives information about pH and leukocytes and other things that could be indicators of potential problems. Once my belly got big enough, she started measuring it at each appointment.

I like how our appointments are casual, and if there's something I've been meaning to mention but forgot about, there's lots of time to remember. Another aspect of the care I'm receiving that I really appreciate is that I can call Christina if I have questions or concerns in between our appointments. I called her once because I had taken a bath with eucalyptus essential oil, and felt quite sick. I was concerned, because of course after I'd taken the bath I looked up eucalyptus and saw that it was contraindicated in pregnancy. She was able to provide me with information and advice over the phone. I've also called her when I've been feeling really emotional and scared that I was going to lose the baby - this has happened to me in both pregnancies around 22 weeks, and it was really nice to have a professional to talk to at length this time! I've called her with a few other concerns as well, and it's always so comforting to know that she is easily accessible.

Having my two year old son around for the appointments, in the familiarity of our own home, has also turned out to be a bonus that I didn't anticipate. He can play with his toys, get a snack etc. while we visit, and he also gets to participate in some of the 'new baby' activities, like using a stethoscope to listen to my heartbeat, measuring my belly, and listening to the baby's heartbeat with the fetoscope. I think that being part of caring for the baby while the baby is still inside me helps him to bond with the baby and feel even more excited about the birth of the baby. We are planning a homebirth, so I think it's also really great that he can get used to Christina being in our home, and it is helping to prepare him for her presence at the birth.

I believe that Christina's philosophy about pregnancy and childbirth is very similar to mine, which is that pregnancy and birth are a normal part of a woman's life, and it is better not to interfere or use interventions unless there are actual problems that need to be addressed. This is a pretty basic tenet of the midwifery model, while the medical model tends to come at pregnancy as an abnormal condition, which only makes sense because doctors are trained to address and find solutions for states of ill health. It's very relaxing for me to be working with a health professional who has a similar philosophy, because I don't feel that I have to convince her into my way of thinking or fight her about the decisions I make. I also don't feel intimidated by her; I can ask questions and express my thoughts without feeling like there is a hierarchy and I'm on the bottom. I think this sense of equality is demonstrated in something as basic as how I address her: I call her by her first name, whereas doctors are most commonly referred to by their last name with the title of 'Dr.' in front, which sets up the hierarchy before you even meet the person.

I am very happy that the health professional who will be attending the birth of my baby is someone who I have gotten to know and like, and that she similarly knows me. When I gave birth to my son in the hospital I was quite anxious because I didn't know who would be my nurse or even which doctor would be attending. And I knew that they wouldn't know me, which would make it harder for me to communicate my choices. I am eagerly anticipating birthing this child at home, surrounded by people who know me and who I know. And not having to drive to the hospital when I am having contractions is just a bonus! I trust Christina, and I think this is very important. I know that research indicates that fear can make labours longer and harder, and so I am very grateful to be able to give birth in an environment where I feel safe, and where I trust that my health professional will listen to me.

If you would like to know more about Christina and how to contact her, you can visit www.yffm.ca/midwives.htm

Clara's Birth Story

2008-02-14T19:58:00.000-08:00

Here's a birth story that was sent to me by a friend in southern B.C. Clara is her first daughter and she was born at home this past summer.

It's interesting to read about what midwives do in other places and to see the range in philosphies. For example, Paige mentions that her midwives considered doing an episiotomy, a procedure our two Yukon midwives probably rarely (if ever) practice. As we move forward in the regulation process, we're trying to ensure that we leave as many options open as possible so that women will be able to have the kinds of births they want, and midwives with all sorts of different philosophies will feel comfortable.

Here's Clara's birth story:
The home-birth went amazingly well, and definitely because of the amazing support we've had from our mid-wives. I can't say enough about the care we received from them, and wish you all the best in advocating for them in the Yukon.

Our home birth was planned (phew!). I was at 41 weeks and 3 days, so was due for a 'non-stress test' at the hospital in the afternoon. Fortunately, we'd had an appointment the day before where the mid-wife did a 'stretch and sweep', gave us some evening primrose oil capsules (one to take orally, and one internally by the cervix) and provided the recipe for the labour 'cocktail' to help promote labour. It worked!

I had my first contraction at about 4am, although I was able to stay sleeping until about 6am when I normally woke up in the summer. My water broke at that point, although not as a big gush, so I wasn't sure of it at the time. After that, it was obvious that I was having contractions, although not in any particular regular pattern. I made up the cocktail and took that - vile, but did the trick! My contractions became quite regular by about 10am.

We called the mid-wife to cancel the non-stress test, and she came by at about noon. While all this was going on, the rest of the farm folk had gathered outside for their regular lunch, and I could hear their excitement in the background - "here we are eating lunch, and Paige is in labour up there!". I got in the pool sometime after that, and eventually got out of it again because I was too relaxed in there. After some moving around, I settled on our couch (safely covered in a plastic sheet) and fairly quickly gave birth to little Clara (who was not so little, after all!).

Our regular mid-wife had called her back-up at some point. I recall her showing up while I was in the pool, although I was too concentrated to really see her. I could hear them consulting and recording every time they monitored the baby's heartbeat, and there was a little concern that it was going slowly (I ended up pushing for nearly two and a half hours). Once I made it to the couch, the second mid-wife took the lead in coaching me, and I remember her voice cutting through and being really clear - push NOW! HOLD IT! PUSH AGAIN! I couldn't believe it when the baby slipped out (at 5:04pm).

They'd frozen my perineum in preparation for cutting, but fortunately didn't end up needing to. I tore a bit, but not badly. They also had to give me a shot of pitocin to encourage contractions to deliver the placenta, but I was on such an adrenalin rush and so relieved that labour was over, I hardly noticed. The placenta delivered fine, and they put me back on the couch with Clara on my chest where she started nursing while they sewed me up. What a trip!

Chris had started calling family by then. My mom was with us, which was great, and Chris' folks got to hear some of her first cries, which they were pretty over the moon about. That moment when you go from being pregnant to having a baby on your chest is so incredibly miraculous. I remember stroking her, hearing her crying, seeing Chris crying, telling her we loved her and were glad she had arrived safely, and just being so amazed that I was done with labour. The preparation we'd had with the midwives about labour was so helpful. I don't remember it as being particularly painful exactly, because I was able to experience it as the culminating event of pregnancy and the process of my baby's arrival. Mind over matter, indeed!

...and we're back!

2008-01-19T20:12:00.000-08:00

Wow, time has flown and there hasn't been ~~much~~ any activity on this blog for quite a few months. My apologies. We've had a pregnancy (Asheya), a miscarriage (me), and lots of travelling and holidays and unfortunately this blog sort of fell through the cracks. But there has been lots going on in our work to get midwifery integrated into the Yukon health system.

In a nutshell, there have been meetings with Health and Social Services, a process established for getting midwifery regulated, a working group put together to work on that process, as well as two meetings of that working group.

Asheya is working on a summary of what we've accomplished so far, and that should be posted soon. We have ideas for more education campaigns we can do over the next little while, and we're still thinking about getting a screening of the movie I wrote about in my last post. Plus we have some birth stories that are getting polished up that we'll be able to share with you soon.

Stay tuned!

The Business of Being Born

2007-10-11T13:57:00.000-07:00

I just heard about this exciting new childbirth advocacy movie. The article below has been copied from the "Navelgazing Midwife" blog. I think I'm going to run off now to see how we can get a screening here in Whitehorse!

“The Business of Being Born” & Its Effect on Audiences
by Barbara E. Herrera, LM, CPM

I’ve watched fourteen audiences walk into and then out of Ricki Lake’s childbirth advocacy movie “The Business of Being Born,” and the word that stands out is transformed.

Natural birth advocates leave natural birth fanatics.

Pregnant women walk into the movie as patients at local hospitals and walk out with resolute plans to leave their doctors and find a midwife for a birth they know will be safe and respectful.

I’ve role played with women who want out-of-hospital births (or out of unsupportive doctors) after seeing the film, but whose partners (who wouldn’t attend the screening) are fearful – helping them with ideas to get their loved ones to the movie.

And families who were initially hesitant to support a midwifery-attended birth have become ardent supporters intent on converting their misunderstanding friends.

I’m finding it challenging to get the press to either view the movie or to cover the importance of it in our community. It seems some people find natural birth not newsworthy… a big ol’ yawn.

But, how can any thinking person who cares about the effects of hormonal attachment/detachment that occurs during birth in our culture find this unimportant? How could someone yawn about the economics of slicing a person open for convenience's sake (the convenience of the clock, the wallet and the courtroom)? I would think that someone with any semblance of a heart would "get" that birth as it stands today is abhorrent and a complete overhaul is needed.

This movie explains why it goes far, far beyond having or having not medication at birth... it is an entire mindset of respect for a woman's autonomy and the understanding that choices in birth create the most amazing human beings that walk in our neighborhoods. Damaged women and babies do nothing but hurt the world... why foster the continuation of such cruelty?

If the right people saw the movie, the word would get out. That is what is so challenging about the publicity surrounding this movie. It has amazing amounts of well-documented –and jaw-dropping – information that relatively few know about. The people seeing the movie could quote the statistics chapter and verse! It’s those that haven’t seen the movie that need to plop their butts in the seats and then they need to tell others about it from their points of view.

If you’re reading this, you can do your part by either attending the movie yourself if it is in your area (check www.thebusinessofbeingborn.com) or sponsoring a viewing.

If you are so inclined to educate the public about the movie, write letters and send fliers to whomever you can – the press, letters to the editor, your email lists, friends, family, support groups, children’s pre-schools, middle and high school health and sex education teachers, women’s studies programs, child development programs, psychology classes, childbirth education teachers, local midwives (including Nurse-Midwives), La Leche League leaders, head nurses on Labor & Delivery floors, friendly obstetricians, chapter leaders of the International Cesarean Awareness Network, local leaders of midwifery organizations, natural clothing stores, cloth diaper suppliers, childbirth educators and lactation educators as well as putting fliers on bulletin boards at natural food stores and attachment parenting baby stores, Babies R Us and other kid-friendly stores and locations.

Together, we can bring more people to know what we’ve known for far too long. Birth can – and should be – an honored and cherished experience, no matter where, or how, it occurs. It is in the knowledge of options and in the light of respect and humanity that birth becomes perfection.

Perfection is rightfully ours.

"Sorry guys, tits are for kids"

2007-09-18T09:16:00.001-07:00

Did anyone find that offensive? Well then you might not want to look at the offensive blog post I'm about to link to. It's a great, tongue-in-cheek look (no pun intended) at a society that thinks nursing in public is somehow obscene.

I've heard of places in Whitehorse who have asked nursing mothers to leave (well, one place) but thank goodness it's generally a breastfeeding-friendly town. Let's see, places I've nursed in Whitehorse include: the library, Klondike Rib & Salmon, Giorgio's, La Gourmandise, Wal-Mart, Superstore, the Health Centre, the Women's Centre, Shopper's Drug Mart, Qwanlin Mall, Mac's, and my office (Yukon Government Public Service Commission - and after an interview, no less).

Check it out (and don't miss the comments, either, from which I pulled the title for this blog post):
http://mamamojo.wordpress.com/2007/09/12/breastfeeding-in-public-warning-offensive-content/

Seventh Annual Health and Wellness Fair and Festival

2007-09-14T15:32:00.000-07:00

What a busy weekend in Whitehorse! It seems that there are all sorts of activites now that fall is in full swing. YFFM will be participating in the Health and Wellness Fair at the High Country in on Saturday and Sunday. The theme for the fair is “Our Bodies, Our Earth: Healing from the Ground Up”.

There will be speakers, health care resource people, booths, workshops, consultations/sessions with practitioners, silent auction and product sales in a family-friendly environment. This year, organizers are adding a new element by giving the event a bit of a festival twist, with outdoor activities, face-painting, clowning, and crafts.

Come check out this fun event and swing by the YFFM booth to say hello!

Yukon Wholistic Health
& Wellness Fair…
… and Festival !!!

“Our Bodies, Our Earth:
Healing from the Ground Up”

Sat. Sept. 15 (10am-4pm)
Sun. Sept. 16 (10am-4pm)

High Country Inn & Jim Light Park
Whitehorse, Yukon

Opening Ceremony: Sat. Sept. 15, 10:00 am

Yukon News Article - August 15, 2007

2007-08-16T14:39:00.000-07:00

Expecting moms poorly served in rural Yukon
By Chris Oke News Reporter

Roxanne Ladue was hoping for a girl. And who could blame her? The expecting mom had been sharing a hotel with her husband Brian and their four sons for nearly two weeks. The Ladue family is from Watson Lake where there is a hospital but no maternity ward. So, for the fifth time, the family packed up the car and drove five hours to Whitehorse – the only hospital in the Yukon where women can come to give birth.

“It’s a safety issue,” said government spokesperson Dennis Senger. It’s a question of having the doctors available. There are specialists in Whitehorse that can’t be in every community.

“That’s why they’re expected to come in. To make sure everything goes well.”

“There seems to be a memory loss in the modern era,” said Senger. “People have forgotten how dangerous (childbirth) is; we take it for granted.”

Even though her due date was last Saturday, Ladue expected to stay a little longer.

“I haven’t had any of my kids on my due date. They’ve all been 42 or 41 weeks. Then we’re here for three or four weeks, in a hotel.”

“It’s stressful,” she said.

And it could be this stress that caused her children to be overdue. Her doctor told her that many of the women coming from the more distant communities, such as Dawson City and Watson Lake, experience the same problem.

The stressful final trip isn’t the only visit to Whitehorse that expecting mothers have to make. Prenatal monitoring can be done by nurses in the communities, but moms still need to make at least three trips to Whitehorse to see a doctor. They then need to arrive two weeks before their due date.

As a First Nations person, Ladue’s hotel bills are covered under non-insured health benefits. Everyone else needs to pay for a hotel or go to the Victoria Faulkner Women’s Centre, she said. However, the women’s centre isn’t an option for many families.

“You can stay there and your husband can stay with you, but your children can’t,” she said.

Even with First Nations benefits, Ladue has been told that as soon as she goes into labour her hotel room is no longer covered.

“If you go into labour at 4 o’clock in the morning, who’s thinking about packing up their stuff and checking out?”

Ladue knows of at least five other expecting mothers who will be coming to Whitehorse this month from Watson Lake alone. Watson Lake used to have a specialist but the doctor has since moved away and now only returns every few months, she said.

One possible solution could be midwives.

For the last two years, there has been a movement to get midwifery accepted in the territory. There are currently only a few practicing midwives in the territory, such as Heather Ashthorn who owns and operates the Almost Home Maternity Centre in Whitehorse, which offers prenatal and postpartum services.

However the Yukon government doesn’t fun midwife services and they don’t come cheap. Private midwife care will set a family back by $2,500.

Ladue suggested that the First Nations and government come together to build a facility, so that families such as hers can have a place to stay while they wait to give birth. She also recommended providing programming for the family, or at least a children’s playground. Trying to keep four boys from getting bored has been expensive in the Yukon’s capital city, Ladue said.

“A lot of people can’t afford to come to Whitehorse for a month at a time.”

Then there’s the loss of work time. Brian Ladue is a contractor in Watson Lake, and the two-week trip to Whitehorse is affecting his job.

“It’s the most difficult part of your pregnancy,” said Ladue. “Being away from home and cooped up in a hotel room only makes it worse.”

(Ladue gave birth to a healthy baby boy on Tuesday.)

Spencer's birth story

2007-08-07T11:17:00.000-07:00

For those of you who enjoy birth stories, here's one that I recently came across in my Internet wanderings. The writer is in Hamilton (another Ontario story - they must have a lot of mommy bloggers out that way) and there were three midwives and a doula involved in this homebirth. I thought it was a beautiful story that highlights how amazing our bodies are, how beautiful birth is, and also how important it is to take charge of your own care.

Happy reading!

Birthing Spencer: The Whole Story

Caesarean rates follow-up

2007-07-27T12:01:00.000-07:00

My friend Robin is very involved in birth advocacy, particularly in educating women (and the health system!) about the advantages of vaginal birth for breech babies. I admit it sounded a bit wild to me when I first heard about it, but when you actually look into it, it turns out that, for certain breech babies, the risks of vaginal delivery are no higher than C-section deliveries. (You can find out more about this at the Coalition for Breech Birth website: www.breechbirth.ca.)

Anyway, I am bringing Robin in here because The Ottawa Citizen ran a story very similar to the CBC story I posted earlier, and she wrote an excellent letter to the editor about the risks of having a high C-section rate. You can read her letter without having read the related Citizen article, but if you're interested in it, here's a link.

Good afternoon!

I was delighted to read your article this afternoon regarding concern over the rise in caesarean rates.

I am one of the co-founders of the Coalition for Breech Birth, an Ottawa-based grassroots coalition working for the re-normalization of breech birth.

I admit that I was shocked to read that Andre Lalonde suggested "there has been a recent push to encourage women with breech babies to deliver vaginally." It is nearly impossible to achieve a vaginal breech birth in Ottawa, especially in the hospital (homebirth with a midwife is an option most women are not aware of). Just this past Monday, a woman who contacted us was forced to fight tooth and nail to achieve a vaginal breech birth at the Civic. She was lectured, coerced, and threatened by the doctors, residents, and nurses, and told (incorrectly, according to the published evidence) that she was endangering her baby. How is this "encouraging" a woman to birth vaginally? It's not even "supporting" an intelligent woman who has already done her research and has made an informed decision about the best birthing mode for her baby. In addition, unless there has been a very recent change, the guidelines of the Society of Obstetricians and Gynaecologists of Canada still state that the standard of care for breech birth is Caesarean surgery, and most obstetricians fear professional censure should they openly offer options that go against their organization's recommendations.

I was also astonished and disturbed to read your quote by Dr. Walker: "Is a 25-per-cent C-section rate a bad thing? I don't think there's the data out there to qualify that it's bad ... What we want is healthy mothers and babies. That's the outcome we want." While it cannot be argued that "healthy mothers and babies" is the basic goal of childbirth, this is the most basic of goals, and "healthy" is a subjective term. A mother who experiences surgical birth unnecessarily walks into the hospital healthy, and leaves the hospital permanently injured, with a uterine scar that makes many obstetricians recommend that she not attempt vaginal birth in the future.

The long term physical and emotional ramifications of surgical birth go far beyond the limited 6 week follow up period for which obstetricians typically follow women. Every surgical birth a woman experiences increases the liklihood of another surgical birth; and with every subsequent surgical birth, the risks grow higher for the mother. Ultimately the number of babies a woman can carry is limited by surgery; a woman who has had 3 surgical births is generally told not to have more children, because her uterine strength has been compromised by the repeated surgeries. Peer-reviewed evidence shows that women who experience surgical birth are more likely to suffer from post partum depression, experience difficulty bonding with their babies, are much more likely to have difficulty breastfeeding, develop painful or even debilitating scar-tissue adhesions, experience bowel or bladder incontinence, have varying degrees of permanent nerve damage, and are three times more likely to die in childbirth. The World Health Organization has stated that no developed nation should have a caesarean rate of over 15%. This means that nearly half of the surgical births in Canada are not needed, at great detriment to the families trying to adjust to a new baby and recover from major surgery simultaneously. What data Dr. Walker is still waiting for is very unclear.

As a woman who experienced both an unmedicated vaginal birth, and surgical birth for no medical indication other than encountering an obstetrician on call who was not qualified to catch a breech baby, I can attest that a "normal" recovery from this surgery, and the recovery from normal vaginal birth, are worlds apart. Mothers are often very traumatized by surgical birth, especially if they have done their homework and know, or even suspect, that the surgery was not needed. Doctors who treat surgical birth as "equal to or better than" vaginal birth demonstrate that they are exceptionally short-sighted and out of touch with the needs of birthing families. There is far more to having a baby than the simple extraction of the child. Treating birth as a pathology that needs to be cured, and that has no merits of its own, is a fundamental disrespect of a natural and safe process of the female body, and demonstrates a paternalistic and condescending attitude towards the woman and her family. The complete, accurate information, and the choices, belong in the hands of the people who live with the consequences of the birth.

I invite you to visit our website and read our stories, as well as the peer-reviewed research presented on the Articles page regarding the safety of vaginal breech birth. I would be delighted to discuss the issue further, and would be deeply grateful for any exposure you can give to this issue.

Best regards,
Robin Guy
613 820 7995
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Coalition for Breech Birth: www.breechbirth.ca.
Please visit and consider signing our petition to have the SOGC change its breech birth guidelines.

"Refusing vaginal breech birth is a human rights violation in that it forces women to consent to surgery in order to obtain medical care. The right to informed consent is meaningless where there is no access to informed refusal." - Henci Goer, author of "The Thinking Woman's Guide to a Better Birth"

More Canadian babies born underweight, by C-section: report

2007-07-26T16:07:00.001-07:00

An article on CBC's website today states that the rate of C-sections continues to increase. While C-sections are, of course, sometimes necessary, it's disturbing to think that part of the reason for the increase is simply that "more obstetrical interventions are becoming accepted".

Here's an excerpt from the article. Click on the article title to go to the full article on CBC's website.

More Canadian babies born underweight, by C-section: report
Last Updated: Thursday, July 26, 2007 2:21 PM ET CBC News

More Canadian babies are entering the world in difficult circumstances — underweight and through caesarean sections, says a new report on birthing trends from the Canadian Institute for Health Information.
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The report also finds that the number of women giving birth by C-section in Canada has risen over the past five years, to 26 per cent in 2005-06 from 23 per cent in 2001-02. Though it is lower than the 29 per cent rate in the United States and Australia, it is higher than England's rate of 24 per cent.

CIHI's analysis found that women who had undergone a previous caesarean section had an 82 per cent chance of having a second one, up from 73 per cent in 2001-02.

Heick says that increasing obesity levels among women are resulting in more C-sections, as obesity can lead to dangerous pregnancy complications that require emergency surgery. She also says changing hospital practices are increasing surgical rates. "More obstetrical interventions are becoming accepted," she told CBC News.

Women having C-sections are on average slightly older than those delivering vaginally, the study indicated.

The World Health Organization recommends that no more than 15 per cent of all births should involve a caesarean section.

Outcomes of planned hospital birth attended by midwives compared with physicians in British Columbia

2007-07-24T14:39:00.000-07:00

Thanks to local midwife Heather Ashthorn for sharing this recent study conducted in British Columbia.

The article is a bit technical, but the message is simple. For women with normal pregnancies, births attended by midwives involve far fewer medical interventions than those attended by doctors AND they are just as safe. Healthy mommies, healthy babies, and major cost and resouce savings for our medical system -- what more could you ask for?

Birth. 2007 Jun;34(2):140-7, Outcomes of planned hospital birth attended by midwives compared with physicians in British Columbia.

Janssen PA, Ryan EM, Etches DJ, Klein MC, Reime B. Department of Health Care and Epidemiology, University of British Columbia, Vancouver, BC, Canada.

BACKGROUND: The impact of midwifery versus physician care on perinatal outcomes in a population of women planning birth in hospital has not yet been explored. We compared maternal and newborn outcomes between women planning hospital birth attended by a midwife versus a physician in British Columbia, Canada.

METHODS: All women planning a hospital birth attended by a midwife during the 2-year study period who were of sufficiently low-risk status to meet eligibility requirements for home birth as defined by the British Columbia College of Midwives were included in the study group (n=488). The comparison group included women meeting the same eligibility requirements but planning a physician-attended birth in hospitals where midwives also practiced (n=572). Outcomes were ascertained from the British Columbia Reproductive Care Program Perinatal Registry to which all hospitals in the province submit data.

RESULTS: Adjusted odds ratios for women planning hospital birth attended by a midwife versus a physician were significantly reduced for exposure to cesarean section (OR 0.58, 95% CI 0.39-0.86), narcotic analgesia (OR 0.26, 95% CI 0.18-0.37), electronic fetal monitoring (OR 0.22, 95% CI 0.16-0.30 ), amniotomy (OR 0.74, 95% CI 0.56-0.98), and episiotomy (OR 0.62, 95% CI 0.42-0.93). The odds of adverse neonatal outcomes were not different between groups, with the exception of reduced use of drugs for resuscitation at birth (OR 0.19, 95% CI 0.04-0.83) in the midwifery group.

CONCLUSIONS: A shift toward greater proportions of midwife-attended births in hospitals could result in reduced rates of obstetric interventions, with similar rates of neonatal morbidity.

PMID: 17542818

Health & Social Services met with Community Services

2007-07-17T09:27:00.000-07:00

Everything slows down for the Government of Yukon in the summer because so many people take this time to have some holidays. Despite that, I'm pleased to announce that the Policy Analyst we've been working with at Health & Social Services sent me an e-mail to inform me that she and her supervisor were finally able to meet with some representatives at Community Services on June 28th.

According to her: "The meeting was very useful and we have received their approval (with a few minor tweakings) for the plan I developed. I anticipate being able to provide a further update in the later part of July or early August."

Write to your MLA

2007-07-10T09:18:00.000-07:00

It's important for the government to know that midwifery is important to Yukoners. If you support having midwifery services integrated into our health care system so that all Yukon women will have more choice, then write a letter to your MLA to let him or her know!

Below is a sample letter that you can copy and paste. Remember to fill in your MLA’s name and your name You can find your MLA’s email address at http://www.legassembly.gov.yk.ca/contact.html.

To the Hon. ------

I am a member of your constituency and part of the group Yukoners for Funded Midwifery (www.yffm.ca). I am contacting you to let you know that the integration of midwifery services into the Yukon health care system is very important to me. All women in the Yukon should have choices in high quality maternity care, and funding midwifery services would allow all Yukon women access to the option of midwifery services.

Our group has been meeting with a policy analyst from the department of Health and Social Services, and as midwifery would have to be regulated to funded, the department of Community Services is involved as well, since it is responsible for regulating health professions under the Health Professions Act. We are in the first stage of regulation, which is asking the question, “should midwifery be regulated?” This question will be put to cabinet after an information gathering process.

I’m hopeful that midwifery services will be integrated into our health care system in a way that meets the unique needs of the Yukon. Thank you for your involvement in representing my voice on this important issue.

Sincerely,

Your Name Here

Midwifery around the world

2007-06-21T09:01:00.000-07:00

Today we have Rachel from Faro sharing her experiences with midwifery in Germany.

"I am a Canadian but my husband is in the British military and we were posted in Germany. I had a midwife until I gave birth and then under German law they had to send me to the hospital to deliver.

My first midwife was Dave (the "wife" part of midwife refers to the pregnant woman). He was great and I felt very comfortable with him. He had delivered about 400 babies before working for the British Military. My second midwife was Alison who had even more experience than Dave. She was great also.

I would have loved to have had a home birth like my brother-in-law's partner in the UK but now we live in the Yukon so I am not sure I can. I do think the care I got was better than what a lot of my friends got here.

However, I will point out that the breastfeeding rate in the UK was around 60% that attempted, and most women breastfed for a short time. I was also horrified that the recommendation for drinking alcohol when pregnant was no more than 3 drinks a week and I was one of the few who abstained from drinking alcohol during my pregnancy. Alison, my midwife, said that most of the Canadian women she knew abstained. No one talks about FAS.

That is my experience.

Rachel"

It's too bad about being required to give birth at a hospital. That's one of the things we would like to avoid as we move forward with regulating midwifery in Yukon; we believe that a woman should be able to choose where to give birth, whether she is most comfortable at home, in a hospital, or in a birthing centre.

Thanks for sharing your story, Rachel. And just so you know, with midwifery unregulated in the Yukon, almost anything goes at this point. You can have a home birth, if you choose to do so, and if you and your midwife decide that's best. However, right now it's much more difficult for a woman to have a midwife and give birth at the hospital; hospital policies don't allow for that to happen.

There is currently no practicing midwife in Faro, but I know that there have been some families who have had midwives come up from the south to attend their births (so you won't get your prenatal care from a midwife); or perhaps you might work something out with one of the midwives in Whitehorse. One of the wonderful things about midwifery is how flexible it can be!

YFFM activity update

2007-06-15T14:06:00.000-07:00

Today Asheya and I met again with the Policy Analyst for Health and Social Services (H&SS) to get an update on the regulation process. Unfortunately, things have not moved as far as we would have liked, but it was still a great meeting with some very interesting exchange of ideas.

We learned that besides H&SS, the department of Community Services has to be involved in the process because they are the ones who are responsible for administering the Yukon Health Professions Act. Since midwifery is going to be the first health profession to go through the entire regulation process under the Health Professions Act, input is needed from Community Services to determine what that process is going to look like.

At the moment, though, Community Services is going through a lot of change (with managers moving around and new folks coming in), and they are also dealing with a few major policy reviews. Diane hasn't even had a chance to meet with anyone at Community Services to agree on a work plan. However, it looks like that meeting might happen in the next two weeks, so we're keeping our fingers crossed that they like the plan that she has drafted up.

So we're still in "Phase I" of the regulation process (a.k.a. the "designation" process) which is to provide Cabinet with enough relevant information that they can answer the question, "Should midwifery be regulated?" Or put another way, "Is it in the public interest to regulate midwifery?" If you had heard the discussion we had in that meeting room, you might be surprised at all the different questions that need to be asked just to answer that one! The major challenge is to separate the issues of whether it should be regulated with the issues of how it would be regulated.

I've never been particularly interested in policy development, but having had a glimpse, I can see how one could get caught up in the excitement of investigating all the facets of a given issue. On the other hand, if the issue were something other than midwifery, I wonder how long it would stay exciting...

Stories from blog readers

2007-06-08T12:49:00.000-07:00

Today we have a few words from Jamie, a friend who lives in St. Catherines. This is an excerpt from a blog posting she made a few months ago.

"I had midwives for both my kids and have nothing but good things to say about them. My first birth ended in a C-section, at which point my midwife turned into my advocate and advisor, a very valuable resource when you are scared about your baby's safety. I think that midwifery should be the standard for birth, with OBs being available for when they are needed in high-risk pregnancies. I definitely think that OBs can be great as well, I just think that their expertise can be better spent working soley with women that need them.

I was at the doctor the other day with Derek. We arrived at 11:50 for our 12 o'clock appointment. When we arrived there was one baby that was a week old, one baby that was 5 weeks old, one that was 2 months old, 2 that were 4 months old, one that was 6 months old and 2 children (including Derek) that were there because they were sick. I cannot figure out why a pediatician needs to weigh all these babies. Most of them would have been there for simple check-ups, routine stuff that their expertise is being wasted on.

My sister-in-law lives in England and there everyone has a midwife unless they are high risk. Another thing they have there is something called a Health Visitor. According to her this is a nurse that visits your home after you have a baby and will weigh your baby and make sure that they are reaching the necessary milestones. They continue this way for about a year (I think). I think this is a wonderful system (though I am sure that there are flaws in it like there are with everything). It would save the doctors time so that when a sick baby (like poor Derek) comes in he doesn't have to wait for an hour to see the doctor, and more importantly, all those healthy newborn babies arn't being exposed to germs from sick kids."

Thanks for letting us use your post on our blog, Jamie!

Now, if you have some thoughts or a story to share, e-mail us at yukonmidwifery@gmail.com.

A woman in bloom

2007-05-31T20:53:00.000-07:00

Thanks to Melissa Valja for submitting this beautiful photo.

Melissa is an artist and an aspiring midwife in Whitehorse, Yukon. She will be presenting an art show at the Victoria Faulkner Women's Centre later this month.

June 28th at 7pm Art Open House
"Body Landscapes" by Melissa Valja

An exploration of meanings we place on our bodies and our land, through black & white and colour photography. The images are from Northern Ontario, Toronto, and Old Crow. Melissa Valja is an artist who likes to explore the interconnection between the way we treat the Earth and the way we treat our bodies.

Join us for an art party with food and fun and creativity.

Victoria Faulkner Women's Centre is located at 503 Hanson Street, Whitehorse. Contact 667-2693 or vfwc@northwestel.net for further details.

Funded midwifery care should be on "The Great Canadian Wish List"

2007-05-30T23:01:00.000-07:00

To recognize Canada's 140th anniversary, CBC is doing a special called The Great Canadian Wish List . They are asking Canadians to put wishes for Canada on Facebook and then gather supporters. CBC News will be following the discussions on Facebook, and reporting about the people behind the wishes on CBC TV, CBC Radio, CBC Newsworld and online at cbc.ca/wish. As Canada Day approaches, they'll summarize the top ideas from Facebook, and come up with "The Great Canadian Wish List" just in time for July 1st.

A wish for funded midwifery across Canada has been added. It would be really great if we could get a lot of people supporting this. Not only would the media coverage be useful to our campaign in the Yukon, it could also help other provinces that are working towards integration of midwifery into the health care system.

You can access this wish for Canada at http://www.facebook.com/sgroup/subgroup.php?oid=2392827649&sub_oid=2380913993

Please pass this message on to any Canadians you know! If you are not a member of Facebook it is easy to join; just go to www.facebook.com.

The devil in the details

2007-05-30T12:35:00.000-07:00

I've been thinking a lot about the story that Asheya posted a few days ago. Although it was a sort of light-hearted look at the ideal attitudes about birthing, I was made uncomfortable by some of the points in it. Because the truth is, there is no ideal way to give birth. Midwifery is terrific precisely because it promotes education and self-awareness and offers choice.

I had a hospital birth with my daughter Jade. It didn't go exactly as "planned"; I was hooked up to an IV, first for antibiotics and fluids, and then for oxytocin to augment my labour. But I was able to forego pain medication (which was one of my goals) and once labour started Jade was born a quick and (relatively) easy 1.5 hours later. I was thrilled about the overall experience and felt I was extremely lucky. It's true that I might choose to do a few things differently next time, but I have no regrets and I don't believe that it was the wrong choice to have my "veins punctured", as Nonna puts it in the story.

What YFM is hoping for by getting midwifery services to be fully funded is to provide choices to women. One woman might choose to have a natural birth at home, while another will still demand an epidural as soon as she walks through the doors of the hospital. I'm certainly not going to judge a woman for making those choices. However, I do believe that a woman who is able to have a midwife for her maternity care will have more confidence in her ability (and her body's ability) to have a natural birth.

One of the best things about being involved in the YFM group has been the great discussions we've had on all sorts of maternity-care issues. We discovered at one meeting, for example, that we really couldn't agree on the definition of risk when it came to "low-risk pregnancy". It was a very clear illustration of why the regulation process is going to be a challenging one, even though the various stakeholder groups are all on board. At the same time, we've managed to avoid letting our debates get personal; we know, after all, that in the end we all have the same goal.

Toronto Star Article - May 25, 2007

2007-05-27T17:11:00.000-07:00

Here's a great article about the demand for midwifery services from the Toronto Star.

MIDWIFE MEASURES GREAT EXPECTATIONS
The hands in demand
May 25, 2007 04:30 AM
Andrea Gordon

Dori Skye Engel has a tiny foot wedged high beneath her ribcage. It's been a long time since she could see her own neatly polished toes. And these days it requires a Herculean effort to hoist her toddler.

But still, Skye Engel's blue eyes sparkle. One month before her due date, she radiates that unmistakeable glow.

Pregnancy hasn't always been this serene, though. Two years ago, when just five weeks along with her first child, Skye Engel, 32, was frantic to find a midwife.

"I was on six wait lists in my catchment area, I called all of them every week," recalls the Toronto mom. "That was a pretty big shocker for me."

This is no surprise to midwives who are distressed at the number of women they are forced to turn away. According to the Association of Ontario Midwives, 40 per cent of women seeking midwifery care can't get it. Those in the profession say clients will lie about their due dates, addresses, and use different names to get on wait lists more than once.

"It's really heartbreaking," says Manavi Handa, Skye Engel's midwife at Kensington Midwives in downtown Toronto. "That's how desperate women are."

When she was five months pregnant, Skye Engel got the call she'd been waiting for from Kensington. She and her husband were elated. Four months later, Noah was born at home, all nine pounds, 13 ounces of him.

Now Skye Engel is back at Kensington, listening to the rhythmic swoosh of her second baby's heartbeat on the fetal Doppler, grinning as Handa gently prods the little being that responds with heels and elbows.

Midwifery has come a long way since joining the Ontario health care system 13 years ago. Midwives have gone from having no hospital privileges to delivering eight per cent of the babies in Ontario says Handa, 35, who has been a midwife for seven years. It has meant more choice for women and families, a boom in midwifery services and a more collaborative and responsive maternity care system.

But the mismatch of supply and demand – which reflects a trend among all maternity care providers, including obstetricians and family physicians – is worrisome.

Kensington's eight midwives, who deliver about 320 babies a year and have privileges at St. Joseph's Health Centre, are among the many who can't meet the demand for their services. Similar tales prevail at practices throughout the GTA.

"You have to call the midwife and get on that list the minute you pee on the stick," says Stephanie Alouche, of Ajax, who had a home birth two years ago, thanks to Sages-Femmes Rouge Valley Midwives, which serves Scarborough and Durham.

The shortage of midwives also creates a conundrum for the profession, adds Elizabeth Brandeis of the Toronto Midwives Collective, a group of 10 who deliver a total of 300 babies a year – two-thirds at Mount Sinai Hospital, the rest at home.

"We're hesitant to promote our services because there isn't the access, but that's exactly what we need to do ... In order to really be providing choice to the women of Ontario, it's important they have access to midwifery."

The Society of Obstetricians and Gynaecologists of Canada, which over the years has become a big supporter of accredited midwives, has been warning for several years now that a crisis is looming in obstetrical care. Nearly one in three OBs is expected to retire from full-time practice over the next five years. Among family physicians, 13 per cent delivered babies in 2004, down from 36 per cent in 1990. And 36 per cent report they do not provide any maternity or newborn care in their practice.

Midwives would like to fill the gap and cite three areas that need to be addressed:

A raised cap on the number of midwives licensed to work in each hospital. Busy collectives can't hire more midwives unless they can promise them hospital privileges. Otherwise, those entering the field can't practise.

Adding spots at the province's three education programs at Ryerson University in Toronto, McMaster University in Hamilton and Laurentian University in Sudbury, which graduate a total 40 to 60 new midwives each year. As well, expand the accelerated program for midwives trained in other countries.

Create birthing centres that would take the pressure off hospitals.

Handa stresses that greater reliance on midwives is cost-efficient. Ten midwives might bring in a caseload equal to that of two obstetricians. But their patient-centred personal care, including 45-minute appointments and continuous emotional support, also means clients tend to leave hospital more quickly, require fewer medical interventions, and receive attentive prenatal and postnatal care. All of which translate to lower costs for the health care system. They are also the only regulated professionals to accommodate home births.

Many midwives are concerned about mounting C-section rates – currently about 25 per cent of all deliveries – and the medicalization of childbirth by specialists whose training focuses on high-risk situations and intervention. The price is fear and apprehension that translates even to women in low-risk labour and delivery. "When does a woman ever get told your body knows what to do?" says Handa.

Adds Brandeis: "A midwife's perspective is that addressing fear with information is probably a healthier place to start."

Personal care was one of the main reasons Lisa Marie Fletcher, of Whitby, wanted to have her babies with a midwife. Now 24 weeks pregnant with her third child, she has received her maternity care from Carole Cameron of Midwifery Services of Durham. Her eldest, 3-year-old William, arrived after a smooth four-hour labour. With her second, a little over a year ago, Fletcher had an hour of contractions, called her midwife and then promptly gave birth to Samuel on the floor of her front hall. Her husband delivered.

"This time around we are hoping for a different kind of home birth," she laughs.

To Fletcher, the most important element of midwifery has been the post-partum care. The midwives were there when Samuel turned blue at two days old and was rushed to intensive care with apnea. They sat with her in the hospital, helped her pump breast milk through the week she couldn't nurse him and helped with the transition when they were finally able to bring the baby home.

Cameron, the first midwife in Ontario to deliver a baby unassisted by a physician just after the legislation passed in 1994, remembers when women had to pay for services and also had to be under a physician's prenatal, labour and delivery care for hospital births.

Since joining the system, midwives can now stand up in hospital rounds, they teach nurses, and work collaboratively with obstetricians

Like many midwives, Cameron joined the profession following the birth of her own children, the first with a physician and the next two with midwives.

"For me, it was about control. I felt as if I gave it all up with my first child." She doesn't blame the people, just the system. "I had to fit."

As midwives, "it's our job to fit the client and what they need."

That's an approach that was hugely important to Alouche as she prepared for the birth of her fourth child. Alouche, 33, had delivered one baby with the OB on call, who wasn't her own; she had one baby induced so her own OB could be there; her third started with midwives and ended up a Caesarean after the baby turned to breech position, which she describes as "the most horrendous experience of my God-given life."

Fourth time round she knew what she wanted: to at least try for a natural vaginal birth at home. She found a midwife who was willing to try. "When I talked, I felt I was being heard. When I said no, she said okay." Alouche delivered Meaghan Rae at home in a joyous bathtub birth two years ago.

For Handa, it's a privilege to be with a woman during the transformative process of birth and motherhood.

"It's the continuity of care that really makes me care. That's what gets me out of my bed at three in the morning."Skye Engel says the trusting relationship with her midwives was what got her through the toughest parts of a home birth.

"People will say to me `I'm not a hero like you.' And I don't understand that. I'm no hero."

Handa doesn't miss a beat on that comment: "As a midwife, I say you are a hero, it doesn't matter how you do it."

Story: May 2052

2007-05-26T12:47:00.000-07:00

Heather Ashthorn, one of the local midwives, emailed me this story. I am very glad that the maternity care in the Whitehorse General Hospital is supportive of natural birthing, and women are "allowed" to eat and drink during labour. However, there is still much room for progress! Birthing in the communities needs to be supported, and women need to be better informed on their own ability to give birth. There is so much fear around birth in our culture, in large part because it is viewed as a medical condition requiring the intervention of doctors.

I like the comparison in this story of a labouring woman to an athlete. An athlete is in a different physical condition from the rest of the population, but this physical condition is not a disease! Rather it is actually a condition of good health. Participating in athletic events poses certain risks to the athlete that would not be encountered otherwise, but the athlete does not dwell on the risks but on the goal. The athlete trains for the event, preparing mentally and physically, and gathers a group of people who will encourage her. The athlete does not spend hours with a doctor before the event, but spends hours with her coach, who helps her visualize her goal and how to get there. A doctor, who is trained in diseases and rectifying unnatural states of the human body, is only needed in rare cases, when an athlete is injured during the performance. The coach enables the athlete to listen to her body during the event, and also stays with the athlete after the event and helps the athlete process what happened during the event.

Midwifery in the Yukon is legal, but at present not integrated into the health care system. That's why we are here!

Jeannie Babb Taylor: May 2052
http://tinyurl.com/25w5z4

“You’re fortunate to be living in this era,” says Nonna, brown eyes twinkling above the dimples in her wrinkled cheeks.

Rachel sips at the red raspberry leaf tea, the cup clinking against the saucer as she sets it down to respond. Her grandmother is already talking again.

“When I gave birth to your mother,” she goes on, “I was not allowed to eat or drink.”

Rachel’s eyebrows shoot up. “The whole time?”

“That’s right. Back in those days, all babies were born in hospitals — even healthy babies. Laboring mothers weren’t allowed a single sip of water.

“I was so thirsty my tongue was swollen and sticking to the roof of my mouth. After many hours, I was given ice chips, but even that was taken away when I was caught swallowing some of the ice to stave off the gnawing hunger.”

“That’s horrible,” Todd interjects, dropping down to perch on the Victorian loveseat beside his wife. “Having a baby is like . . . running a marathon. What athlete would attempt such a feat dehydrated on an empty stomach?”

Nonna chuckles at his analogy. “You’re right, of course. But you see, laboring women were not treated like athletes. We were treated like sick patients, like there was something wrong with us. According to the doctors, our ‘condition’ was best treated with narcotics, opioids, and surgical intervention.

“By 2005, the c-section rate went through the roof, with nearly one out of three mothers sliced open for delivery. From the doctors’ point of view, laboring women were all potential targets for expensive surgery. That’s why they starved us.”

Rachel scowls, rubbing puffy hands over the swollen full-moon belly. “But labor can go on for hours — or even days,” she notes.

“Especially when you’re lying down with feet in stirrups, pushing uphill,” the old woman acknowledges.

“That’s absurd,” Todd murmurs. “Why not let gravity work?”

Rachel shakes her head. “That position was designed to benefit doctors, not women.”

“You’re right,” Nonna answers. “It placed us at a great psychological disadvantage, too. It allowed medical staff to treat us as objects, paying attention only to the ‘business end,’ as if we had no face, no heart, and no mind.”

“I’m so glad no caregiver would think of using stirrups today,” Rachel sighs, rubbing her belly again. “It’s a wonder women were able to push at all.”

“The doctors had ways of speeding up labor artificially,” Nonna answers. “But the drugs sometimes caused uterine rupture, killing the baby or causing permanent brain damage.

"One drug, Cytotec, was not even FDA-approved for obstetrical use. Eventually they had to stop using it.”

Rachel smiles, her face transformed. “So they went back to the natural ways?” she guesses. “Not at first,” her grandmother answers.

“At first they skipped the contraction drugs and resorted to the knife much sooner.”

Rachel looks down, distracted for a moment by the contracting of her own womb.

“I’ll go heat the rice bag,” Todd offers, trotting to Nonna’s kitchen with the handmade cloth pouch. Nonna watches him round the corner, thinking how glad she is for Rachel.

At last Rachel’s attention comes back to her grandmother’s wizened face. “Why did the women allow it?” she asks.

Nonna sighs, holding out empty hands. “We just didn’t know better. Our own mothers were knocked out for birth. We thought we were making progress just by being awake. Some women realized things should be different, but it was a constant fight.

“I chose a hospital that was supposed to be supportive of natural birth. They still pulled the ice chip stunt. Before I registered, they said they allowed ‘rooming in’ so I would not be separated from my baby girl.

“But right after birth, they whisked her away! I begged for her, but they kept her ‘under observation’ for four hours. They also gave her sugar water against my wishes, and pushed to inject her with vaccines just hours after birth.”

“That’s horrid,” Rachel clucks. “Why didn’t women just stay away from hospitals? Have their babies at home?”

“Well, in Georgia it was illegal.”

Rachel laughs. “How can birthing a child break a law?”

“Oh, it was not homebirth that was prohibited, so long as we did it alone! It was homebirth midwives they outlawed.”

“So women could birth at home — but only without help?”

Nonna nods. “Things were different back in 2007 when your mother was born,” she says. “For one thing, eight out of 10 lawmakers were men. There had never even been a woman President. Women only earned 70 cents on the dollar.

“We didn’t have the kind of power you gals have!” She beams at her granddaughter, so young and confident. “My next child — your Uncle Tim — was born at home with an ‘illegal’ midwife.”

“Wow,” Rachel whispers, throwing a glance at Todd as he tucks the warm rice bag into the small of her back, “There was a black market for midwifery?”

“Certainly. There were always women who refused to be mistreated, and there were always midwives willing to skirt the law to give excellent care. The legal risks were high for those midwives. Once in a while, a baby dies during birth. It happens sometimes, no matter where women give birth.

“In a hospital, these deaths were considered a statistical eventuality. In the early 2000s, no one was charged for hospital deaths, even when the damage was clearly caused by uterine-rupturing drugs or overuse of painkillers.

“It was extremely rare for a baby to die in a homebirth setting — but when it did happen the midwives were charged with manslaughter. In other cases, overdue women were jailed for refusing to have a c-section.

“It was actually against the law to disobey a doctor’s orders! Eventually it was the women who turned the tide.”

“Through lawsuits?” Todd guesses.

“That was part of it.” Nonna nods thoughtfully. “The studies showed clearly that it was doctors’ drugs and fasting that caused most of the ‘danger signals’ (like blood pressure drops and changes in babies’ heart rates) that led to the c-sections. But that went unreported for 20 years!

“It was not until women stood up for themselves that things changed. Women reporters talked about the studies on the six-o’clock news. Women journalists wrote about the prohibition of home midwifery and the barriers to natural childbirth. Women doctors watched the signs instead of the clock. Businesswomen opened natural birthing centers. Women were elected to office and they legalized home-birth midwifery in Georgia, and later nationwide.

“Most of all, laboring women refused to let their needs be sacrificed to hospital protocols and doctors’ schedules. We had to insist on change!”

Nonna sets down her teacup. “We insisted on dignity. We did not let doctors push us into inductions or surgeries just to accommodate their schedules. Women who still used hospitals refused the wheelchair and the gown that were presented at check-in.

“Women refused to be starved, or to have their veins punctured with unnecessary IVs. Mothers refused to let doctors break their waters or insert electronic monitors in the baby’s scalp.

“When we pushed our babies into the world with our own fierce power, then we refused to let them out of our sight.”

Nonna smiles. “Eventually even the medical community came to recognize that birth is an act of motherhood, not an act of medical science. Today a laboring woman is not regarded as a body on a table, as if she and the baby needed some doctor to ‘deliver’ them from each other. Today women are honored as life-bringers.”

Jeannie Babb Taylor is a business leader and author. She also teaches Sunday school, educates her children at home, and engages in Georgia politics. To contact Jeannie, E-mail jeannie@babb.com.

What does YFFM do?

2007-05-24T09:44:00.000-07:00

Since the government has agreed to start looking at regulating midwifery services in the Yukon, we haven't been doing much actual "lobbying". We're really more of an advocacy group or planning group now, which is great because it means that we have made progress since the group was started in December!

At our last group meeting, we decided that besides taking part in the process of regulation and providing the consumer point of view in that process, our other role should be public education. There are all sorts of misconceptions out there on what midwifery is. That's not really surprising, of course, because who really thinks about midwifery until they're planning to have a family?

A lot of my friends in Ontario (where I lived before moving north) are a few years older than me and they started have kids before I did. One friend used a doula for her two births, and I had no idea that a doula and a midwife aren't the same thing! (For the record, a midwife is a health professional who can provide primary care throughout pregnancy, birth, and post-partum. A doula generally provides support and care during labour and delivery, although some also do post-partum support. However, women who use a doula also generally use a doctor or midwife for their primary care.)

One common misconception when it comes to midwives is that having a midwife automatically means having a home birth. While that can be a great choice for some women, not everyone is necessarily comfortable with that. In many jurisdictions, a woman can choose to give birth in a hospital, but have a midwife as her birth attendant.

To support our public education goal, we are going to be putting up posters around town to help people learn what a midwife does. Look for them on a bulletin board near you!

New Brunswick to regulate midwives

2007-05-16T08:57:00.000-07:00

Here's an article from CBC news today. There's no word in here on whether New Brunswick is also funding midwifery services.

N.B. to regulate midwives
Last Updated: Wednesday, May 16, 2007 10:58 AM ET
CBC News

Midwives are about to be made part of the New Brunswick health-care system,
the provincial government announced Wednesday.

Health Minister Mike Murphy said he will introduce legislation to regulate
the profession.

Midwives help women in their pregnancies, including deliveries, often in
their homes.

Murphy said there is evidence from other countries that midwives offer an
effective alternative to hospital deliveries in normal pregnancies.

Until now, New Brunswick, Prince Edward Island, and Newfoundland and
Labrador were the only provinces that hadn't passed midwifery legislation.

The Progressive Conservative government in Nova Scotia introduced
legislation in November to integrate midwives into its health-care system.

The service is funded in most provinces where it has been regulated.

Do-it-yourself birthing?

2007-05-15T13:33:00.000-07:00

There was an interesting article in the Globe & Mail online today, called "DIY delivery". There was no synopsis of the article, so this headline could have referred to pizza or to speeches, but since it was in the health section I figure it was actually related to birth issues and I clicked on the link to have a read.

(I have linked to the G&M article, but I don't know how long they archive their material, so I've pasted the text below.)

Anyone who reads this blog is probably interested in birthing issues, so I just had to write a post about it. One of the interesting points in the article is the statement that the evidence stacked against unassisted births is "overwhelming". On the other hand, the evidence for midwife-attended births shows that the outcomes are just as good or better than "traditional" hospital births. (Keep in mind that midwives are usually used only for low-risk pregnancies.)

But at the end of the article, I'm left with one question: is unassisted birthing really a growing (if tiny) trend? Or did the reporter just think that this was a provocative topic?

Here's the article:

DIY delivery
ADRIANA BARTON
From Tuesday's Globe and Mail
May 15, 2007 at 8:41 AM EDT

BURNABY, B.C. — When Nicole Becker felt the pangs of late labour in January, she lit candles in the bathroom of her two-bedroom flat in Burnaby, B.C., and filled the tub. Only her husband and the couple's four-year-old son looked on as baby George slid into the water. "It was my dream birth," Ms. Becker says.

Ms. Becker planned throughout her pregnancy to give birth without a midwife, doctor or other birth attendant. After using a doula for her first child's home birth, Ms. Becker decided that the job of a good midwife is to "let the process happen," she says. So with George she decided to go solo.

Choosing to deliver without skilled help remains a controversial and uncommon choice. But now, spurred by the Internet, unassisted childbirth is reaching a broader range of women than ever before.

On sites such as Birthjunkie.com, Mothering.com and Trustbirth.com, women trade tips on such topics as how to measure the uterus to calculate the due date and how to figure out if the baby is breech. One of the most popular sites, Unassistedchildbirth.com, now has 30,000 to 40,000 visitors each month.

Many women join one of nearly 100 Yahoo groups that list unassisted childbirth in their subject lines, including UCbirthnews, an online newsletter with over 1,110 members. They also browse online for books, videos and do-it-yourself resources such as Unhindered Childbirth - The Online Childbirth Class (at Unhinderedliving.com) as well as inflatable birthing pools.

"People who wouldn't have considered this years ago are considering it now," says Laura Shanley of Boulder, Colo., who wrote the influential book Unassisted Childbirth in 1994 and runs the website Unassistedchildbirth.com.

Until recently, "I was hearing more from hippie types, people more on the fringe," says Ms. Shanley, who gave birth to five children without medical attention - including one breech presentation. "I do think it's getting more into the mainstream."

But most doctors and registered midwives strongly oppose the practice. Skilled attendants play a crucial role in identifying problems such as hemorrhages and fetal distress before they become emergencies, they say.

In a few cases, child welfare authorities in Canada and the United States have investigated parents who planned unassisted births.

Although there are no large or recent studies on the outcomes of planned unassisted childbirth, the evidence stacked against the practice is "overwhelming," according to Vyta Senikas, associate executive vice-president for the Society of Obstetricians and Gynecologists of Canada.

Dr. Senikas questions the rationale for choosing unassisted childbirth. "By all means, choose the home," she says, "but have a skilled attendant there."

Childbirth is a natural process, she adds, "but you can die and you can end up having problems."
Advocates of unassisted birth say that any medical interference, no matter how well-meaning, can disrupt the instinctive and hormonal processes of labour, triggering a stress response that halts the birth's progress. They believe that widespread use of interventions that slow labour can contribute to higher rates of C-section.

Adherents base their beliefs on the writings of authors such as French obstetrician Michel Odent, who wrote Birth Reborn in 1984. Although he does not specifically advocate unassisted childbirth, Dr. Odent says that in his practice, women who weren't observed in their labour had faster and easier births.

There is no way of knowing for sure how many Canadians are choosing to give birth unattended, since neither the federal nor provincial governments collect statistics on planned unassisted childbirth. But the rate is probably much lower than home births attended by registered midwives, which accounted for just 1.5 per cent of all deliveries in British Columbia and Ontario in 2005 and 2006.

Jodie Boychuk of Dunnville, Ont., says she chose an unassisted birth for her second child because of the difficult recovery following the cesarean delivery of her first daughter. In September, 2005, her second daughter was born at home into the hands of her husband, Richard. The labour was smooth and the 8½-pound baby was healthy, Ms. Boychuk says.
But the practice remains controversial enough to impel some midwives and authorities to intervene. When Ms. Boychuk declined the services of a registered midwife during her second pregnancy, the midwife - who questioned the safety of even an attended home birth after a cesarean - promptly called the Children's Aid Society.

A two-week investigation ensued, but it was dropped because unassisted childbirth is not illegal.
Even the staunchest advocates of the practice acknowledge that it's not for everyone.
Sarah Buckley, an Australian physician trained in obstetrics and author of the book Gentle Birth, Gentle Mothering, says a woman must be healthy and educated about birth to deliver unassisted.

As well, she says, the woman should be relaxed enough to avoid triggering the fight-or-flight response that can delay the birth, and should have a backup plan such as transferring to a hospital.

Registered midwives agree that too much medical intervention can impede labour - but they "cannot support the concept of unassisted, unattended births" due to the risks, says Elana Johnson, president of the board of directors of the Association of Ontario Midwives.

For Ms. Becker of Burnaby, the birth of her baby in January is still fresh in her mind. It was a joyful occasion to share with her husband and her son Max, she explains, and most of all, "it was just us."

Successful event

2007-05-09T11:21:00.000-07:00

Thanks to everyone who helped to make our International Day of the Midwife event a success!

Considering that downtown Whitehorse isn't always at its liveliest on Saturdays (particularly with a cold wind blowing), we were wondering what kind of a turnout we'd get, but we ended up having quite a steady stream of visitors.

One of my favourite moments was when an early visitor asked how much a cookie cost. When we told him it was free, his look of amazement was really quite comical! I'm sure the free food was a big attraction, but we had interesting conversations with most everyone who came to the table.

Lots of folks signed the petition in support of funded midwifery services, and a bunch of new names got added to the e-mail list. It's great to find yet more proof that people want to see midwifery services become more available to women in the Yukon.

Thanks go out to:

Alpine Bakery, for donating a big tray of sweets, and another huge tray of delicious pizza
Aroma Borealis, for providing tea
Zola's for providing a huge jug of water
Copy Copy, for printing up free colour posters to advertise the event
PSAC, for providing photocopying, a table, and a great sound system for the event
The Salvation Army, for providing tables, cups, napkins, and a tea carafe
Advocacy group members for donating goodies (especially to Janet and Melissa for making a great banner for the group, as well as Michael for designing the logo)
Founder/President Asheya Hennessey for all the hard work organizing, as well as for the great live performance!

May 5: INTERNATIONAL MIDWIFERY DAY!

2007-04-26T14:19:00.000-07:00

May 5 is the International Day of the Midwife. The aim of the day is to celebrate midwifery and to bring awareness of the importance of midwives' work to as many people as possible.

In Whitehorse, we will be celebrating this day by holding an information booth at the Elijah Smith Plaza on Main Street starting with a Baby Parade at 1 p.m.

Come out to learn about midwifery services, why we are working to integrate midwifery into the Yukon Health Plan, and how you can get involved.

Refreshments are being provided by Alpine Bakery and Aroma Borealis.

Whitehorse Daily Star Article - April 13, 2007

2007-04-26T14:18:00.000-07:00

By Stephanie Waddell

When she moved to the Yukon from British Columbia, Asheya Hennessey was pregnant and had been considering using the services of a midwife.

Learning that midwifery isn't covered under the territorial medical services plan, Hennessey ended up giving birth to her son at Whitehorse General Hospital under a doctor's care.

Since then, Hennessey has been joined by close to 20 others in starting a group pushing for midwifery to be covered under health services in the territory.

"I really believe in options for women," she said.

As an educator, Hennessey is also a strong believer in people being able to make informed choices.

Though Hennessey admits she doesn't know from experience, it's her understanding that patients have more time with their midwife to go through their various choices around their child's birth as well as to discuss the emotional aspects of pregnancy.

At a doctor's office, Hennessey noted, appointments are usually just about 15 minutes long without the same amount of discussion she believes a patient might get from a midwife.

When she started discussing this issue with others, she found it's a service she not would have wanted(A) but also something others may have used as well.

Thus the lobby group was born. The group is currently calling itself the Yukon Midwifery Lobby Group, but is considering changing that name because some have thought the group was made up of midwives.

Rather, Hennessey said, the close-to 20 in the group are coming from more of a consumer point of view in its lobbying.

Most of the group is made up of mothers of young children, though there are also a couple of men, including Hennessey's husband.

"It keeps growing," she said of the organization.

After meeting with Health and Social Services Minister Brad Cathers and a policy analyst, Hennessey learned it would likely be a least 2009 before midwifery could potentially be included as part of the medical system.

The first step, she said, is looking at whether midwifery should be recognized(B). That's where the government currently is.

"We're sort of blazing a new trail," Hennessey said.

If it's decided the services should be recognized, regulations would have to be drawn up.

All of that also needs to be done in consultation with stakeholders, who would likely include midwives, doctors, nurses and consumers.

Hennessey hopes the department will include her group in its discussions.

In the meantime, the group is also working on plans for May 5, International Midwives Day, to be on-hand at the Elijah Smith Building downtown.

Anyone who would like to become involved with the group can contact Hennessey at 456-7711.

******
(A) sic
(B) this should say "regulated" rather than "recognized"

Letter to the Editor - March 27, 2007

2007-04-26T13:49:00.000-07:00

There were some errors in the Yukon News article, which we addressed in this letter to the editor.

*******

Dear Editor,

I was glad to see the story on midwifery in the Monday, March 19 edition of the Yukon News, and would like to clarify some of the points of the article.

The headline read “Midwives push for government support,” but the group that has been lobbying the government to include midwifery services under the health care plan is not a group of midwives but a consumer group of mostly Yukon moms of babies under two years old. We are not trying to get our work funded, but rather are trying to get midwifery services integrated into the health care system so that midwifery services will be an accessible maternity care option for all women in the Yukon in the future.

I would also like to clarify that the main reason I am in favour of regulation of midwifery is to have midwifery services integrated into the health care system, which includes funding. Government and other bodies are generally interested in regulation primarily for consumer safety.

To comment on the dissatisfaction of some midwives in regulated systems, I think this just highlights how important it is that as we work toward regulation, we include all the important stakeholders in the discussions, so that we can come up with the best system for our unique needs here in the Yukon. Our goal is to learn from what has been done in other provinces and territories, in order to integrate midwifery into the health care system in a way that is professionally viable for midwives and provides the most choice for women.

I also want to make it clear to readers that our goal is a regulated, funded system where women would have the choice of a home or hospital birth with a midwife, as is the case in the Northwest Territories, BC, Alberta, Manitoba, Ontario, Quebec, and Nunavut. Midwifery services are in the process of being regulated in Nunavut, although they are already funded.

We would like to broaden our consumer voice, and so invite any Yukoner who has an interest in seeing midwifery services become integrated into the health care system to contact me at asheya (at) alumni.sfu.ca or at 456-7711.

Thank you,
Asheya Hennessey
Whitehorse, Yukon

Yukon News Article - March 19, 2007

2007-04-26T13:33:00.000-07:00

By Sarah Fox News Reporter

The Yukon Midwifery Lobby Group is one step closer to realizing its dream of having its work funded by the Yukon government.

“We’re in the first part of the process of bringing up the question, ‘Should midwifery be regulated?’” said mother and lobbyist Asheya Hennessey, after meeting with the government last week.

She’s in favour of regulation for consumer-safety.

As well, regulation would help establish protocols for midwifery in the hospital, and with doctors and nurses, said Hennessey.

“Ultimately I’m interested in getting it funded, but for a health profession to be funded it would first have to be regulated,” she said.

“I feel very positive and I feel that things are moving forward and that there will be action taken on this issue.”

Hennessey gave birth to her son Elias in a hospital with a doctor just over a year ago.

She would rather have had a midwife perform the birth, but could not afford the $2,500 it would cost for private midwife services.

So Hennessey pulled together a group of mothers to lobby the government to fund midwifery under the health act and medical services.

“We’re doing this, so a woman would be able to choose if she wanted a doctor to be her primary caregiver for her maternity care, or if she wanted a midwife to be her primary caregiver, so it would provide more choices for women,” said Hennessey.

“Right now there are a few women who have that choice open to them.

“Some women just don’t feel comfortable having a home birth and some women just don’t have $2,500, so it’s not really an option for all women in the Yukon right now and we’d like to see that that becomes a choice for all women.”

Nunavut and the Northwest Territories, as well as several provinces have regulated and funded midwifery under their medical service plans.

“The reason why I personally value midwifery is because one of a midwife’s mandates is informed choice for the woman,” said Hennessey.

“A lot of doctors just don’t have time in that 15-minute appointment to go over all the different options for care and the risks and the benefits to the different procedures and tests.

“A midwife really values a woman being able to make her choice based on being educated.

“Midwives spend between half an hour and an hour in every appointment talking to the woman and educating her about the issues that come up in pregnancy and issues of childbirth and post partum.”

They discuss breast feeding versus formula feeding, drugs versus natural pain management during labour, subjecting yourself to blood tests to check for birth defects during pregnancy and other issues.

Local midwife Heather Ashthorn supports government funding, but is concerned about what a regulated profession would look like.

She fears that her services would become less accessible to woman if regulated and funded.

“There becomes a real system of permission, so midwives are permitted to do low-risk births and not permitted to be involved in the care of anybody with high risk.”

There are certain high-risk cases that a midwife wouldn’t accept, and there are others they would, she said.

And those families might benefit from a midwife’s care.

“So you get a whole bunch of people who fall into that category who really could quite likely have a better outcome than they would within the western medical system, but they are not able to access midwifery because midwives are not permitted to work with them,” said Ashthorn.

“It sort of shifts the accessibility more than it creates it.”

Ashthorn would like to see as much freedom of choice remain for women and their families as they have in the Yukon’s current unregulated system.

“Hopefully we’d have a choice where midwives are self-regulated and we’d have a choice of what kind of a practice we’d like to be in,” she said.

“One of the things that I am really committed to standing up for is a system where families still have as much choice as they do now — they can choose a regulated midwife, they can chose an unregulated midwife, they can choose their grandmother, they can give birth at home or in the hospital, what ever they want to do to get access to that service.

“They can pay, they can not pay — whatever they need — and then the flip side of that is that midwives are able to choose what kind of practice they are in.

“That’s where I come from, it’s just creating choice for everybody and making sure that that whole gamut is available.

“I’ve seen friends go through regulated systems in other provinces and they are now grossly unsatisfied with the professions that they are in.

“They got into the profession for a completely different reason than what they are able to provide now.

“That’s really sad and I think that’s a pretty harsh reality — to go through all of that training to then become part of a system that you don’t even like.”

The territory should have regulated and funded midwifery, said Yukon Liberal leader Arthur Mitchell.

“Our party has long had a policy supportive of midwifery, so the Liberal caucus supports including that in medical coverage.

However, it must be regulated and supported by legislation drafted in consultation with all health practitioners, “to make sure everybody is on board and onside and comfortable with it,” said Mitchell.

NDP leader, John Edzerza also supports funded midwifery in the territory.

Women should have the choice to have their babies at home or in a hospital, he said.

“From what I understand about it and from some of the ladies that I have talked to, I think the comfort of home is a good thing too,” said Edzerza.

“There’s not so much stress there, you feel relaxed … but of course now-a-days it’s important that things are regulated and that’s probably the process that will happen.”

Contact Sarah Fox at sarahf@yukon-news.com