On the afternoon of Sunday, October 24, a group of about 50 people gathered to share their experiences of, and hopes for, midwifery in Nova Scotia. With the sounds of happy babies in the air, an exciting dialogue regarding the past, present and future of midwifery in this province unfolded.
The Community Forum on Midwifery in Nova Scotia was organized by the Midwifery Coalition of Nova Scotia, a group that lobbies for increased access to funded midwifery services for all women in the province. “The MCNS is a consumer group” Jean Steinberg, a member of MCNS, said. “We represent different consumers and need to check in with the people who we serve.” Jean makes the point that midwifery at its core is all about women and families and stresses the importance of continuing to prioritize women's voices throughout the process of implementing midwifery in Nova Scotia. The forum was organized as a way to do just that, while at the same time educating women on the current standing of midwifery in the province and opening doors to discussion around future directions.
The afternoon was led by professional facilitator Paula Knowles, and began with some icebreakers, which got people started on the topic they had come to discuss. The conversation went a bit deeper as Paula handed out pieces of cloth and fabric markers, asking the participants to identify the time when and why they first began to become interested in midwifery in Nova Scotia. People shared personal stories around the importance of having the option of birthplace, and of the connections and supportive relationships that are possible with midwifery care. Throughout the course of dialogue, it also became clear that women and families are dissatisfied with how midwifery has been handled in this province and that they are ready and willing to mobilize for change.
Some of the concerns that were raised involved lack of access to midwifery care in areas outside of the three model sites chosen for implementation of the midwifery program (the IWK, South Shore, and Antigonish Guysborough County.) People living in many areas of Nova Scotia - including the Annapolis Valley with its rich history of midwifery - no longer have access to this service. “We all have the right to choose what kind of service we want [when we give birth] and when that choice is taken away it leaves us in a really uncomfortable situation,” said Selene Cole, a member of Valley Families for Midwifery. “What's the best way to move forward? We've been writing letters and getting no response from the DHA. It feels like our voices are not being heard. And what can we do in the interim?” A number of members of the group were present at the forum, ready to share their experiences with lobbying their local health authority and seeking support in their struggle.
Even within the model sites accessibility to midwifery services was a concern. There are only 7 midwifery positions in the province (2 full-time and 2 part-time in HRM, 2 in the South Shore, 2 in Antigonish Guysborough). This means that even if a woman is aware of midwifery, has health care, and wants to work with a midwife throughout her pregnancy and birth, there is no guarantee that this can happen. These accessibility issues led to stories of the lengths women will go to in order to give birth in the way that they choose, including leaving the province and choosing unassisted childbirth at home.
A third major concern that was voiced that afternoon was regarding the way that midwifery has been integrated into the public health care system within the model sites, and whether that integration allows midwives the full scope of their practice. Is midwifery being implemented in Nova Scotia in a way that is fully compatible with the midwifery model of care? There have been countless studies on the safety and effectiveness of midwifery care, and midwifery is integrated into the health care system in BC, Manitoba, Ontario, Quebec, Newfoundland and Labrador and the NorthWest Territories. “We don't need to re-invent the wheel!” was a common sentiment that afternoon.
Throughout the afternoon it was clear that the women at the forum were passionate about midwifery, and there was a lot of positive energy created to continue building towards accessible services for all.
Nova Scotia is still in process when it comes to how and where midwifery services will be available to women in the future. For more information, or to get involved, contact the Midwifery Coalition of Nova Scotia.
