Special Series: Twelve Canadians

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Helping People Out

By David Kattenburg

Midwives catch babies.

A midwife cares for a pregnant woman throughout her pregnancy, birth and postpartum period. Most everything relevant to a woman’s health in the childbearing period comes under the midwife’s watchful eye.

The “mid” part of the word midwife is derived from the German mit, or with. The French phrase for midwife is “sage femme,” or wise woman. Put the two together, says midwifery educator and researcher Elaine Carty in this audio piece, and you’ve got the whole story.

Midwives answer their phones in the middle of the night, in the wee hours of the morning, posing questions of the caller like, “How often do they come? Let’s time it,” and “Can you speak through it? Can you speak right now? … OK. I’ll be there in twenty minutes.”

Death of Rachel, by Francesco Furini

Not many health professionals will drop everything they’re doing — beginning with sleeping — at the drop of a hat, or the ring of a phone, in the dead of night or frozen throes of winter. Midwives do.

Midwives are regulated professionals in seven Canadian provinces (BC, Alberta, Saskatchewan, Manitoba, Ontario, Quebec and Nova Scotia), and in the Northwest Territories and Nunavut. Having introduced midwifery licensing legislation in 2008, the Department of Health in the province of New Brunswick recently decided to disband the licensing body as a cost saving measure.

Before they came under regulation, wherever they were, midwives practiced their craft within their own communities; “lay” midwives, some called themselves; or “traditional” midwives; or “homebirth” midwives. Many also worked with groups like La Leche League.

Being a midwife was a political act (as Marla Gross says in this radio story).

Marla Gross, Manitoba midwife

Midwives believe most women are completely capable of birthing at home (as indeed they are) with little other in the way of intervention than a bit of pain relief. In situations where “home” was just too far from hospital, midwives have been known to help women give birth in pleasant A-frame rental units or in their own beds.

These days, registered midwives catch babies in birth clinics and in the hospital, as well as at home. A recently published study reported that midwife-attended homebirths have better health outcomes for mums and babies than births attended by physicians, or by shared, multi-caregiver groups.

That midwives save overburdened, hospital-based health care systems money seems to be an article of faith. Women attended to by a midwife in hospital are less likely to undergo a costly C-section or episiotomy than those cared for by obstetricians, and they tend to leave hospital earlier — if they go there at all. Breastfeeding rates seem to be higher, and breast-fed babies are healthier.

And yet, oddly, very little has been published in the way of rigorous economic research on this topic, certainly not in the most populous Canadian province of Ontario, where midwifery has been regulated for almost twenty years, and where midwives have taken pay equity demands to the provincial human rights tribunal. Their incomes should be closer to those of doctors, they say.

There are about nine hundred practicing midwives in Canada today — nowhere near enough, some say. Here’s an article from the UK. Here’s one from Canada.

Given the enormity of their work load and shortage in their numbers, it’s not surprising that many midwives burn out, or go on stress leave. It’s a loving but demanding profession.

This episode features the voices of three pioneering Canadian midwives: Elaine Carty, Lee Saxell and Marla Gross. Here’s the voice of one of Marla Gross’ homebirth clients — Maxine Fehr.

Maxine

Thanks to Marla and family for these beautiful birth photos.

Twelve Canadians is a multimedia series about women and men who’ve been devoting their lives to social, economic or environmental justice, and to the healthy development of Canadian communities and the world. Each episode examines a specific issue or situation, through the voices of people who’ve been active in that area. Lots more than just twelve. Thanks to the Social Justice Fund of the Canadian Autoworkers Union for their generous support. Thanks as well to CKUW, University of Winnipeg Radio.