Alberta delivers on midwives’ potential

By Jodi A. Shaw

I prefer not to know the finer details of child birth. Instead, I’d rather wait my turn to experience it, and find out the good, the bad, and the ugly of pregnancy and delivery. A pregnant co-worker, however, has been spoiling some of the secrets for me . . . and affirmed my belief that gestation and childbirth aren’t all that glamorous.

I don’t like it when people ask me about me and my husband’s child bearing plans (see this earlier post) and I am almost certain that, when my time comes, I am not going to be overly fond of all the poking and prodding that I will be subject to.

My fear and concern, though, and likely the fears and concerns of many women, has recently been lessened by the government of Alberta’s announcement that, as of April 1, 2009, the costs of midwifery will be covered in the province’s maternity package. A huge sigh of relief for people like me, who are very private about their bodies and bodily functions, and value the personal relationship and trust a midwife has to offer.

My sister-in-law, who is pregnant with her second child and final child, also applauded the decision. “I honestly don’t think the doctor provides enough time in your visit to answer some of your questions. Or some of your questions aren’t questions you would go to a doctor about,” she says. “A doctor often looks at pregnancy [from] a medical standpoint, not so much a hormonal, emotional standpoint.”

Amanda describes her experience with her first pregnancy as a fact finding mission, in which she had to independently research pregnancy itself, as well as “prenatal classes, preregistering at the hospital, classes for infant car seats, etc. None of this information was provided to me by my physician.” She acknowledges that it is likely not part of many doctor’s jobs to fill in all the blanks for expectant mothers, but thinks it would be beneficial for doctors, who have seen a pregnancy or two, to give new mothers suggestions or information they may not think of. “It was never even asked if I wanted support for breast feeding, what my birth plan was, whether I wanted an epidural, none of this was discussed in advance between me and my doctor.”

While the new Alberta benefits won’t arrive in time for Amanda to take advantage of them, she acknowledges the benefits that a midwife could offer. “The biggest thing would be the support during labour. Which if you ask any woman [who has given birth], is the most overwhelming, painful, uncertain event in your entire life. At this time of uncertainty, you are left to manage through on your own with minimal hospital support.”

Enter the midwife . . . and you get an experience like Jennifer Davis, who paid $4000 out of her own pocket for one. “It was worth every penny,” she says. “My midwife was with me from month four of my pregnancy until Donnovan, my son, was five weeks old. I could phone her and ask questions anytime, she would come over and have tea with me and discuss my feelings and my body, she even came to a doctor’s appointment with me when my husband was unable to make it.” Jennifer says that her midwife, Sherry, helped her enroll in prenatal classes, recommended prenatal yoga and swimming, and even helped her pick out a stroller and a car seat.

“Sherry knew all the regulations for things [for cribs, car seats, etc.], and even suggested things I never even thought of. I’d never had a child before, but she was educated on the entire process, and had helped many mothers before me . . . she was a pro.”

Midwives have, of course, been aiding women for centuries. Here in Canada, they were reintroduced as a regulated profession in the early 1900s. While they must undertake training in order to be licensed, they are not permitted to intervene medically, and so are recommended for low-risk pregnancies; higher risk ones are left to doctors.

“My midwife helped me map out a birth plan, make difficult decisions regarding prenatal testing, pain management, and birth setting. She made sure I was informed about every step of the process so that I could make the best decision for me.”

Jennifer’s labour and delivery, like Amanda’s, was in a hospital. But while Amanda was visited by nurses every hour or so “to fill out their forms, and check [my] stats,” Jennifer’s midwife was in the room, at her side, for the entire experience. “She helped both my husband and I get through. She knew when to stand back and let us be, and when to step in and help us out. If I had had a home birth she could have delivered Donnovan, but I chose a doctor, just in case. But my midwife was in charge of checking my cervix, rather than having several different nurses and doctors checking me.”

Post-delivery, both Amanda and Jennifer spent a few days in the hospital and were relieved when they were finally sent home. Jennifer’s midwife was at the house waiting. She helped them to get unpacked and settled in and then took a few moments alone with Jennifer to help her breastfeed Donnovan.

For Amanda, it was a different. “[I received] very little support for nursing. I managed fine, but many new moms [get] frustrated and throw in the towel very quickly. There is almost no support for learning to breastfeed while in the hospital.” When she had questions, Amanda called a healthlink number and was put in touch with community nurses. “They are very helpful,” she says. “I still call them to this day.”

Similarly, Jennifer still calls her midwife with questions. “She came and checked up on me a couple of times a week for five weeks. I could call her and if she would answer my questions, explain things to me, and if I needed, come over and help me out. She is amazing . . . I know I paid her to hang around me, but it was like having a really good friend by my side every step of the way. And she is so knowledgeable about everything to do with babies and pregnancy, that she was able to educate my husband and I where we were clueless.”

So hats off to Alberta for joining British Columbia, Saskatchewan, Manitoba, Ontario, Quebec, and the Northwest Territories, in covering the costs of midwives. It won’t remove the good and the bad of pregnancy, but it might deal with some of the ugly.