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COVER STORY: Better options for birth
It was just over seven years ago when Dayna Dueck, mother of five, went into labour with her third child while living in a rural area of Alabama.
Her water broke and she was desperately rushing to the hospital to make it in time for the birth.
To complicate matters, her doctor’s practice was too far from the hospital and was unlikely to make the trip.
Not that it mattered. She gave birth in the car on the way to emergency.
Dueck, now a Tsawwassen resident and pregnant with her sixth child, vowed not to let that happen again.
“So when we moved here and I found out I was expecting my fourth child (Anneliese) it was really important that I found a midwife close by and I really wanted a home birth,” she says.
It’s a good thing, too. When she went into labour with Anneliese, her midwife arrived 10 minutes after the phone call and the baby arrived 12 minutes after that.
Dueck describes her experience with midwives as “amazing,” and says she was surprised by how much time midwives devote to their clients throughout the entire pregnancy, including postpartum care.
“I found it really great, the midwives came to the house and checked on us,” recalls Dueck. “We didn’t have to go out anywhere, which was so nice because I was needing rest with four little ones aged six and under.”
She was also impressed how attentive her midwives have been to her needs, despite having other clients and busy schedules.
“The midwife called me as I was leaving my ultrasound just to follow up. You would never get that in a more medical setting. Doctors just aren’t able to give that kind of care.”
It’s precisely for that reason the Midwives Association of B.C. (MABC) recently called on the province to inject $3 million annually–or $225 per birth per year–beginning in 2014-15 to increase the number of midwife-assisted births in B.C. to 35 per cent by 2020.
Ganga Jolicoeur, executive director of the MABC, says this would improve access to quality maternity care, especially in rural, northern and First Nations communities.
Jolicoeur says their request isn’t about creating more jobs for midwives but better access to maternity care for women by bringing births closer to home.
“We do know that the closer to home a birth is kept the better it is on the system and the better it is on the family,” she says.
The MABC claims that the money is merely an investment, and that by integrating midwifery into the health care system it will ultimately save $60 million through reduced need for physicians and obstetrician interventions.
A midwife also lowers the incidence rate of a Ceasarean section by 42 per cent and lowers the average hospital visit by 18 hours, according to the MABC.
“There are very few instances where changes to the system can be made without some kind of initial investment,” says Jolicoeur. “But the savings occur immediately and so we feel confident in our message and our vision.”
Jolicoeur says the MABC is also trying to educate the public about the level of medical expertise offered by midwives. Choosing a midwife doesn’t necessarily mean choosing a home birth. In fact, 83 per cent of midwives assist in births that take place in hospitals.
Alex Bacon is a Ladner resident and midwife at South Delta Midwifery in Ladner. She and two other full-time midwives handle 120 clients annually through the clinic.
Although most clients give birth at Richmond Hospital, 40 per cent of them choose to have home births.
“I think that has a lot to do with geography here, frankly,” explains Bacon.
Without a maternity ward in Delta Hospital, women are forced to take the George Massey Tunnel to Richmond.
Depending on what time of day the baby chooses to enter the world, traffic problems could severely complicate matters and bring stress to the mother.
Many choose to simply stay in the comfort of their own home and give birth under the care of a registered health care professional.
Bacon works with her clients from the moment she becomes pregnant to six weeks after she gives birth. The home visits every other day in the first week after the baby is born saves mothers the trip back to the hospital or clinic.
“Women love that we visit their home space and help them with breastfeeding and other things,” she says.
Bacon says the midwives also help get new mothers set up in “birth circles” with other mothers for socializing and sharing.
With an average age of 60 for obstetricians in B.C. and a lack of maternity physicians in Ladner, Bacon says there will be a growing need for midwives in South Delta in the near future.
She is also quick to dispel any lingering myths about home births meaning a more painful birthing experience.
“As midwives a lot of people think we’re anti-medication,” says Bacon. “They don’t know you can have an epidural with a midwife.”
Midwives are medically certified to handle nearly any complication and stay with their clients the entire time they are in labour, whether that be 24 minutes or 24 hours.
That can be seen as an advantage over a doctor who might check in periodically to measure the dilation of the cervix between attending other responsibilities.
Midwives are also fully covered by the province’s Medical Services Plan and are not private for-profit businesses.
Perhaps most importantly, midwives are certified through four years of university, and are medically trained professionals specializing in maternity.
Following her positive experiences with midwives, Dueck decided to become a doula in 2009, as well as a birth photographer. She teaches group and private birth preparation classes in South Delta and Richmond and keeps a photo blog documenting her work.
While Jolicoeur says midwives have a positive working relationship with doulas, it’s important to note that doulas provide non-medical support for childbirth. By educating the public about midwives it will prevent people from confusing the profession with doulas, she adds.
“The misrepresentation and the lack of information on midwifery is still fairly widespread,” says Jolicoeur. “But the moment we engage with the public or with fellow health professionals or other agencies in the conversation around midwifery those myths seem to get dispelled quite quickly.”