WOMEN IN OTTAWA MAY LOSE ACCESS TO MIDWIFERY CARE:
The Ottawa Hospital Set to Lower Number of Midwives with Admitting Privileges

OTTAWA – Each year there are hundreds of women whose names sit on waiting lists for midwifery care. Despite the growing demand for midwifery care in the Ottawa region, The Ottawa Hospital intends to begin lowering the number of midwives with admitting privileges at its Civic and General campuses as early as April 2004.

Cost Effective Maternity Care

The Finance Department at the General Campus of The Ottawa Hospital has stated that midwife-attended births cost the hospital an average of $442.00, while physician-attended births cost an average of $1418.00. This is because midwife-attended births do not take up valuable (and busy) nursing staff. Also, across Ontario, midwifery clients who give birth in hospital have much shorter postpartum stays (75% leave within 6 hours of delivery), saving even more on in-care. Finally, in Ottawa, over 40% of births attended by midwives took place at home, representing the greatest possible savings for the Ontario health care system and The Ottawa Hospital. Yet, despite the cost effectiveness of midwifery care, The Ottawa Hospital will not be renewing admitting privileges for 3 Ottawa midwives as of Spring/Summer 2004.

Woman and Family-Centred Maternity Care

Worldwide, 4 out of 5 babies are born into the hands of a midwife.¹ In North America, midwifery is gaining in popularity as pregnant women look for health care that is responsive to their needs. The midwifery model of care is founded upon three principles:

1. Continuity of Care: Midwifery care is available to women throughout their pregnancy, labour, birth, and the first six weeks after birth. Midwives spend time developing relationships with women and are available 24 hours a day, seven days a week.

2. Informed Choice: Women are active decision-makers in the care they receive; midwives give information to help women make informed decisions.

3. Choice of Birthplace: Midwifery clients may choose to give birth at home or in hospital. Midwives maintain hospital privileges at many Ontario hospitals and work collaboratively with other health care practitioners.

A Cochrane systematic review of ten studies involving over 60,000 women found that women who chose midwifery care were more satisfied and had the same clinical outcomes compared to women who used obstetrician/gynecologist care. ²

In 1994 Ontario became the first province to regulate and legislate midwifery. Midwifery care is completely funded by the Ontario Ministry of Health and Long-Term Care. Presumably this move would make it easier for women to access midwifery care. However, this new move by The Ottawa Hospital will actually limit that access.

Fewer Costly Medical Interventions

Women who give birth attended by midwives are far less likely to have costly medical interventions. Whereas the average rate of Cesarean birth at The Ottawa Hospital in 2002 was 26.4%³, the rate of Cesarean birth amongst midwifery clients was approximately 15%. Furthermore, the rate of women using epidurals at The Ottawa Hospital approaches 90%, whereas less than 30% of midwifery clients use epidurals.

Consumers Supporting Midwifery Care

Consumers Supporting Midwifery Care is an Ottawa area grassroots group of consumers advocating for increased access to midwifery care. We are a large and ever-growing group of women and men alarmed at the proposed changes that will lower the number of midwives available in Ottawa. We believe that families in Ottawa must have access to more midwives, not fewer.

Our next meeting will take place at the home of one of our members: Wednesday, November 26th, 2003 from 7-8:30pm at 2159 Saunders Avenue, Ottawa. Our website, http://www.midwiferyconsumers.org contains information on midwifery in Ottawa, upcoming meetings and events, and current campaigns to promote midwifery.

Consumers Supporting Midwifery Care says, “NO!” to the proposed changes by The Ottawa Hospital. We demand more midwives with hospital privileges, not fewer. Women in Ottawa must have the right to choose who will be the primary caregiver for their pregnancies and births.

Contact: Shannon Smith, Consumers Supporting Midwifery Care 831-6443 or cell 863-3943
info@midwiferyconsumers.org

¹ Association of Ontario Midwives, www.aom.on.ca 1-866-418-3773

² Villar J, Carroli G, Khan-Neelofur D, Piaggio G, Gülmezoglu M. (2003). Patterns of routine antenatal care for low-risk pregnancy (Cochrane Review). The Cochrane Library, Issue 4, 2003. Chichester, UK: John Wiley & Sons, Ltd.

³ Perinatal Partnership Program of Eastern and Southeastern Ontario – Annual Statistical Report, 2002 http://www.pppeso.on.ca/english/Statisticalreport_2002.pdf