Re: Midwifery cuts will lengthen waiting lists, Nov. 18.
The Ottawa Hospital wants to save money, but by cutting midwifery services it will force more women to have doctor-attended births.
Due to shorter hospital stays, lower rates of epidurals and caesarian sections, and reduced demand on nursing staff, midwife-attended births cost our health system significantly less than doctor-attended births. It seems the way to save money would be to have more midwives practising at The Ottawa Hospital, not fewer.
Re: Midwifery cuts will lengthen waiting lists, Nov. 18.
The Ottawa Hospital has 13 midwives with full privileges which is more than any other hospital in Eastern Ontario.
In the last two years, three additional midwives were given temporary privileges to complete their training and cover staff on leave. Recently, these three were notified that when their privileges expire, their services would no longer be required. This does not represent a reduction in our midwifery service. Our hospital is committed to continuing to offer this type of care as a choice for expecting mothers.
Growth in demand for obstetrical care over the past two years has been greater than increases in funding to support it. Unfortunately, this gap is now affecting our ability to support other services at The Ottawa Hospital, like gyne-oncology, for example, or high-risk pregnancy care.
Recently, we began discussion with our partners regarding a regional strategy to respond to the growing needs for routine obstetrical care.
Our goal in these discussions is to maintain choice and access for expecting mothers while ensuring that all partners are able to support an appropriate share in responding to this need.
Dr. Jack Kitts,
Ottawa
President and CEO,
The Ottawa Hospital
Nathalie Schiebel says midwife-attended births, including those of her two daughters, Josephine Crone, 1, and Lara Crone, 3, save the health-care system money because they are the cheapest way to deliver low-risk babies.
CREDIT: Rod MacIvor, The Ottawa Citizen
Re: Midwifery service was not reduced, Nov. 22, and Midwifery cuts will lengthen waiting lists, Nov. 18.
I was profoundly dismayed and saddened to read that the Ottawa Hospital has chosen not to renew the temporary privileges of three midwives.
I had midwifery care for my two pregnancies, and I was impressed by the clinical skill, caring, and dedication of my midwives. Given the waiting lists for midwifery care, and that midwife-attended births are the most cost-effective in the low-risk category, more money will be saved in the long term by making the privileges of these three midwives permanent.
Women on the waiting lists who are unsuccessful in attempts to secure midwifery care must turn to a family doctor who delivers babies or to an obstetrician: Both are more expensive to the health-care system.
Midwife-attended births are more cost-effective because women who are being cared for by a midwife have the option of giving birth at home. My two daughters were born at home, so I did not require the services of obstetricians, anesthesiologists or nurses. I provided my own pain management, labour and delivery room, and post-partum bed.
Although I would never have considered a home birth had the excellent facilities of the Ottawa Hospital not been available to back up my midwives, I was happy not to have to make use of them.
I agree that obstetricians should focus on high-risk pregnancies and complicated deliveries. If moving low-risk births out of tertiary-care facilities allows them to do this and saves money, that’s great. But all low-risk births should be considered as a whole.
More money would be saved by increasing the number of midwives with privileges at The Ottawa Hospital, thereby reducing the number of low-risk births taken on by obstetricians and family doctors. As the waiting lists show, the demand is there.
In response to the letter from Dr. Jack Kitts, the president and CEO of The Ottawa Hospital, as long as there are women on waiting lists for midwifery care in the Ottawa area, the services of additional midwives in this city are acutely needed.
Most individuals do not realize that midwives without hospital privileges are unable to practise midwifery in Ontario (no pre- or post-partum care, no homebirths).
By failing to renew privileges for midwives, The Ottawa Hospital is needlessly increasing costs to taxpayers. Women unable to access midwifery care will be forced to seek medical care at increased costs to taxpayers, since physician-attended deliveries cost $1,000 more than midwife-attended births. These midwives, out of work, will be collecting employment insurance benefits at taxpayers’ expense.
I am unable to comprehend how failing to renew hospital privileges for three midwives will increase funding to other areas of health care.
There is a conflict of interest in a physician allocating hospital privileges when such a decision will financially benefit physician colleagues. Where is the accountability to the taxpaying consumer?
Check out Montfort Hospital Head Midwife Teresa Bandrowska’s interview on CBC radio’s Ottawa Morning, aired this morning on Friday June 5th: http://www.cbc.ca/ottawamorning/archives.html
Article by Christy Swift.
Certified Nurse-Midwives, Certified Midwives and Lay Midwives: It is helpful to understand the different types of midwives practicing in the U.S. in order to choose one who best fits your needs.
