30th Anniversary

Can you believe we've been at this lobbying thing for 30 years now? Thirty years we've been trying to convince various governments that midwifery is necessary, desirable and cost-effective care.

But we have had some successes, and we're going to whoop and holler and celebrate. We'll gather at the Company House, Gottingen in Halifax at 1pm till 3, have a party then screen the film, "Microbirth." Everyone is welcome to the screening, the party or both.

If you'd like to pass along invitations, you can download a PDF here.

Microbirth

To help us celebrate our 30 years of labour, we're screening the film, "Microbirth"

Visit their website.

Provincial Government declares May 5, 2014 as International Day of the Midwife

On May 1, 2014, Leo Glavine, Minister of Health read the following proclamation in the Leglislature:

Whereas midwives provide care to birthing women in every corner of the globe; and
Whereas this is an opportunity to pay tribute to the dedicated and compassionate work of midwives, as well as the many Nova Scotians who are recipients of their care;
Be it resolved that I, Stephen McNeil, Premier of Nova Scotia, do hereby proclaim May 5, 2014, as International Day of the Midwife and acknowledge their role in providing quality health and maternity care to Nova Scotians.

Download the full release here.

On May 5, midwives and midwifery will be honored around the world for their contributions to the health and well being of mothers, babies and families. Two reports have looked at the implementation of midwifery in Nova Scotia—one in 2010 and another in 2011. Among many other recommendations, both of these reports urged the Department of Health and Wellness to announce a plan for the growth of midwifery in Nova Scotia.

"When midwives began to practice as part of our public health system in March of 2009, their services were available in three sites. Five years later, despite increasing demand from mothers, they are still available at only three sites," said Dawn Hare, Spokesperson for Valley Families for Midwifery.

"Midwifery care is a good, solid investment in health for women and for their babies, the future population of this province. It is evidenced-based care and can make an enormous difference to people who may not have other resources," said Nicole Eddy, MCNS Spokesperson. "While we recognize that the Department of Health has taken steps in implementing midwifery it has been much too slow. We look forward to working with them to make midwifery care widely accessible to women throughout Nova Scotia."

International Day of the Midwife 2014

http://www.internationalmidwives.org/events/idotm/

AGM 2013: The Road to Midwifery

The MCNS met for our special Annual General Meeting: Midwifery 2013.

We had a chance to hear from Kelly Chisholm from the IWK midwifery clinic and Kerstin Martin with an update on the situation in Nova Scotia.

November 30, from 2 to 4 pm, Keshen Goodman Library, 330 Lacewood Drive, Halifax.

Read the details...

Rally 'Round Midwifery - Sept 28th

We rallied together on the grounds of the Halifax Public Library, Spring Garden, heard speakers talk about the need for midwifery, enjoyed some music and each others' company. There were bright flags, things to buy and oodles of happy babies. And yes, we made lots of noise.

Thank you to the Canadian Press who covered our event.

Read more

International Midwives' Day, May 5th

On May 5, midwives and midwifery will be honored around the world for their contributions to the health and well being of mothers, babies and families.  Sadly, here in Nova Scotia, midwifery services are still available to too few women.

Here's our press release, what we think about how it's going here in Nova Scotia...read more...

Celebrate International Midwives' Day
Read up on midwifery on an international scale at
http://www.internationalmidwives.org/

Attend a virtual conference with speakers and presentations at
http://vidm.wikispaces.com/
Follow

Kerstin Martin Appointed Practice Specialist

After a year-long search, the Department of Health and Wellness has hired Kerstin Martin as Practice Specialist. We are please because Kerstin has been involved with midwifery in NS for a long time. She is expected to provide guidance on how to build the midwifery model as the province moves forward.

—April 2013

Midwifery in 2013

We had a terrific forum with lots of great energy. Now all we have to do is harness all that energy towards the wonderful ideas. Please consider joining our work. You can now become a member using PayPal on our membership page.

What Next? The Forum on Midwifery 2012

The MCNS is inviting you to a special Forum on Midwifery 2012.

What should midwifery really look like in Nova Scotia? A special panel of women who have had midwifery-assisted births talk about how midwifery really makes a difference. Then hear an update on the situation in Nova Scotia, and take part in talking about our next moves.

We'll begin with a meet-and-greet with yummy snacks to give you the opportunity to share conversation with like-minded women. Come for an hour, come for the day. Children welcome. Read the details.

Download the poster, print it out, pin it up. Spread the word!

—October 2012

CBC-TV covers IWK's hiring of the midwives.

http://www.cbc.ca/player/News/Canada/NS/ID/2302924089/

IWK has finally hired 2 full-time midwives.

That brings the total to 3 and 1/2. They are planning to re-open the Dartmouth clinic, but have still not committed to offering home births. —October 2012

One more (part of a) midwife for the IWK

I suppose we're all supposed to be excited, but the IWK having hired a second midwife - and only part-time - doesn't even put us back to the beginning of the program.

When will there be sufficient staffing to allow for the home births that are desperately wanted by many women in HRM?

Where is the midwifery chief? What will happen in her absence?

And what administrative and policy changes have they made that will ensure that the midwives can function in a true women-centred midwifery model of care?

Yes, Good, but WHEN?

Hon. Maureen MacDonald, Minister of Health and Wellness, made a statement today announcing their plan. What is in there is good and follows the recommendations of the recent evaluation. But it doesn't expand midwifery services to other parts of the province, and doesn't include a timeline.

Here is our press release:

"(Halifax/Annapolis Valley)- The Midwifery Coalition of Nova Scotia and its supporters, including the Valley Family for Midwifery and the Women's Action Alliance for Change NS, commends the Nova Scotia government for committing more funding towards midwifery in Nova Scotia, but is concerned that women in the province are still left with no plan for rolling out midwifery province-wide." Read more...

Midwifery in Nova Scotia Report Released

Download it from the Dept of Health website
Find the link on the right sidebar: Midwifery in Nova Scotia..

or go directly to the .pdf

Our Response

Women in Nova Scotia want, need and deserve quality midwifery care now
August 11, 2011
HALIFAX- The Midwifery Coalition of Nova Scotia (MCNS) is overall pleased with the report, Midwifery in Nova Scotia.
We are pleased that this report supports the future of midwifery in Nova Scotia by providing concrete next steps towards sustainability. The authors state that they “think midwifery in Nova Scotia has good potential and that investment in its future is fully warranted.” We couldn’t agree more.

Kristel vom Scheidt, MCNS Board Member says, “We believe that the recommendations are evidence-based and doable. We would support their implementation within the context of respecting the Canadian midwifery model of care.”
This model was supported by the women who shared their experiences with us in our 2010 report Uncomfortable Positions. This model of care is community-based, collaborative, and founded on the principles of:

The MCNS echoes the report’s call for the Department of Health and Wellness to “articulate a long term goal for the province to have midwives in each District as an essential part of women’s health care services.”

“The current situation cannot continue. Women in Nova Scotia want, need and deserve quality midwifery care in their community.  We ask that the Minister of Health act without delay upon her stated commitment to midwifery in Nova Scotia by providing leadership in midwifery and implementing the recommendations,” says Kristel vom Scheidt.

For media inquiries, please contact: MCNS Board Member, Kristel vom Scheidt at 420-1785.
The Midwifery Coalition is a consumer group. For over 25 years, the MCNS has been working to have midwifery accepted as a regulated health profession. Our goal is for midwifery services to be available to all women in Nova Scotia.

New Dept of Health Review

Hi Everyone,
An independent review of midwifery services in Nova Scotia is presently underway. This review is what the Department of Health promised the MCNS, and the public, back in January when the midwifery situation in NS was making headlines (after the rally, and after the evaluation was released.) The review team includes a midwife from Manitoba, a midwife from Ontario, and a nurse manager from Manitoba.

The MCNS was lucky to receive a one hour meeting with the review team on Monday. This was very important as the review that is taking place does not include interviewing consumers. So we spoke on behalf of all of you!

Our three key points were:

1) Move midwifery from the tertiary care centre to the community as the current situation is creating an atmosphere of bullying and undermined informed choice. If this does not occur, a consumer advisory committee is to be set up immediately! This committee is to be consulted regularly.

2) Department of Health needs to take a leadership role to protect Canadian model of midwifery. This includes implementing midwifery province wide, and to provide funding with clear guidelines, timelines and outcomes.

3) In the interim, look at alternative funding and models so midwifery can be available now!
The review team was responsive to all our suggestions, and we left with a good overall feeling about the discussions that took place!
We will keep you updated!

May 19, 2011

My Fair Baby - Revived

After an absence of a few years, My Fair Baby is back. Back at St. David's Hall, such a cozy venue right across from Steve-O-Reno on Brunswick St. And many of our favorite vendors are back along with new and very interesting folks. Razzmatazz, too!

June 11, 2011 from 1 till 4

My Fair Baby is a family event that focuses on a natural approach to pregnancy, birth and parenting. We will celebrate women and their families as they prepare for the arrival of their new little one, with live entertainment, retail exhibitors, community groups, door prizes and tasty treats.

Admission is by suggested donation of $5.00 per family, all proceeds from My Fair Baby will support our efforts to have publicly funded midwifery services available to all women in Nova Scotia.

Read more...

Behold! Our Newsletter!

April 18, 2011

We've been promising you a newsletter for quite some time now. Thanks to Jackie we have just the thing for your reading pleasure. Download the .pdf

Dare to Declare!

April 5, 2011

We have asked the Nova Scotia government to recognize the International Day of the Midwife, May 5. Given the lack of action on getting midwifery services going in this province, do they dare to declare the day?

Declare it, then take action to make midwifery happen.

Valley Families for Midwifery information session

Join the wonderful women of VFM at the Wolfville Memorial Library, April 13 from 6:30 to 8:30 in a discussion about the current situation in Nova Scotia and the Valley.

Valley Families for Midwifery believe that all Nova Scotians deserve access to the high quality maternity care that can be provided by midwifery care services. In March 2009 provincial regulations cut off midwifery services to Valley families and since then the group has been dedicated to reinstating this model of maternity care. Their efforts are focused on achieving publicly funded midwifery care for all Valley families through collaboration with the Province and the District, as well as public education campaigns within our communities.

For more information contact Dawn Hare at 902 678-2446

Dal Students in Support of Midwives Raise $

The Dal Students in Support of Midwives have held two bake sales and raised a whopping $200 and donated it to us, the Coalition. We're thrilled to have their support as well as their donation. Thank you to everyone who baked, and everyone who bought.

Evaluation finally released: Implementation of Midwifery in Nova Scotia

January 20, 2010

The report prepared for the Nova Scotia Department of Health & Reproductive Care Program of Nova Scotia has been released January 20th.

You can head to the DoH Primary Care web page about Midwifery and click on the blue box on the right.

Implementation of Midwifery in Nova Scotia

Our own report, Uncomfortable Positions, is available here.

And then there were none...

December 18, 2010

What is happening to the IWK Midwifery Program?
The Midwifery Coalition of Nova Scotia is concerned about changes occurring in the IWK Midwifery Program. Here is what we know, what our questions are and what we would like to see happen.

What We Know

There is presently only one full-time midwife still employed at the IWK Clinic, Kelly Chisholm, who has taken a leave of absence. The other full-time midwife, Theresa Pickart tendered her resignation on December 15. Four midwives were originally hired (two part-time and two full-time). With only one midwife still employed we are not certain what this means for midwifery clients. It is possible for them to still receive some care from the midwife, but given the caseload and demands, it is likely that some clients will not be able to remain under midwifery care and most clients will not know whether part of their care including delivery will be handed over to physicians.

The Department of Health provided funding for three full-time equivalent midwives to the IWK as a model site. The IWK has not posted a job ad for either two part-time or one full-time midwife for the position that became vacant the first week of November when a second midwife (Rachel Godwin) was terminated from the program. (The first – midwife, Karen Robb - was fired in December 2009, but subsequently cleared of all complaints by the Midwifery Regulatory Council.)

Previous to the resignation of Theresa Pickart, the IWK had told midwifery clients that a registered nurse will now provide care in the midwifery clinic to midwifery clients. She does not have a license for clinical midwifery practice and she has never practiced midwifery in Canada. As a registered nurse, she is required to work under the direction of a midwife or other primary care provider. Moreover, as a member of the IWK midwifery management team, she will need to be 'supervised' by her employees (the midwives).
The IWK also informed midwifery clients that they would no longer be allowed to plan homebirths for the foreseeable future. The IWK advised clients that home birth services could not be offered when there were still two midwives employed. However, the South Shore midwifery practice of two midwives have been providing homebirth services all along.

Our Questions

Why has the IWK midwifery program been so fraught with problems?
Why was the midwifery job ad not posted in November? Why the delay? What has happened to the money allocated to filling midwifery positions while those positions remain vacant?
What is the IWK's rational for employing a nurse to work out of the midwifery clinic as an interim solution to the midwifery vacancy? The money could have been used to hire a “second attendant” for homebirths and ensure that one of the central tenets of midwifery –choice of birth place – was respected. Alternately, why not decrease the case load to fit the complement of midwifery staff that is employed?
Do midwifery clients clearly understand the registered nurse's role and the restrictions on her midwifery license? Will her nursing duties end at the clinic when another midwife is hired?

Our Concerns

Should the last midwife continue to practice, clients in the IWK midwifery program will no longer have the choice to give birth outside of the hospital. Clients will also now receive care from various providers including nurses and family physicians. Continuity of midwifery care, as an important tenant of the midwifery model, has been replaced by fragmented care. There will be discontinuity of support and of care planning which could compromise the quality and safety of care provided.
The attrition of midwives and the numerous interruptions in services makes it clear that a community-based midwifery program cannot function under the management of a tertiary care hospital whose expertise lies in high-risk hospital-based clients and not in primary health care.

Money specifically allocated to provide midwifery care should not be used to pay for nursing care. Moreover, having a nurse providing clinical care alongside midwives in the midwifery clinic is bound to create confusion. A critical part of successfully integrating a new professional into the primary health care system is to clearly communicate to everyone precisely what this new professional's scope is, where their competence and expertise lies and what they bring that is unique in terms of training and skills. Further role confusion between nurses and midwives isn't helpful to that goal.

What Do We Want to See Happen?

We want midwives in this province to be able to work according to their full scope of practice within a model that provides the best care possible to women and their families.

We want midwives to be able to use their unique skills and training, in a way that responds to the needs of women and families across this province, who value the different model of care provided by midwives.

We want midwives to continue to collaborate with other care providers as necessary to ensure that a woman receives the safest care. However, midwives are not interchangeable with nurses and family physicians or obstetricians. If they were, why integrate another professional group into the maternity care system just to provide the same care and have the same outcomes? Surely, the reason for integrating midwives into the public health care system was because the evidence demonstrates they provide safe care that results in fewer interventions, higher breastfeeding rates, and excellent overall outcomes for women, babies and families.

There are alternative ways to organize and manage midwifery in HRM.

The Department of Health could allow publicly-funded midwives to practice autonomously within the Capital District Health Authority.

There is also an opportunity to take advantage of the expression of interest by the North End Community Health Centre to locate midwifery there in a community-based, primary maternity care model located in a collaborative team environment that will also address the needs of vulnerable and marginalized. Opening the lines of communication and bringing all of the stakeholders to the table to discuss this opportunity (including midwives, and consumers) could be a timely solution.

A “model” model-site: South Shore Midwifery Program

We know what it takes for a midwifery program to work. We have a model site in our province that is working and could be a model for other sites as midwifery expands across the province. The South Shore Midwifery Program embodies all of the tenets of the midwifery model of care.

Here is what we know about that program:
There are two practicing midwives who have a store-front midwifery clinic operating out of a house on Dufferin Street in Bridgewater. This is a community-based midwifery practice that offers women/family-centred care enabling their clients to make informed choices including choice of birth place. Clients get to know both midwives well, thus are assured that they will be cared for prenatally, during delivery and postpartum by care providers whom they have developed a trusting relationship.

Only one midwife left standing in the IWK midwifery program

HALIFAX, NS – The Midwifery Coalition of Nova Scotia (MCNS) is very concerned about changes occurring in the IWK Midwifery Program. In just one year, the IWK midwifery program has gone from employing four midwives to employing one. The attrition of midwives and the numerous interruptions in services makes it clear that a community-based midwifery program cannot function under the management of a tertiary care hospital whose expertise lies in high-risk hospital-based clients and not in primary health care.

There is presently only one full-time midwife still employed at the IWK Clinic, Kelly Chisholm. The other full-time midwife, Theresa Pickart, tendered her resignation on December 15. As Erin Hemmens, Co-Chair of the MCNS said: “With only one midwife still employed we are not certain what this means for midwifery clients. It is possible for them to still receive care from the remaining midwife, but given the caseload and demands, it is likely that some clients will not be able to remain under midwifery care and most clients will not know whether part of their care including delivery will be handed over to physicians.”

This is only the last of a string of occurrences in the program in this week that have us very concerned. Previous to the resignation of Theresa Pickart, the IWK had told midwifery clients that a registered nurse (Lorraine Jarvie) will now provide care in the midwifery clinic to midwifery clients. She does not have a license for clinical midwifery practice and she has never practiced midwifery in Canada. As a registered nurse, she is required to work under the direction of a midwife or other primary care provider. Moreover, as a member of the IWK midwifery management team, she will need to be 'supervised' by her employees (the midwife).

Also, previous to this resignation, the IWK had already informed midwifery clients that they would no longer be allowed to plan homebirths for the foreseeable future. The IWK advised clients that home birth services could not be offered when there are only two midwives employed. However, the South Shore midwifery practice of two midwives have been providing homebirth services all along.

According to Hemmens, “For women under care at the IWK midwifery program it means no end of stress and anxiety. It means, should the last midwife continue to practice, these clients will no longer have the choice to give birth outside o the hospital. Clients will also now receive fragmented care from various providers including nurses and family physicians. We are concerned that this could compromise the quality and safety of care provided.”

There has to be an alternative to this program being managed by the IWK. The alternative must allow midwives to work according to their full scope of practice within a model that provides the best care possible to women and their families. It must allow midwives to be able to use their unique skills and training, in a way that responds to the needs of women and families across this province, who value the different model of care provided by midwives. It must allow midwives to continue to collaborate with other care providers as necessary to ensure that a woman receives the safest care.

A couple of alternatives to the hospital-based program are possible. The Department of Health could allow publicly-funded midwives to practice autonomously. In addition, according to Jane Moloney, Executive Director of the North End Community Health Centre, "the centre has already expressed interest to the Department of Health to be considered as part of the future for midwifery in the province to offer culturally specific, collaborative care that meets the needs of vulnerable and marginalized populations. The Centre now has the space available to work together with midwives, consumers, and the province to consider how to implement that opportunity".

Women who want to access midwifery care in Halifax deserve answers and they deserve to know what is being done to ensure that they can receive the care they expected to receive under the care of midwives.

For more information and to arrange a media interview, contact Erin Hemmens 422-6429.

Evaluation

MCNS Evaluation report available

Download your own copy of the Midwifery Coaltion of Nova Scotia's evaluation report:
Uncomfortable Positions: Consumer Comments on Midwifery Implementation in Nova Scotia
and the Appendix of Letters

Position Statement

In response to some issues raised at the Forum, as well as for our own use when speaking with politicians and media, the Midwifery Coalition of Nova Scotia has created a new position statement. It outlines our thoughts and wishes for midwifery in Nova Scotia and we will be using it as the foundation for our lobby efforts in the coming year. Please feel free to cut and paste/draw from for your letters to government officials.

Download it here.

Forum: Finding our Common Voice

We had an amazing turnout for our Forum. Wonderful people with positive energy discussed their personal experiences with and without midwifery. From here we strategize and throw our efforts behind making midiwfery available to all.

If you have some lobbying ideas, ideas about what kind of political action you'd like to see or to take, give us a jingle. mcns at chebucto.org

Also consider coming out to our annual general meeting. We'll talk about next moves, about what the Coaliton needs to do in order to forward our goals.

Implementation

When the Midwifery Act became effective in March 2009, several things happened:
• Midwifery became a legal, regulated, publicly funded service.
• It became illegal to practice midwifery without a license. 
• Midwifery services became available in three model sites—the IWK in HRM; the South Shore DHA; and GASHA (Guysborough, Antigonish, Strait Health Authority.

What this means for women is that some of us have access to publicly funded midwifery care, but many more don’t. 

Right now, the Department of Health is evaluating the process of implementing midwifery in the province. Along with this evaluation, the Midwifery Coalition of Nova Scotia (MCNS) has been asked to collect the stories of women and families who live in parts of NS where midwifery services are not available. We have collected these stories and written an analysis which will be available soon here on our website.

We are also meeting to look at the evaluation and consider recommendations.

Our Vision

The Midwifery Coalition believes that midwifery provides the highest standard of care for mothers, babies and families. We believe it is an important part of maternity care and is a choice that should be available to families in Nova Scotia.

We are working to have midwifery accepted as part of Nova Scotia's health system and to have midwifery care covered by MSI.

Our October Board Meeting

Our next regular board meeting will be held on Sunday, October 5th, 10:30 am, at the South House, 6286 South Street, Halifax, NS. If you have questions or need directions you can call Catherine at 902 471-1744

Midwifery and the MCNS in the News

Would you like to listen to an interview on the radio or read the articles in the paper. Listen and read...

Are You on Facebook?

Join our group, "Midwifery Coalition of Nova Scotia"

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This site has been updated October 8th, 2013

Like the new look of the website? We can thank the Halifax Peninsula Community Health Board and the Community Development Fund for a grant to hire a graphics advisor. Many thanks to them and to Kim Squared for being that inspired graphics advisor.
If you have suggestions for this site, I would be keen to hear them. Submissions, news, suggestions for links, etc are all welcome. E-mail Catherine at "mcns AT chebucto.org"