A New Vision for Midwives and Maternity Care

The Maternity Association of BC (MABC) has developed a New Vision for Midwifery and Maternity Care that aims to:

• Increase access to maternity care in rural, northern and First Nations communities;
• Improve health outcomes for maternity care;
• Reduce costs of maternity care and freeing up $60 million for other health care priorities.

Their vision seeks to fully integrate midwifery into BC’s health care system and increase the number of midwife-assisted births in BC to 35% by 2020.

There are several short videos available on the site, including an interview with Dr. Michael Klein, Professor Emeritus of Family Practice and Pediatrics, UBC. Dr Klein states that the average age of obstetricians in BC is almost 58, fewer and fewer GPs are incorporating maternity care into family practice, and we are not training enough midwives. Five to ten years down the road he believes we are heading towards a crisis of maternity care in BC.

In response, UBC has increased the capacity of their midwifery program from 10 graduates a year to 20, but, in order to meet future needs, it should be 40 to 50 graduates per year. He states that midwives should be the backbone of the maternity care system, working in partnership with family doctors. He said that research has demonstrated that outcomes from midwife-assisted births are as good for mothers and babies as the current model and with much lower costs and fewer interventions.

The MABC Vision posits the following rationale:

Midwifery in British Columbia

• Registered midwives are highly trained, educated and regulated professionals who are experts in low-risk pregnancy, birth and post natal care. Midwifery services are fully covered by the Province’s Medical Services Plan.
• Midwives practice in clinics, hospitals and homes and provide 24-hour service.
• Midwives offer a full range of maternity care services, including: prenatal laboratory tests, genetic screening and diagnosis options, ultrasound imaging, procedures and medications, and access to a full range of comfort and pain-relief options for labour.
• A significant body of scientific research demonstrates that midwives improve health outcomes for women and newborns.

By-the-numbers

• 192 - Number of registered midwives practicing in 2012/13
• 7,360 - Number of midwife-assisted births in 2012/13 (16% of the total number of births)
• 17% - Percentage of midwife-assisted births that are planned home births
• 18 hours - Average reduction in hospital stay duration after a midwife-assisted birth
• 42% - Fewer caesareans in midwife-assisted births than the provincial average

The challenge: BC’s maternity care gap

• The number of family physicians practicing obstetrics in our province has declined in recent years, while the number of obstetricians is projected to fall significantly in the near future as baby boomers retire. Twenty rural maternity services have closed in BC since 2000.
• The maternity care gap will grow: the number of annual births in BC is projected to increase by 17 per cent to over 50,000 from 2011 to 2020.
• Demand for midwifery services is growing, with wait lists at most practices.

The solution

• Fully integrating midwifery into BC’s health care system and supporting midwives to assist in the delivery of 35 per cent of the births in BC by 2020.
• The MABC’s vision acknowledges that a high level of inter-professional collaboration among BC’s maternity care providers will deliver the best outcomes for BC’s women, babies and families.

The benefits: 35 per cent midwife-assisted births by 2020

• Increased access to quality maternity care closer to home in rural, northern and First Nations communities.
• Improved health outcomes for moms and newborns.
• Reduced pressure on family physicians in underserved communities.
• Fewer Caesareans and obstetrical interventions.
• Closing the growing maternity care gap.
• Freeing up approximately $60 million for other health care priorities.