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Yukon is one of the last two remaining jurisdictions in Canada without regulations for midwives.
After nearly two decades of discussion, the current government has made it a priority to regulate and fund midwifery. Yukon women can pay up to $3,000 out of pocket for midwifery services.
Midwives working in Yukon are limited in their ability to provide the best possible care.
Since they aren’t recognized as professional healthcare providers, they cannot order diagnostic tests or labs. Yukon midwives also don’t have hospital privileges, which means they can’t deliver a baby if the mother chooses or needs to go to a hospital during labour.
Registered midwives are primary maternity care providers who look after healthy pregnant people and their newborn babies. Registered midwives are well-educated healthcare professionals who are fully integrated in the public health care system. They care for women during their pregnancy, labour, birth and the postpartum period- including care of the newborn during the first six weeks after birth. Registered midwives practice evidence-based, client-centered maternity and newborn care.
Registered midwives work to empower families by offering informed choice decision making throughout their care, as well as recognizing that pregnancy and birth are a life changing event for any family. Registered midwives offer continuity of care within small group practices, choice of birthplace, and a focus on the woman as the primary decision-maker in her maternity care. When women or their newborns experience complications, midwives will work in consultation with appropriate specialists. In a nutshell, midwives are experts in healthy pregnancy and birth.
Registered midwives are autonomous primary care providers which means they are fully responsible for clinical decision making and the management of care during a healthy normal pregnancy.
- Registered Midwives listen, observe, educate, guide and care. They screen for physical, psychological, emotional and social health
- Registered Midwives offer the complete panel of prenatal laboratory tests, genetic screening and diagnosis options, ultrasound imaging and many other tests and procedures for clients and newborns.
- A Registered Midwife’s scope of practice includes prescribing many medications that may be indicated in pregnancy, during labour—including emergency situations or pain medication—and following the birth. If medication or testing is required outside of this scope of practice, midwives consult with and refer to doctors as indicated for more specialized care.
- They attend women during labour, and birth: normal and complicated; either at home, in the hospital, in a midwifery clinic, or in a birth center. They catch babies.
- They care for, assess and monitor a healthy newborn; providing advice and information on care for newborns and infants.
- Registered midwives visit families at your home after the baby is born. They help with breastfeeding.
- Between visits, registered midwives provide 24/7 call coverage for urgent care.
- Registered midwives are committed to collaborative practice and work with other health professionals such as obstetricians, paediatricians, family physicians and nurses
An important part of midwifery care is the idea of continuity of care. Continuity is both a philosophy and a process that is facilitated by midwives working in small teams. It allows a relationship to develop over time between clients and their midwife or midwives, with the purpose of providing safe, individualized care that meets a person’s personal health care needs.
Registered midwives engage in a non-authoritarian and supportive partnership with clients throughout their care. Midwifery recognizes the intimate client-care provider relationship as being integral to the provision of care that is responsive to the unique cultural values, beliefs, needs and life experiences of each client. Research suggests that the nature of the relationship between a client and healthcare provider is one of the most significant determinants of positive health outcomes. For Aboriginal communities, the inclusion of extended families and the integration of culturally safe care increases positive health outcomes.
Choice of birth place is an important part of midwifery care. Well-screened healthy women may choose to have their baby at home or in hospital. Midwives are unique care providers in that they are competent care providers in either environment. Registered midwives hold admitting and discharge privileges in hospitals, which enables them to provide care at home, but transfer safely to the hospital if needed or desired. Many women will also choose to have their baby with a midwife in the hospital. Above all, midwives respect the right of the client to choose the birth setting.
When discussing home birth, midwives provide clients with research-based information. They address questions and concerns, and assess whether the client is a good candidate for home birth. In any setting registered midwives are committed to team based care and work collaboratively with specialists like obstetricians, nurses, family physicians, paediatricians, anesthetists and lactation consultants.
Where you decide to have your baby is your choice. Regardless of where you choose to give birth, you will receive excellent, safe care from a registered midwife.
Midwives and doulas are quite different. Where registered midwives are full-scope maternity care providers, doula’s DO NOT provide clinical care or deliver babies. Doula’s DO provide excellent continuous labour and postpartum support and are an important part of the childbirth team with either physicians, nurses, or midwives. If you would like extra support at your birth, a Doula may be a great option in addition to midwifery care.
Midwifery education in Canada is a four-year baccalaureate (health sciences) program, currently offered at six universities in British Columbia, Manitoba, Ontario and Quebec.
There are also two bridging programs for midwives who were educated outside of Canada. Ryerson University and UBC offer programs designed for experienced international midwives to learn how to work in a Canadian context.
Registered midwives in Canada come from a variety of educational and clinical backgrounds including vocational training (often hospital-based), apprenticeship training, and baccalaureate and masters level university-based education.
All registered midwives in Canada, including those who were educated internationally, have undergone rigorous assessments to ensure that they meet the requirements and professional standards to deliver safe, competent, high quality care in the Canadian health system. In Yukon, the registration process and requirements will be consistent with those in other Canadian provinces.
A significant body of scientific research demonstrates that the full integration of registered midwives in the public health care system improves health outcomes for women and newborns. This research continues to demonstrate that midwifery care is a safe choice for low-risk healthy women. Many studies over the past two decades have demonstrated that midwifery in Canada offers optimal health outcomes and increased client satisfaction compared to other models of reproductive healthcare. In fact, the Canadian model of midwifery care is a highly valued around the world and the profession is considered the gold standard for maternity care globally.
Midwifery practice is informed by research, evidence-based guidelines, clinical experience, and the unique values and needs of those in their care. Aboriginal communities value the traditional knowledge that has been passed down orally and experientially through generations of midwives and midwives also use this knowledge in practice for optimal birth outcomes. In Canadian rural and remote communities without c-cesarean section capacity, care with midwives has been proven to be safe and culturally competent care.
In studies where midwifery was compared to physician-led care for low-risk women, midwifery clients experienced lower rates of forceps, vacuum extractions, caesarean sections, episiotomies, infections and babies born requiring resuscitation. And, in BC-where midwives have been fully integrated in the health care system since 1998- there is an average reduction of the hospital stay by 18 hours after a midwife-assisted birth, resulting in fewer hospital acquired infections and substantial savings to the health-care system. By providing postpartum care at home, midwives are able to safely discharge mom and baby from hospital sooner after birth, resulting in a significantly decreased average length of stay and fewer readmissions. As well, recent research by Perinatal Services BC reveals that there are 42% fewer caesareans in midwife-assisted births than the provincial average.
The Society of Obstetricians and Gynecologists of Canada supports collaborative maternity care and the important role that midwives play in caring for healthy women with uncomplicated pregnancies. In this vein, the profession of midwifery that is well-integrated and supported within existing health care services, is essential to improving reproductive and child health outcomes across Canada.
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