By Aprille Janes
Special to The Toronto Sun

Long gone are the days when the midwife was simply the neighbour woman you called in when labour pains began.

Today's trained midwife acts as the primary care provider throughout the entire childbearing process, including six weeks after the baby's arrival. Midwives provide a high quality, cost effective option for both women and the health-care system.

Today, in order to practice as a midwife, you must first complete a four-year university degree program. In Ontario there are three universities offering the Bachelor of Health Science in Midwifery: McMaster University (Hamilton), Ryerson Polytechnic University (Toronto) and Laurentian University (Sudbury).

Kristy Hook, a registered midwife (RM) who currently works in a Peterborough group practice, attended Ryerson. "It was a good balance, about half clinical and half academic, so you start doing midwifery-related work pretty soon into your training, which is important.

"We also had rotations where we worked with other health professionals such as obstetrical and nursing rotations. We got to learn how these professions function, what was their scope of practice since we work closely with them. But primarily, your training is done with midwives."

In addition, there are the academic studies. Hook mentions they can be classified into two different groups, medical sciences such as biology, reproductive physiology, microbiology, pharmacology and the social science aspects of health care, which includes women's studies, health promotion and health education.

On top of all this, midwives must also attend a minimum of 60 births before applying for registration to practice to The Ontario College of Midwives.

OCM also requires practitioners to upgrade their skills and education on an ongoing basis. Conferences and other educational opportunities are offered and every other year, midwives recertify their emergency skills.

Once registered, midwives work together in practice groups. These dedicated professionals do more than just deliver healthy babies. They counsel, monitor and support the health of the mother throughout the pregnancy and during the post-partum period. Trusting relationships and continuity of care is an important part of the process.

The field is growing and offers excellent employment prospects for new graduates. In 1994 there were only 68 registered midwives in Ontario attending 1,800 births. Today, there are about 250 practitioners who covered more than 6,000 births last year. But another 1,300 expectant women were unable to obtain services.

"It's really patchy around the province, where there are practice groups and where there are not," Hook says. "There are some quite large communities that have no midwives."

Hook's advice for someone interested in the profession? "It requires a great deal of personal flexibility because you never know what your day is going to bring. You need to be able to roll with the punches," Hook says.

"You need to be confident. We're a primary care practitioner, so you need to be able to make clinical decisions and stand by them. You have to be ready and able to learn, to see the practice of midwifery as a process of ongoing education. If you want to get into a groove and get comfortable with it then midwifery is not really your role. And you must be a good communicator. That's the foundation of everything in midwifery."

In 1993, Ontario was the first province to recognize and fund midwives as registered health-care providers. Since then, British Columbia, Alberta, Manitoba and Quebec have also officially recognized the profession.

Midwifery is finding new value in today's society. What may have seemed quaint a generation or two ago is now a respected vocation offering opportunity, challenge and satisfaction.

If you're interested in finding out more about midwifery as a profession, contact the Association of Ontario Midwives at 416-425-9974 or visit the Web site at www.aom.on.ca.

And just a reminder that Sept. 9 is Fetal Alcohol Syndrome Awareness Day.

Speak with your midwife or doctor about alcohol and your unborn baby. The effects of FAS last a lifetime, but they are preventable. Make your pregnancy alcohol-free.

(Aprille Janes is a freelance writer based in Port Perry. She can be reached at afj@ajanesinc.com.)



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