By Susan Poizner
Special to The Toronto Sun
Over the last century, there have been huge technological and scientific developments in the Western world. More and more women give birth in hospitals, and to some it may seem that midwives are no longer necessary.
Yet, in a world where doctors and specialists have so little time, some pregnant women long for the type of one-on-one care a qualified midwife can provide. In 1994, there were just more than 60 midwives in Ontario. Today there are more than 260, and that's not enough.
"Today, fewer young doctors are becoming obstetricians," says Maureen Silverman, a registered midwife who earned her bachelor of health sciences in midwifery at Ryerson University in 1999.
"Being on call 24 hours a day while running a family practice must be difficult. So as the older doctors leave, fewer are entering the profession and women are having trouble getting obstetric care," she says.
Midwives have always existed in Canada, but they worked outside the health system. Then in 1994, Ontario became the first province in Canada to legislate midwives as regulated health-care professionals funded by the Ministry of Health and Long Term Care.
But if you think midwives are still the kindly ladies that sit by the bedside just holding the labouring woman's hand, you're far off the mark. After four years of full-time study, midwives are qualified to face many of the problems that may arise.
"About 70% of the births we oversee take place in the hospital, and 30%, at home. The women we care for are low risk and normal, and that leaves obstetricians to work with high risk women, which is their specialty," she says.
Even if the midwife is attending a home birth, she'll come with first-line emergency equipment, including medication that can stop hemorrhaging, oxygen for the mother or child, and suction equipment to clear mucus from a baby's airway.
Birth, however, is just a small part of the relationship between a woman and her midwife. Because they are primary health-care providers, the midwife also takes care of prenatal and post-partum visits, often spending more time with a client than most doctors can.
"Appointments may be anywhere from 30 to 45 minutes. We see the mother as the primary decision maker, so the midwife will give the woman all the information around an issue, like pain relief, and allow the mother to make the decision that's right for her," says Laurie Clemens of the Association of Ontario Midwives.
Maureen Silverman loves her career, but she does warn others who are interested in getting into the profession that there are some drawbacks.
"We have creative ways of trying to take time off. But the bottom line is none of it really works well because our priority is to be with women in labour."
And while the demand for midwives has grown quickly in the last decade, the salary for full time midwives has stayed at $55,000 to $77,000, with a full-time midwife attending 80 births a year.
And yet for Maureen Silverman, her job never fails to instill a sense of awe.
"Giving birth is a very complex and unbelievable process. During the recent blackout I had two home births that went off without a hitch. We didn't need electricity or technology and all the equipment we've come to rely on. It amazes me that these births happen in spite of it all."
For more information: www.aom.on.ca
(Reach freelancer Susan Poizner at (firstname.lastname@example.org).
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