Chris Dowesett

Charis Lynn Williams of Prema Sai Prenatal, with daughter Stella, says it’s been a long fight for midwives to be fully funded under the provincial health care system

More than a decade after midwives in Alberta started lobbying to be fully funded under the public health-care system, the provincial government has granted their request. Health and Wellness Minister Ron Liepert announced October 16 that as of April 1, 2009, midwifery services will be covered by the province, offering more choice for expectant woman and better access to health care while reducing pressure on doctors, nurses and hospitals.

“It’s validating,” says Charis Lynn Williams, owner of Prema Sai Prenatal at the Arbour Birth Centre, a clinic offering a variety of prenatal services including midwifery. “It means that they feel that midwifery is a valuable service.”

Currently, women who want to access the services of a midwife have to pay about $3,500 out of their own pockets. The government approved the regulation of midwives in 1994, and began covering most of their liability insurance in 2003, but stopped short of covering the service under the provincially funded health-care system. Williams says midwives never stopped fighting and lobbying the government to take that next step.

“This has been a long fight. It’s great that the midwives have stuck with it,” Williams says. “It just didn’t make any sense. It costs less to have a birth with a midwife than to go into the hospital.”

Kimberley Schmidt, a former labour and delivery nurse who has been a registered midwife for four years, says the cost of hiring a midwife has been a real financial burden for some women, and completely out of reach for others. “For them to have the opportunity to get midwifery care without the huge expense is fantastic.”

Schmidt says she left nursing after the focus shifted from supporting women through the birthing process to increased intervention, such as epidurals. “It became a whole lot less satisfying to be a nurse,” says Schmidt. “I knew that if we provided women with good support, we were going to get better outcomes for these women, and better emotional outcomes.”

Schmidt, who is on the board of directors of the Alberta Association of Midwives, says midwives have a limited number of clients, and spend more time providing prenatal care — appointments range from 30 minutes to one hour, and cover everything from lifestyle issues and nutrition to managing labour. Midwives also remain with the client throughout labour and birth, and offer postpartum services, including home visits and breastfeeding support. Women can choose to give birth at home, at a birthing centre or at a hospital.

Schmidt says she received a dozen phone calls inquiring about her services in the 24 hours following the government’s announcement. Unfortunately, there may not be enough midwives to meet the initial demand — when funding failed to follow regulation, Schmidt says, some midwives left Alberta for the U.S. or other provinces where the service was covered. At this time, there are 30 midwives in Alberta, including 19 in Calgary. She expects those numbers to climb, but says it will take time.

When asked why it took more than 10 years for the province to fund midwifery services, Alberta Health and Wellness spokesperson Howard May responded that the Alberta government was working with midwives to look at how to incorporate them into the system. “We’ve recognized that midwives can play an important role in the system for some time, and we’ve looked at ways to support them,” he says. “This is just a natural progression.”

The funding comes too late for Jessica Klassen, who hired a midwife when she became pregnant with her first child more than three years ago, and will have a midwife by her side again when she gives birth to her second child next month. Although the province won’t be paying the tab, she says she’s excited about what the changes will mean for people who could really benefit from the care of a midwife but couldn’t afford it, such as single mothers with no support.

“I think it’s just such a huge leap forward for health in Alberta — and especially given the state of our health system right now,” says Klassen.