Tuesday, February 28, 2023

Midwives the themes for Monday morning presentation in Legislature for MLA Jennifer Rice


North Coast MLA Jennifer Rice had all the audio Gods on her side on Monday, her first opportunity since Thursday to return to her remote feed to the BC Legislature and thankfully for the MLA, the audio gremlins that plagued her Thursday efforts were cleared up by yesterday.

The topic for her morning address to the Chamber was that of Midwives, a theme she has been putting forward for much of the month, that following an announcement on February 17th of new seats at a UBC program .


Monday the North Coast MLA who is also Parliamentary Secretary for Rural health expanded on the practice of Midwifery and the new opportunities that the UBC program will provide.

Here in B.C. and around the world, midwives help to facilitate positive birth experiences for parents. They do this by focusing on patient-centred and evidence-based care. Not only can midwives provide families with the opportunity to access primary maternity care from the comfort of their own homes, but they specialize in healthy and low-risk pregnancies, effectively reducing pressure put on hospital resources. These incredible caregivers work meticulously to ensure the health and well-being of newborns and mothers before, during and after delivery. 

This fundamental type of care has provided my family and many other parents across B.C. with access to this skilled maternal support care when it is needed most. In British Columbia, we are fortunate enough to have over 500 highly trained midwives accredited through the B.C. College of Nurses and Midwives who provide trauma-informed, culturally safe, inclusive and effective services to families across the province. 

Midwives assist in just over 12,000 births a year, which is approximately 27 percent of births in the province. This is the highest proportion in Canada. 

You don't need a referral to see a midwife, and midwifery services are covered by the B.C. services plan. Midwives have been regulated and legally recognized as autonomous health care practitioners in B.C. since 1998. We need more midwives in B.C., especially for rural, remote and First Nations communities. 

That's why British Columbians will soon have improved access to primary maternity care, as our B.C. government adds 20 seats to the University of British Columbia's midwifery program. This brings the total annual intake to 48 seats, an increase of more than 70 percent. We're adding 12 seats to the bachelor of midwifery program, bringing the total annual intake to 32. Four of the seats were added in last September, and the additional eight seats are being added this coming September. We've also added eight seats to the internationally educated midwives bridging program, bringing the total annual intake to 16 seats. 

Ms. Rice also put some focus on the approach that the program is taking towards Indigenous communities and towards a rural support program.

 In recent years, the midwifery program has updated its curriculum to reflect the core cultural competencies identified by the National Aboriginal Council of Midwives. It has also appointed an Indigenous midwifery coordinator to support students and cultural learning experiences. 

The midwifery program has also committed to implementing actions contained in Mary Ellen Turpel-Lafond's 2020 report, In Plain Sight, addressing Indigenous-specific racism and discrimination in B.C. health care. 

The government is also committed to supporting Indigenous midwifery through various initiatives. The Midwives Association of B.C., in partnership with the Ministry of Health, is working on the rural support program and the rural midwives locum program and provides additional information about midwifery for Indigenous families and aspiring Indigenous midwives. 

Our government is working with partners, including the First Nations Health Authority, to explore ways to support Indigenous midwifery in such areas as reclamation of Indigenous birthing practices and Indigenous remote birthing. 

Our government provides funding to the Midwives Association of B.C. for an Indigenous midwifery stipend for the association's Indigenous midwives advisory council. The Indigenous midwifery stipend is intended to offset the increased time commitment of participating in additional cultural activities when providing maternity services to Indigenous clients. 

In January of 2022, UBC launched an advanced placement program for registered nurses interested in becoming midwives. This advanced placement study enables most RN applicants to reduce the 143-credit bachelor program by 27 credit hours, thereby reducing the cost required to complete this degree. Creating career development pathways for midwives is a key aspect of B.C.'s health human resources strategy, which was announced in September. 

This strategy puts patients first by ensuring that they get the health services they need and are cared for by a healthy workforce. It focuses on 70 key actions to recruit, train and retain health care workers while redesigning the health care system to foster workplace satisfaction and innovation. 

The new seats also support the province's primary care strategy by increasing access to primary maternity care and supporting family practices to care for low-risk births in community and closer to home.



BC Liberal MLA Coralee Oakes was the follow up speaker to the topic and she spoke to the theme of the midwifery program and hopes that it will deliver on the outcomes anticipated. 

The Opposition MLA  also noted of the past stresses on families and  highlighted some gaps in the provincial program in some communities in the province.

Despite some hints by government suggesting that maternity services could be added to the new hospital later on if needed, a freedom of information search by the opposition revealed the following from Fraser Health: "As pediatric and maternity services are out of scope for the new Surrey hospital and B.C. cancer centre project, there are no clinical services planning documents available that pertain specifically to this site." 

These challenges in accessing maternity care are not just isolated to the Lower Mainland. In Kamloops, the Thompson regional family obstetrics clinic, which delivers 60 percent of the babies born each month in the city, has announced a permanent closure after raising concerns for nearly a year. 

These impacts will be felt deeply by families in Kamloops, and those in rural communities as well, as demand for the clinic has increased as smaller regional operators have also lost doctors. Communities like 100 Mile, Lillooet, Barriere and Merritt relied on services of this clinic, so there is much uncertainty for them right now. 

I'll note that the news of the facility's closure comes less than a month after another clinic, Sage Hills community midwives in Kamloops, announced its closure.

That was area of opposition concern that was highlighted earlier this month by the Liberals.


You can review both MLA's presentations to the Legislature through the Video archive of the Monday morning session, the North Coast MLA begins her commentary at the 10:54 AM mark.

The transcript of the comments can be found from Legislature Minutes at the same time mark as the video archive.

A look at the UBC program is available here.

More notes on the work of Northwest MLA's a the Legislature can be reviewed from our archive page.

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