Women's health
Pushing for ‘normal' childbirth
February 28, 2011
Andrea Gordon
FAMILY ISSUES REPORTER
Ontario midwives are calling for the creation of birth centres across the province to give women in low-risk pregnancies a new and more natural option for delivering their babies.
Giving women the choice to move away from hospitals and into community-based birth centres “is a critical step in supporting and promoting normal birth,” says Katrina Kilroy, president of the Association of Ontario Midwives.
“We think this would help us to move away from a system of medicalized and quite industrialized birth that we have evolved into.”
Most women in Ontario have their babies in hospital under the care of physicians or midwives, while a small percentage in the care of midwives choose to deliver at home.
Birth is the main reason women are hospitalized, even though most women have no medical reason to be admitted, Kilroy says.
Under the association's proposal, birth centres would be led by midwives and provide care from conception, through labour and delivery and including postpartum support until the baby is six weeks old.
Kilroy says with the province's midwifery system already firmly in place, it would require a minimal capital investment, primarily for space. She estimates it would cost less than $10 million to get one or more centres into operation.
The proposal comes on the heels of a major report last week that found many Ontario women and their doctors are opting for medical interventions — from Caesarian sections to episiotomies — even when there are no complications.
The Power Report, based on research from the Institute for Clinical Evaluative Sciences, found that 28 per cent of all births were by C-section, and a quarter of those were performed even when babies were head down, full-term single babies, which is considered low-risk. The World Health Organization indicates an adequate Caesarian rate is between 5 and 15 per cent.
“As midwives, we believe this trend needs to be reversed,” says Kilroy. She says research shows when women can deliver away from hospital environments, the rate of medically unnecessary interventions is reduced.
Currently Quebec is the only province with midwife-led birth centres, with a dozen currently in operation, and more in the works. Plans are also underway for one in Winnipeg.
Ontario had proposed three pilot birth centres in the early 1990s in Toronto, St. Jacob's and Thunder Bay, but the initiative never got off the ground.
The midwives believe that with hospital services and budgets under considerable pressure, the time is right. Relieving hospitals of low-risk deliveries would give them more resources to focus on high-risk pregnancies that require medical support, Kilroy says.
For women's health advocates like Pat Campbell, women deserve as many choices as possible when it comes to health care.
“We want to see birth normalized as much as possible and midwives have done an amazing job of that,” says Campbell, CEO of the Ontario Ministry of Health's Echo agency to promote women's health.
But she stressed there must also be access to medical interventions for those who need it.
Midwives cannot practice unless they have hospital privileges and under a system of birth centres, they would be able to move patients into hospitals quickly if needed.
Toronto mother Jill Parsons, who had her three children at home, says birth centres would be a welcome option for many expectant parents she knows who aren't comfortable with a home birth but don't want to be in hospital.
“This might end up being a really nice middle ground,” says Parsons, 33. adding it would help promote access to midwives and the growth of the profession, which has trouble meeting demand in many areas including Toronto.
“I have a lot of friends having babies that are on four or five waiting lists for (midwifery) clinics.”
Kilroy says the association will formally launch its birth centres campaign May 5, the International Day of the Midwife.