Making the Transition to Midwifery
Fouillard, Camille, Herizons
Making the transition to Midwifery.
When her baby's head began to crown, Alison stood up, hung on to her husband Bruce and, in a semi-squat position, pushed one last time. Alison gave birth to Jenna in her home in Pierrefonds, Quebec last September, while her mother and two-year-old daughter Caitlin looked on.
Alison chose to have her birth assisted by midwives. Although she didn't know at the time that midwifery was illegal, she says it wouldn't have mattered. She just knew she wanted a more positive birth experience than she had with her first child in hospital.
"I was very single-minded. I didn't think about bureaucracy, laws and doctors, or the province and Canada," she explains, "I was just thinking about my needs, our needs."
Alison didn't ask midwives Kerstin Martin or Marie Brunet about formal training and diplomas. She had done a lot of research and knew that she wanted a home birth. The long hours spent with the midwives meant that all her questions were answered. When it came time for the birth, she was allowed to deliver in her own way, to breathe, move and ear if she needed to, and stand for the final push because her body wanted to. In short, the midwives didn't take her power away.
"I never would have believed that I would do anything as unconventional as a home birth," says Alison. But she wanted to give birth in a safe, familiar environment "where the people you love and who love you are quietly just going about their lives and making sure everything is okay for you. It's just fantastic. It was wonderful."
Three years ago, the Quebec government authorized midwifery pilot projects when it passed Bill 4. For midwives, this is the first legal opening to practice since the late 1800s, when the Quebec Corporation of Physicians (QCP) clinched the exclusive legal right to handle childbirth in the province. Before the 1800s, midwives routinely delivered babies in New France. In some rural areas, midwives were even elected!
Over the last 20 years, a women's health lobby has been demanding a more humanized birthing process, including the legalization of midwifery. The purpose of the Quebec pilot projects is to see how midwifery will affect the quality and continuity of obstetrical services, the health of babies and mothers, as well as the level of medical interventions in childbirth.
The projects were scheduled to start in the spring of 1993, but the labor has been a long one. In the three years since the bill was passed, only two projects have moved past the approval stage. One of the projects, the province's first birthing centre, is in the northern Inuit community of Povungnituk. The Povungnituk centre was actually set up before the midwifery bill was passed, but it is now considered a pilot project. A second birthing centre in Gatineau is scheduled to open its doors this fall and another six projects (these may or may not be birthing centres) are excepted to follow. Thirteen pilot project proposals have been submitted and more are expected before the September 23 deadline. An estimated 60 midwives will be needed to staff the projects. But the midwifery bill contains no real provisions for licensing or training future midwives.
Not surprisingly, many midwives are critical of the way the health ministry has gone about introducing midwifery. Kerstin Martin, one of Alison's midwives, is one of them. Martin has helped deliver 500 babies in her eight years of practice. Half were home births; the rest were in hospitals. She charges $500 to $900 for her 50-or-so hours of service. A mother of four, Martin's interest in midwifery came from the time she had her first baby.
"In 1968, I had my first baby in five-and-a-half hours from start to finish. Within that time, without asking me at all, nurses plunged Demeral in my hip twice, the doctors ordered a spinal anaesthetic and did a forceps delivery. I was just a piece of meat. Even at 20, I felt in every cell of my body that this was wrong. …