Rebuilding Canada's Maternity Care System... With More Midwives

Canada is experiencing a shortage of both obstetricians and midwives.  This article in today's National Post online speculates on the possibilities of building a better maternity care system to replace the current one by giving women more access to midwives and freeing obstetricians to tend to high-risk pregnancies.

The dual shortages paint a grim picture for women looking for pregnancy care, but they also create an opportunity.

Provincial governments will be forced to do something that should have been done before now: build a sustainable maternity care system, one that makes proper use of midwives and therefore recognizes that not all pregnant mothers need to be treated as if their conditions are medical emergencies.

Giving more women access to midwives would not only serve Canadian women well but would save the health system money. Shifting more routine, low-risk births to midwives could halt the rising cesarean rate, which is a factor in skyrocketing health-care costs. It would also free obstetricians to work with more complex and risky pregnancies. No wonder obstetricians support increasing the number of midwives in the system.

Alleviating health-care shortages, unfortunately, does not happen overnight. Doctors and other health professionals take a long time to train. But the dilemma of pregnant women is one that people have long seen coming. Fewer and fewer family doctors deliver babies. Anyone who has been pregnant or has friends and colleagues who are pregnant will have heard anecdotal reports about the difficulty in finding a midwife.

The good news in all of this is that, by force of necessity, the role of midwives has gained legitimacy in Canada. Low-risk pregnancies are handled effectively by midwives everyday in countries around the world, but Canada has been slow to make midwifery part of our health-care system and now has some catching up to do.

To find a midwife or learn more about midwifery in Canada, visit the Web site of the Canadian Association of Midwives at