Quebec’s midwives are reaching out to the general public to get midwifery fully funded through a petition directed at the National Assembly.

The petition, available on the National Assembly’s website, is a call to the Ministry of Health to raise provincial funding to 100% as the price tag is currently being divided equally between the province and the region.

According to Christine Roy, a midwife who previously headed up the midwifery program within the Cree Board of Health and Social Services of James Bay (CBHSSJB), though midwifery is covered by Medicare, regional infighting over dollars is keeping the service out of reach for Quebecers province-wide. The same rings true unfortunately for the Crees of James Bay.

“Let’s say a region receives X amount of funding for all of the health services that they offer in the region, it’s then up to the region to decide what they will do with that funding and this is where fighting will start within the region about which program is more important than another,” said Roy.

As it is always the squeakiest wheel that gets the grease, Roy said funding for midwifery and birthing centres often gets pushed aside.

While the CBHSSJB has been mulling over the idea of starting up a birthing clinic in Mistissini as a means of bringing birth back to the communities and also looking to develop a English-language midwifery program through the existing French-language program at l’Université du Québec à Trois-Rivières, provincial problems may stand in the way of progress.

For example, within James Bay, a large number of births occur at the Chibougamau Hospital where a doctor-run obstetrics system is in place in lieu of a midwife-run birthing clinic in the territory. Funding would have to be diverted back to the communities if they desire Cree-run midwifery clinics, which is a huge administrative ordeal.

Non-Cree midwives would also have to be hired first within the territory and that is another issue because without them, Crees would have to complete the 1600+ hours of apprenticing under another midwife outside of the communities.

At that, midwives are very hard to come by in Quebec as they don’t get hired in the regions and so not many students feel encouraged to complete the four years of schooling the program requires and then all of the on-the-job training if they are not going to get a job. The current program offered in Quebec falls just a few credits short of a bachelor’s degree.

“In Quebec, we started with 60 midwives in 1994 and today the number is around 125,” said Roy.

Funding midwifery however could be the solution to a number of province-wide medical quandaries, according to Roy, especially when it comes to ensuring that pregnant women have optimal tcare as well as having a cost-effective healthcare system.

She gave the example of how a large number of obstetricians are retiring within the next five years and the province has yet to line up younger doctors to replace them. As these doctors retire, so does their knowledge honed from working many years in their field – something that family doctors simply don’t have.

At the same time, the number of family doctors willing to offer obstetric care is also declining, limiting the options for those living outside urban centres, where most specialists can be found.

“This becomes a public-health issue because women then receive less optimal care. Regardless of the loss of the knowledge in the regions – and I’m not just talking about James Bay here, I’m talking about all of the small places that are not doing obstetrics anymore – women will continue to get pregnant and emergency births will continue to happen,” said Roy.

While she acknowledges that midwives could never accommodate the high rate of high-risk pregnancies common to Crees that result from gestational diabetes among other issues, Roy still argues that having midwives in the Cree communities would increase the quality of pre- and post-natal care for Crees.

Having midwives within the communities would mean that pregnant women and new mothers could get consistent care from the same individual for the duration of their pregnancy, instead of many doctors who are only available short-term under the current system. These midwives would work hand-in-hand with the doctors available to the communities, but the care would be more personalized.

“For births, only low-risk women would be able to stay behind, but it would mean that you would still have highly skilled personnel around when emergencies occur. So, you can have the best of both worlds as the community would be completely covered,” said Roy.

Despite numerous attempts to get in touch with the Cree Health Board concerning this issue, no response was made on their behalf.

To sign the petition: www.assnat.qc.ca/fr/exprimez-votre-opinion/petition/Petition-1389/index.html