Fort Smith (May 23/05) - The first official midwifery program in the NWT has begun in Fort Smith.

Midwives Lesley Paulette and Gisela Becker were hired in mid-April by the Fort Smith Health and Social Services Authority.

"Now, we're officially part of the health system," Paulette says.

For Paulette, it has been a 13-year struggle to have midwifery recognized in the NWT. "I didn't think it would take that long. I felt it was inevitable. All I had to do was hang in there."

The biggest barrier was the lack of territorial legislation, but that changed earlier this year when the Midwifery Profession Act came into force, Becker explains.

The Fort Smith program is funded with $320,000 over three years from Health Canada.

Stefany Bourke has not noticed much of a difference in the service offered by the two midwives.

"Other than just coming into a different building," she says. "They still offer the same support they always did."

Bourke, who is expecting her third child in September, says doctors come and go in Fort Smith, and an expectant woman would have to start all over every time. "Lesley and Gisela, they know your history."

Paulette explains birthing services were once available in Fort Smith. However, that came to an end because of physician turnover and the lack of obstetrics experience by most doctors.

Under the new system, if there is a high-risk pregnancy, the delivery would happen in Yellowknife or another larger centre.

Nothing will change for a woman wanting to have a baby in Yellowknife or under the care of a doctor, Paulette says.

One of the concerns raised over the years was the lack of surgical back-up in Fort Smith in case of an emergency.

"You can't blame everything on location," Becker says. "Things can happen everywhere."

30 births

Prior to becoming part of the health system, Paulette and Becker estimate they offered prenatal care to about 50 per cent of pregnant women in Fort Smith. Of approximately 30 births each year, about 10 per cent of women chose a home delivery with a midwife.

The two Fort Smith midwives say they are aware other communities are watching Fort Smith.

"We're very conscious we are breaking new ground," Paulette says.

The service is being established in three rooms at the Fort Smith hospital -- an office, a prenatal room and a birthing room, which is awaiting renovations.