Fort Smith (Feb 09/04) - For years, two Fort Smith midwives have struggled for official recognition of their profession.

Now Lesley Paulette and Gisela Becker will shape the future of midwifery -- not just in their town, but across the NWT.

Fort Smith midwives Lesley Paulette and Gisela Becker, seen here with a practice baby, have fought for recognition of their profession. - NNSL file photo

They have been contracted by the Fort Smith Health and Social Services Authority to plan and develop a midwife maternity service based on the new Midwifery Profession Act.

It is expected the service will be available no later than Oct. 1.

Paulette, who has been a midwife in Fort Smith for 11 years, calls it a significant step forward.

"It gives me a lot of satisfaction that we've come this far, but I realize that there's a lot of work ahead."

Fort Smith is lucky to have two veteran midwives to begin the process in the NWT, said Dana Rasiah, the CEO of the health authority.

"We have the right people to get it going."

Fort Smith has been a beachhead to establish midwifery and birthing services outside of Yellowknife, said Health and Social Services Minister Michael Miltenberger.

There are still many protocols and procedures to develop, he said.

"The plan is to work out the bugs here and it will be easier for other areas."

In an average year, there are more than 30 pregnancies in Fort Smith. About half the women are cared for by midwives and give birth at home.

There are no birthing services at the local hospital, other than in rare emergency situations. Women wanting to have their babies in a hospital must go to Yellowknife, Edmonton or elsewhere.

Comprehensive care

Becker said the midwifery service will perform prenatal, birthing and postpartum functions.

It will be established in a room to be renovated at the Fort Smith hospital.

"The plan is to create a birthing area that is as home-like as possible," said Becker.

Medical equipment will not be visible. It will be designed to allow families to come and go as they wish.

"Midwives in the NWT will provide birthing in a hospital or at home," said Becker. "It's the woman's choice."

The comprehensive midwifery program will include such things as pregnancy tests; examinations; and advice on nutrition, lifestyle, smoking cessation, breastfeeding and the avoidance of alcohol.

The care -- physical and emotional -- covers the pregnancy and continues for a few months after a birth.

More relaxing

April Davies has had one baby with the help of Fort Smith midwives, and is expecting another child in April. She is pleased with the latest developments.

"I think it's a good idea because it provides women a choice of where they want to give birth," she said.

The midwifery service will mean a new relationship between doctors and midwives. In the absence of legislation and insurance, doctors have been reluctant to work with midwives.

"It is a relief to us to know we are dealing with partners who are insured and licensed," Dr. Mahmud Sultan, the chief of medical staff with the Fort Smith health authority.

Under the new service, he said Fort Smith doctors would be involved in birthing if needed -- midwives would carry the bulk of the load.

Community support

In the coming months, the health authority will seek community input to help plan the service. Linda Sheesley, the director of patient services, notes the community supports midwifery.

"I think the bureaucracy is now catching up to community demands."

The project will get $320,000 in funding from the Primary Health Care Transition Fund of Health Canada during the next three years.

That money will cover development, equipment, supplies and renovations.

The $75,000 contract to Paulette's company is for one year.