Hay River (May 09/05) - Doctors in Hay River believe even a small risk is too high when it comes to midwifery.

Dr. Tina Lacerte said the physicians are worried something may go wrong during a delivery if midwifery is offered in the community, explaining surgical backup is not available.

"It may be a small risk, but we are concerned about taking that risk," Lacerte said.

Most Hay River women now have their babies in larger centres.

Lacerte was speaking at a May 3 public meeting called by the Hay River Health and Social Services Authority, which has a steering committee to consider introducing midwifery.

The chief of medical staff at the health authority noted she conferred with her colleagues prior to the meeting, and she was speaking for all of them.

She said midwifery should be in centres where C-sections and other emergency procedures are available.

Lacerte said there is sometimes no way of telling if there will be complications in a delivery, until a problem occurs.

Despite the doctors' concern, there was support for midwifery from some at the meeting.

Marny Twigge, who had a baby in Hay River several years ago, said things go wrong in big hospitals as well as small communities.

Twigge said midwifery sounds like a good idea for Hay River. "I think we really need that option for people."

She thinks common sense will prevail for safety if such a program is established, noting most first-time mothers will go to Yellowknife, for example.

Aubrey Reintjes, one of four women who had a baby in Hay River last year, said it would be good for women to have the option of seeing a midwife.

Reintjes also believes midwives would help deal with women's frustrations over the high turnover of doctors in Hay River. "That would be very helpful."

Basic issue

Dr. Bing Guthrie, an obstetrician from Yellowknife's Stanton Hospital who once worked in Hay River, said the basic issue is how safe would midwifery be without surgical backup.

Guthrie pointed out experience elsewhere supports midwifery. "On the whole, the evidence is quite good that birthing is safe."

However, he said a system requires good communication between women and their caregivers, pointing to Rankin Inlet as an example.

Even then, roughly 10 per cent of expectant mothers who decide to stay in Rankin Inlet end up being flown to a larger centre, he noted.

Wendy Baker, a midwife from Yellowknife, said midwives don't plan to do emergency procedures. "In any emergency situation, people do their best."

Guthrie said midwifery gives women a choice. "They're the ones who should be ultimately making the decisions where they're going to have their babies."

Good outcomes

In the last two years, 45-50 Hay River women have had babies, and most of them did so in Yellowknife.

Four had their children in Hay River last year, mostly because the babies arrived early.

"Thankfully, the outcomes were good," Guthrie noted.

Paul Vieira, the CEO of the health authority, said the steering committee on the midwifery issue will likely make a recommendation to the board in June.

"There is no preconceived notion of which way we're going to go," Vieira added.

New midwifery legislation came into force in the NWT in early 2005.

The NWT's first midwifery program is currently being established in Fort Smith.