NORTHWEST TERRITORIES

In her 17 years as a midwife, Lesley Paulette has learned a few things about taking care of pregnant women. For one, it's a 24-hour job.

"I couldn't do it alone," said the Fort Smith resident, one of only three midwives in NWT. "It's a demanding job and it's one where the service has to be there 24/7."

Paulette, president of the Midwives Association of the NWT, has been practising in Fort Smith for five years

There exists what has been, until now, the territory's liveliest base of support for midwifery with two practising midwives servicing a population of a little more than 2,000 people.

But more than 260 petitioners across the territory have recently called for the expansion of NWT's midwifery services, particularly to allow for more than one midwife in Yellowknife.

The capital's midwife can take on only three expectant mothers per month, and her wait list is prohibitively long.

Yellowknife mother Heather Scott was "one of the lucky ones" who gave birth with help from a midwife recently, but she started the petition after a friend was turned away because the midwife already had too many clients.

"I had a really positive experience with that, but at the same time, it opened my eyes to the tireless efforts of the midwife here and how unsustainable the program is as it functions currently because it is only one person trying to run an entire program," she said.

"Everyone who used the midwifery program with their births had such a great experience, but so many people get turned down it's ridiculous," Scott added, referencing the Department of Health and Social Services' promise in its 2009 document "A Foundation for Change" to expand midwife services in Yellowknife and look at providing similar programs in other areas across the territory.

"As far as I know, no measures have been taken to do either of those tasks."

While Scott said the petition isn't meant to take away from the quality of maternity services provided by hospital doctors and nurses, she said midwifery is so popular because of the consistency of care parents receive - from prenatal classes to post-partum monitoring up to a year after giving birth.

"People have really great birth experiences without using the midwife, but it's just that it's a program that does interest and attract a lot of people and if more people had access to it, it would maybe improve quality of life for some people," she said.

Paulette said she didn't want to comment on the petition itself, but she believes communities that don't have access to regular maternity services in their health centres should look into midwifery as an option for maternal care.

She said Fort Smith's midwifery program has been studied nationally for its contributions to low premature birth rates and high breastfeeding rates, which have been shown to lead to improved health conditions for infants.

At the time midwifery sprouted in Fort Smith, pregnant women were leaving the community to give birth, as the local hospital didn't provide maternity services.

While Paulette said there is currently no waitlist to see one of the two midwives there, she said two practitioners is the minimum for the volume of clients they get - sometimes they work with expectant parents for up to two years each, including time before, during and after birth.

"The work that we do makes such a difference in the lives of individual women and their families and their babies, but at another level it makes such a difference in the health of communities and national populations," Paulette said. "I find that really rewarding to know that even at our small scale, in our little micro-community here, we are making those same kind of contributions that midwives are making all over the world.

"And for me that's very rewarding. It helps to keep me going, even though the hours are crazy sometimes."

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