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NORTHWEST TERRITORIES
Midwives could be delivering babies in Hay River in a little more than two years, pending funding and territorial government approval, said the NWT's minister of Health and Social Services.

Lesley Paulette, a Fort Smith midwife, listens for Stefany Bourke's baby's heartbeat with a fetoscope. Midwifery services could begin returning to NWT communities outside of Fort Smith by 2015. - NNSL file photo

Tom Beaulieu said a midwifery program in Hay River could be implemented by March 31, 2015.

"What we're doing is we're hoping to expand the midwifery program," he said. "Right now we have the midwifery program running in Fort Smith. What we want to do is to try and set the program up for Hay River."

Fort Smith is currently the only community in the territory offering midwifery services.

Beaulieu said the department is looking at ways to implement the findings of a consultant's report calling for more midwives in the territory.

The Midwifery Options Report, which was published last March, recommended midwifery programs in Hay River, Inuvik, Behchoko and Yellowknife, which would each be serviced by two midwives.

Beaulieu said Hay River would be the first location to receive the program, which would be incorporated into the community's new health centre. The centre is expected to open in 2015.

"When that's complete, we're going to be able to roll right into the midwifery program," he said.

The program is expected to cost $427,779 annually, according to the report.

The report also recommended the future expansion into regional centres to service women living in communities where populations are too small to support midwifery programs of their own.

Inuvik was chosen as the regional centre in the Beaufort Delta, Norman Wells in the Sahtu region, Fort Simpson in the Deh Cho and Behchoko in the Tlicho region. Three midwives per centre would be required for the programs.

Beaulieu said these programs could begin in March 2016.

Yellowknife was the chosen location for a territorial program, which would require eight midwives. The projected date for implementation is 2017, Beaulieu said.

However, Beaulieu was quick to mention that all plans still had to be approved by the legislative assembly before programs could begin and that funding had not yet been secured. He also said public consultations and funding discussions would have to take place as well.

The consultant's report called the midwifery program in Fort Smith "highly successful" and stated that 244 women, or 92 per cent, have taken advantage of the program since it began in 2005.

The program, which is housed in the Fort Smith Health and Social Services centre, has become an example in other jurisdictions as well, said midwife Lesley Paulette.

Paulette, a member of the Aboriginal Council of Midwives, said midwives from British Columbia, Saskatchewan and Manitoba have travelled to the centre to learn about starting their own midwifery programs.

"We're part of something that's going on right across the country," Paulette said.

Her team is made up of herself and another registered midwife, Gizela Becker, as well as a nurse.

Paulette said she believes midwives provide women with a "continuity of care." A midwife assists the mother from the beginning of her pregnancy until a few weeks after she gives birth, even if she chooses to have her baby in a hospital rather than the centre.

"It gives time for a relationship to form," she said.

That relationship means a midwife can notice subtle changes throughout a woman's pregnancy, Paulette said.

"You're more sensitive to those things because you have a sense of this woman's history and how her pregnancy has been," she said. "If something is changing, you're aware."

Paulette said the program assists about 50 women per year, plus their babies. An additional 50 women use the service for other needs, such as trying to get pregnant or if they miscarry. Either Paulette or Becker is on call 24 hours a day, seven days a week and alternate weeks when they are on call.

"It's always busy," she said. "It's not just when babies are due to be born that you need someone available. We have to be available to respond."

Paulette said giving women a choice of where they are going to give birth can ease a lot of stress. Even if a mother chooses to travel to Yellowknife to deliver, her midwife is still her lead caregiver.

While some women still choose to leave town to deliver, others find it more comfortable to stay in Fort Smith, Paulette said.

"I think when women can make those choices, that in itself helps to relieve stress," she said.

Many women who leave town to give birth have to travel alone if their partner isn't able to go with them and sometimes have to leave up to a month before they give birth.

Being away from family for an extended period of time, having to make childcare arrangements and worrying about travelling alone can add anxiety to an already stressful time, Paulette said.

"If they can stay in their home community and give birth here, that alleviates the stress of being away from their families," she said.

Paulette said midwives also assist mothers for at least six weeks after birth, but can continue to support them for up to a year providing anything from breast feeding help to support for mothers with postpartum depression.

Yellowknife resident Wendy Lahey said not only did she want to have a midwife during the birth of her child, she even considered becoming one.

In 2010, Lahey applied and was accepted to Laurentian University's Bachelor of Health Sciences Midwifery Program, beginning the following year.

But, when the midwifery program at Stanton Territorial Hospital was shut down in 2011, Lahey decided it was a poor career move.

"After seeing the lack of support for midwives here in the NWT, I decided not to go," she said.

Lahey is now a member of the NWT Citizens for Midwifery and has helped launch a petition supporting the service on the legislative assembly's E-Petition site.

There were 119 signatures as of deadline.

Jennifer Young is also a member. She said the group is pushing to expand the midwifery programs into other communities.

"We would like to see progress toward expansion of midwifery services, we're not saying it has to be in Yellowknife," she said. "As long as they're expanding it across the NWT, outside of Fort Smith, we're happy."

Lahey said she believes the consultant's report was correct in its findings. The report stated that midwifery services in communities provide more opportunity for fathers to be involved, which can reduce domestic violence.

Midwives can also play a large role in preventing "high risk" behaviours, such as drinking and smoking while pregnant.

The program also saves money, according to the report. Birthing outside the home community means expensive transportation and hospital costs. The report stated that midwifery programs can save the territory an average $4,000 per birth. There is an average of 701 births in the NWT each year.

Paulette said she knows her midwifery program has proven the model is successful.

She said she hopes the government will come through and expand the program.

"I think what we've done here in Fort Smith, we have demonstrated that it does work," she said.

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