From the ground up
Student learns how a midwifery program is developed in remote communities
Meagan Leonard
Northern News Services
Monday, February 22, 2016
HAY RIVER
Hailing from southern Ontario, Erin Hayden said one of the first things she noticed upon arrival in Hay River was the movie theatre.
Erin Hayden recently completed a six-week placement working alongside Hay River's midwifery team. Hayden is attending the midwifery program at Ryerson University, where she is pictured taking blood during a phlebotomy class. - photo courtesy of Erin Hayden |
"I was pretty impressed," she said with a laugh, speaking to News/North after her six-week placement as a midwife in the community wrapped up last week.
The third-year student in Ryerson University's midwifery education program said she was required to choose an elective placement in a Northern or remote region. She had read an article about the work being done in Hay River and was interested to see how a maternity program is developed from the ground up.
"In Ontario, midwifery has been regulated and set up for about 20 years," she said. "But here in the territory they've had to start from scratch ... I've found it very daunting, but it's also really exciting because there's so many possibilities."
Introduced in 2014, the program is relatively new in Hay River, with two full-time midwives on staff. It was part of a larger initiative developed by the GNWT in 2012 aimed at bringing birthing back to the community level as a way to reduce medical travel expenses.
A midwife is qualified to give necessary care and advice to women prior to and during pregnancy, labour and postpartum. Some of a midwife's roles include counseling throughout pregnancy, identifying conditions that require consultation with a doctor, completing delivery after-care procedures and prescribing certain medications.
Currently, ultrasound capability is only available in Hay River, Fort Smith, Inuvik and Yellowknife and most women must travel out of their communities between 36 and 38 weeks gestation for delivery. Because many of the health-care positions in small communities rely on locum or interim staff, continuity of care can also an be an issue.
"While this practice serves to ensure safety and minimize risk, it has been associated with heavy social and economic costs to the individual, community and public health system," a 2012 Department of Health and Social Services document called the Midwifery Option Report stated.
The department says communities with over 25 births per year qualify for the midwifery program. Fort Smith, Yellowknife and Hay River have already implemented the initiative and consideration has been given to Inuvik and Behchoko.
Hayden says in Ontario, midwives provide care up to six weeks, whereas in the NWT, care lasts up to a year. This helps forge strong relationships with patients and accommodates breast feeding support. She said working this closely with the mother and health authority creates an atmosphere of trust and allows for better reproductive health as patients feel more comfortable expressing concerns or reaching out for help.
"(I liked) seeing how the relationship ... can help the birth process," she said. "Because of the trust issues in the system, you can be that first contact that people find reassuring and can really have an impact on their overall health, not just in the child-bearing years."
Having never traveled North before, she said she has gained a new-found appreciation for pioneers in the field.
"It's created a respect in me for midwives who were on the front lines and really trying to make midwifery work and make it safe and also provide clinical care on top of that," she said.
Although midwifery is gaining a foothold in both urban and rural regions, Hayden said after graduation she would love to be on the front lines in a community such as Hay River where it is still relatively new.
"They're working on implementing and maybe offering it in other communities and I find it exciting and kind of daunting at the same time," she said.
