Once a week in March, Natalie LeBlanc drove herself to the Prince County Hospital in Summerside for her routine prenatal checkups. She was anxious about COVID-19 and worried about getting sick, but at eight months pregnant, she had no other choice but to check in regularly.
“At that point, the hospital was the last place I wanted to be,” said the 24-year-old first-time mother, whose son, Louie, was born on April 9.
If a midwife was an option in Prince Edward Island, Ms. LeBlanc would have contemplated using one. She says she felt isolated at the hospital during labour with access to just one support person, her partner. She struggled with having no in-person professional care after her discharge – she had to make do with a checkup phone call from PEI’s Department of Health and Wellness.
“Running off three hours of sleep in the last three days and you have to get help over the phone,” she said, “that was really tough.”
PEI is the only province in Canada with no regulated midwives. The province’s Department of Health and Wellness had announced funding for a preliminary midwifery program last fall, but it has yet to be put in place, leaving expectant mothers with no other alternative to giving birth at the hospital during the COVID-19 outbreak.
In all other provinces, midwives are regulated health professionals who provide medical and emotional support to a mother and infant during pregnancy, birth and a postpartum period of at least six weeks. They enable home and hospital births, and they can be a bridge between the mother, infant and other health professionals such as obstetricians or family doctors. The first province to regulate midwifery was Ontario in 1994. In 2016-17, there were 1,690 midwives in Canada who supported more than 42,000 births.
PEI’s 2020-21 provincial budget for the first time included $150,000 for midwifery services and plans to hire a midwifery program co-ordinator, giving some Islanders the impression that services were on their way. In the fall, PEI’s Minister of Health and Wellness James Aylward had told reporters he expected to have some services in place by January, 2020.
In February, however, the Department of Health and Wellness announced that more steps, such as developing program guidelines and regulations, had to happen before the program could start. Mr. Aylward recently declared the program deferred indefinitely, as a result of COVID-19.
Since the start of the outbreak, PEI midwife-advocacy group BORN has received many questions about whether midwives would be rushed into the health care system to meet the needs of some families. In response, the group founded a bi-weekly virtual postpartum support group, said BORN member and doula Megan Burnside.
“We saw there was a need for personal support right now on the Island,” Ms. Burnside said. “There’s a bit of a sense of panic for expectant families, because they don’t know what the situation will be when they enter the hospital.”
Luckily, PEI’s hospitals have not so far been overwhelmed with COVID-19 patients. As of Wednesday, there were two active COVID-19 cases in the province. But the possibility of contracting the virus still exists for mothers and babies.
Amy-Mae Jewell, a third-year midwifery student at Toronto’s Ryerson University, is from Covehead, PEI. She is saddened that midwifery is not established in her home province, as she sees ways in which it could help families stay safe as the pandemic lingers.
“Midwives can enable mothers and their babies to stay at home and not contract the virus. When the baby is born in a hospital right now, they can be very vulnerable.”
Canada has seen a spike in demand for midwifery services since the start of the COVID-19 outbreak. In Toronto, midwifery practices had reported a jump in intake from women who want to avoid hospital deliveries in early April. Around that time, 25 per cent to 50 per cent of clients at the Midwives Collective in Victoria who had planned for a hospital birth inquired about a home birth.
In March, the Nova Scotia Association of Midwives received a spike in requests for information about birthing outside hospitals. Yet, on March 30, Nova Scotia suspended home births until April 30, in a bid to curb the spread of the virus and protect midwives and birth attendants.
Ms. Jewell said keeping midwives and patients safe could have been done in other ways.
“They could have assigned some midwives in the hospitals and others for home care to prevent crossover,” she said.
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