I would like to clarify my position on midwifery fees as well as the potential problems with regulation, as discussed in the recent Yukon News article Regulated Midwifery: To Push Or Not To Push.
I told Vivian Belik, I think the fee charged by Yukon midwives for their services is very reasonable and a good value for the service.
I also told her midwives in the US often charge two to three times that much. For example, a friend of mine in California paid $6,000 for a homebirth and the Juneau Birth Centre charges $7,600 for a homebirth, not including postpartum care.
At $2,500 women in the Yukon who choose midwifery services are getting excellent care and paying a very low fee compared to other jurisdictions. This fee includes all prenatal visits, telephone consultation whenever the woman requires, continuous attendance through labour and birth and a few hours after, cleanup after the birth, assistance with breastfeeding if required, postpartum visits every day in the first week after birth, performance of newborn tests if desired (i.e. PKU), and availability for consultation for at least the first six weeks postpartum.
I am extremely satisfied with the care I received from my midwife, Christina Kaiser, for the birth of my second and third children.
If I could go back in time, to the exact same financial circumstances I was in with the birth of my first son, I would definitely pay for midwifery services. There are women who truly do not have any extra in their budget for midwifery care. There are other women, like myself in my first pregnancy, who feel the constraints of job uncertainty and less than ideal income, but who have the resources to pay for midwifery services when they realize how valuable those services actually are.
Funding would definitely make midwifery a more feasible choice for most women and, in the meantime, those of us who pay privately for the service recognize how valuable it truly is.
I decided to start Yukoners for Funded Midwifery (YFFM) in the fall of 2006, when my first son was nine months old, because I thought it would be great if the government would pay for midwifery services for my subsequent pregnancies, and I could also see a benefit to other women from my efforts.
I thought it would be only fair for mothers in the Yukon to have the same access to midwifery funding that mothers in other provinces, like BC and Ontario, do.
I have had two midwife-attended homebirths since then, which of course have not been reimbursed by the government. I am now on the other side of having received midwifery care and, because of this, I appreciate midwifery as it is in the Yukon so much more than I did in 2006.
I still think midwifery should be funded by the government, but I am not willing to sacrifice informed choice on the altar of regulations.
The difficulty, which Belik’s article did not address, is who would get the final say in what the regulations are.
If midwives and consumers have the final say in the regulations, all will be well.
But Yukoners for Funded Midwifery is concerned physicians, who may not approach birth from a midwifery model, will have a large influence in the regulatory process. We know the government has a vested interest in keeping the Yukon Medical Association and individual doctors happy, as the former minister of Health, Brad Cathers, indicated to our group in a meeting in 2007.
Because of this, we are concerned that if physicians are not happy with the regulations as midwives and consumers would write them that they would influence the government and overpower our voices, so that choice becomes restricted in the name of what the medical world perceives as best for women, instead of listening to women themselves.
I would also like to clarify that Yukoners for Funded Midwifery is not a coalition between midwives and consumers. We appreciate the midwives’ support and collaboration, but Yukoners for Funded Midwifery is a consumer-advocacy group.
Asheya Hennessey, founder
Yukoners for Funded Midwifery