Regulation could ease doctor shortage: midwife

The only clinics accepting new patients in the Yukon today are maternity clinics. All Yukoners seeking a family doctor, besides pregnant women, are left with few options besides the emergency department.

The only clinics accepting new patients in the Yukon today are maternity clinics.

All Yukoners seeking a family doctor, besides pregnant women, are left with few options besides the emergency department.

Kathleen Cranfield would like to do her part to ease the doctor shortage. As a midwife registered with the colleges of B.C. and Ontario, she could take on some of the maternity clients, freeing up those spaces for others seeking a family doctor.

“I think that in the crisis that exists right now, to fit midwives in there, I think it would be a cost savings to have midwives. Midwife clients in general have shorter hospital stays. In general they have less readmission to the hospital, both moms and newborns.”

But midwifery is not regulated in the Yukon, unlike almost every other jurisdiction in Canada.

This makes it very difficult for Cranfield to offer her services here.

For one, the patient must pay for the service out-of-pocket. The cost for complete pre-natal, birth, and post-partum care runs about $2,500 to $3,000.

Secondly, the lack of regulation means that Cranfield cannot access the same supports she is used to when working in other places outside the territory.

“You don’t have access that’s needed during the pregnancy,” said Cranfield. “You can’t order diagnostic tests, you can’t order lab tests. All of these things are out of your reach. Also, if someone does have to have a baby in the hospital for whatever reason, you no longer remain their primary care provider.”

Right now Cranfield is working as a midwife for a short-term placement in Cambridge, Ontario. Clients can choose to have their baby at home or in the hospital.

The Yukon government has been talking about writing midwifery legislation since at least 1996.

The Liberal government of the early 2000s promised regulation, but never brought it forward.

Today, the Yukon Party government says it has other legislative priorities.

Health and Social Services carried out a study in 2010, said Minister Doug Graham in the legislature earlier this month.

“It was determined at that time that it didn’t rate high enough up the list to bump some of the other major pieces of legislation that we are currently looking at – a pharmaceutical act and the health information systems act, which is the biggest thing that we have underway currently,” Graham said on May 10.

“That was really unfortunate,” said Cranfield regarding Graham’s comments. “I was hoping to come back and there would be an answer as to how we’re going to move forward with this. But obviously it’s not a priority.”

Cranfield plans to return to the Yukon in September and try to offer her midwife services here.

But she is not hopeful that demand will be high, given the limits on the services that she can offer. There is currently one midwife offering service in the Yukon.

“It’s going to be difficult practising that way considering what I’ve been used to, which is having the support of the hospital, which is being able to order tests, which is being able to prescribe.”

But Cranfield is committed to promoting midwifery in the Yukon.

She moved to the territory in 1997 at the age of 19, and decided to become a midwife not long after, when she visited a pregnant friend who was a midwife client.

“I think (pregnancy) is the most magical process that some women are lucky enough to experience in this world,” said Cranfield. “It’s quite phenomenal.

“But it’s also a scary time. Women don’t know so much about the process, and a lot of women, it’s their first time. I think it’s so important to have people there that are doing the research as to what is going to benefit the most. What is healthiest for their baby? What is healthiest for them?”

Midwives offer things that busy doctors cannot, like extended appointments and 24 hour-a-day on-call service, she said.

“I just think it’s wild that we’re not moving forward on it.”

Contact Jacqueline Ronson at

jronson@yukon-news.com

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