Based on more than 30 years of practice as a newborn care specialist and family physician attending births, I have great concern that women in British Columbia and throughout Canada have insufficient numbers of appropriate care providers available to care for them, and this maternity care gap is growing.
Increasingly some women and families have to travel hundreds of kilometres to access quality maternity care.
This puts tremendous strain on expectant mothers and their families, particularly in rural and First Nations communities, where the shortage of maternity care is experienced most acutely.
When women have to leave their communities to receive essential maternity care, they experience increased stress and health risks.
Adverse outcomes increase for both the mother and baby, even when excellent care is finally provided in distant locations, leading as well to increased costs to families and the provincial health care system.
BC’s growing maternity care gap is due to a decline in the number of family physicians practicing obstetrics coupled with the closure of more than twenty rural maternity services since 2000.
This gap is even more troubling when you consider the number of births in our province is projected to increase to over 50,000 by 2020.
While I am a family physician who strongly supports family practice maternity care, I have also been an advocate for midwifery as being part of the solution.
Although there have been recent increases in the number of posts for midwife trainees, we are still not training enough midwives.
Wait lists at most midwifery practices are currently far outstripping demand.
I thought for a time our government was beginning to recognize the vital role midwives play in the province’s maternity care system.
However, based on the current situation, where midwives have finally felt it necessary to withdraw clinical education services at UBC and terminate their contact with the B.C. Ministry of Health, it is clear the government fails to understand or value the role of midwifery in B.C.
The reality is that midwives can increase access to maternity care in urban and rural communities and help to improve health outcomes for mothers and newborns.
It is time for the provincial government to recognize this fact.
Dr. Michael Klein is Professor Emeritus of Family Practice and Pediatrics at UBC, and the former head of the Department of Family Practice at BC Children’s and Women’s Hospital and currently Senior Scientist Emeritus at the Child and Family Research Institute in Vancouver.