Citing a lack of progress in coming up with a new agreement with the province, B.C.'s 220 midwives have taken job action.
The action includes giving 90-day notice for the termination of the present Midwifery Master Agreement, taking effect Oct. 7. It was slated to end March 31, 2014. The midwives have also stopped volunteering to provide clinical education to University of B.C. midwifery students, doctors and nurses.
"We presented what we believe to be a sensible set of proposals to the ministry, but the ministry came back with an inflexible stance, said Ganga Jolicoeur, the executive director of the Midwives Association of B.C. "We felt that our proposals were not being met."
At this point, there are no negotiations happening.
The midwives want to see 16 more midwives per year for the next five years, which would allow them to increase the number of births they can service from 16 per cent of all of B.C.'s births to 35 per cent. They'd also like to see a pay increase of 15 per cent to those who have worked for over five years.
The association also wants more integration between midwives and healthcare professionals. Midwives take a four-year degree and are required to meet practicing standards. Prince George is ahead of most communities in integrating its five or six midwives, Jolicoeur said.
It also wants the ministry of health to take over a pilot project that provides substitute midwives for midwives living in rural areas looking for a vacation. Currently, the association pays. Jolicoeur said in rural areas, midwives haven't been able to take a vacation in a year.
"We have many midwives practicing in rural communities and northern communities, but we also recognize that rural practice comes with its own set of challenges," Jolicoeur said "Our proposal's aimed at trying to make those rural practices more sustainable, more attractive to new midwives and looking for opportunities for collaboration between midwives and other health professions."
Jolicoeur said women travel far to access maternity care in Prince George, which results in a great cost to the family. It also causes more stress, which in turn results in more premature birth and visits to intensive care. That costs the healthcare system more.
"There's an interest in accessing more northern and interior communities, which is precisely the reason why we brought these proposals to the table now because we know that there are a decreasing number of obstetricians," she said. "We also know there are a lot of family physicians that are choosing not to do maternity care."
These proposals could save the government money, Jolicoeur said
"The solutions we've brought to the table are also cost effective because what we're asking the ministry of health to consider is an investment in programs and policy that will actually being $60 million worth of savings to the system by 2020 and another $20 million in saving annually thereafter," she said.
Kristy Anderson, a health ministry spokesperson, said the government wouldn't talk about negotiations publicly. Judy Darcy, the NDP's health critic, said her party supports increasing public access to midwives in the province.
"This is one of those things where the government has this knee-jerk reaction - we can't spend any more money on health care - but this is an area that's not just a good investment in women, babies and families, it's also about saving healthcare money," she said. "To me, this is a win-win-win situation. It's good for women and birthing, it's good for families and it's good for the healthcare budget."
Darcy said the New Democrats think the government needs to think outside the box and look at using more midwives, nurse practitioners and multi-disciplined teams to deliver healthcare to improve outcomes and save money.
