New NS midwifery rules. - Page 2

[NSmomtobe]

Even though I plan to deliver at the IWK, I am ineligible for midwifery services because I live outside of the Capital Health District. So I also need to write to my MLA, and it was also suggested that I write to the Minister of Health and the CEO of the Truro hospital, asking for midwives in Colchester East Hants.

Of course it is low on the priority list with the new building being built and everything, but maybe I can get a midwife for the birth of my second child.

[Bluegoat]

Originally Posted by NSmomtobe

Even though I plan to deliver at the IWK, I am ineligible for midwifery services because I live outside of the Capital Health District. So I also need to write to my MLA, and it was also suggested that I write to the Minister of Health and the CEO of the Truro hospital, asking for midwives in Colchester East Hants.

Of course it is low on the priority list with the new building being built and everything, but maybe I can get a midwife for the birth of my second child.

This is also what they told me, so I did write to all of those groups. It would be nice if someone else did as well though! I think they are looking at a date of 2011 for the hospital to be finished.

[Pam_and_Abigail]

Wow, that is super-lame. This whole thing has been such a huge debacle. It's sickening, it really is. I'm going to throw in another suggestion for keeping UC in mind as an option.

[Bluegoat]

You know, I don't mind, really, that it has temporarily become hard to get a midwife in parts of the province, even though I wish I could have had a midwife for this birth. There were NEVER enough midwives here to serve everyone that would like one, much less everyone that ought to want one. But the number of potential clients was kept low because of cost and other factors, so people willing to pay were often able to get a midwife.

At the moment, there are people in the pilot project regions who didn't have access, and they do now, including those who are financially disadvantaged. That is good. And as more regions join in, I hope we will attract more midwives and most people will have the option of a midwife. That can only be good too.

But I really wish they had done it so that midwives practiced independently, like GPs, and billed MSI for their services, and regulated by a proffesional group for midwives. (I suspect this would be more expensive than what they have done, where they will be on salary and covered for insurance purposes under the health regions.) As it is now, they are going to be under the thumb of the health regions and doctors, even for home births. I can't help but think a medical model of care could be imposed upon them, and make them less effective.

[NSmomtobe]

I agree with you, Bluegoat. It is a step in the right direction. Even though I would have been willing and able to pay for a midwife and now I have to go without, I am happy to know that they are there for some who would not have been able to access their services before. And eventually, hopefully a midwife will be available to any woman in NS who wants one. We're just not there yet and have to keep working on this issue.

The mandatory liability insurance is what has made private practice cost prohibitive. It is probably a good thing to make the insurance mandatory, but maybe in the future there could be ways to have the insurance subsidized or at a reduced group rate for those who do not work for districts.

Bluegoat, did you send a letter or email? One of the reasons I have been putting it off (besides not having the time to do it before today) is that I am not sure what the best format is, nor am I sure of what exactly to say. I will try to keep it simple: Midwifery regulations are good and MSI coverage has made it more accessible for some, but what when will we be able to get access in this area?

[Bluegoat]

Originally Posted by NSmomtobe

I agree with you, Bluegoat. It is a step in the right direction. Even though I would have been willing and able to pay for a midwife and now I have to go without, I am happy to know that they are there for some who would not have been able to access their services before. And eventually, hopefully a midwife will be available to any woman in NS who wants one. We're just not there yet and have to keep working on this issue.

The mandatory liability insurance is what has made private practice cost prohibitive. It is probably a good thing to make the insurance mandatory, but maybe in the future there could be ways to have the insurance subsidized or at a reduced group rate for those who do not work for districts.

Bluegoat, did you send a letter or email? One of the reasons I have been putting it off (besides not having the time to do it before today) is that I am not sure what the best format is, nor am I sure of what exactly to say. I will try to keep it simple: Midwifery regulations are good and MSI coverage has made it more accessible for some, but what when will we be able to get access in this area?

I sent emails. I think a letter would probably have more impact, but I am so terrible at getting letters sent that I sent the email - I thought it would surly be more effective than a letter hanging around on top of my piano!

I said something to the effect of when would women in all the health regions have access to midwifery care, and what was the plan to implement this?

As an aside, my secret sources in the medical world have told me that so far, there doesn't seem to be much of a plan for expanding the pilot program. They seem to be doing things as they come up rather than having some kind of strategic plan.

[NSmomtobe]

I feel the same way. I've been putting it off because I don't want to write a letter, but I should be able to manage an e-mail.

Just out of curiosity, did you receive any response?

My secret sources say the same thing re: lack of plan to expand and that, in fact, there is resistance to the idea from the medical community. Docs don't want to lose their easy patients to midwives.

[Bluegoat]

Originally Posted by NSmomtobe

I feel the same way. I've been putting it off because I don't want to write a letter, but I should be able to manage an e-mail.

Just out of curiosity, did you receive any response?

My secret sources say the same thing re: lack of plan to expand and that, in fact, there is resistance to the idea from the medical community. Docs don't want to lose their easy patients to midwives.

I did actually receive a response from mu MLA, the Dept of Health, and the Colchester Hospital Board. Jamie Muir was my MLA and actually sent me a nice note saying that since he had left Health he was out of the loop, but he had forwarded my note to them. (He retired very shortly after that.) The others responses were less than satisfactory.

Unfortunately, GPs actually aren't getting paid in amounts that really give them enough time to spend with patients, so if they lose the simple ones, they end up even more stressed with the same pay for more complicated cases. I wouldn't be surprised if many GPs get out of birth - there are already a lot that are. But it isn't great for the ones who really enjoy it.

One thing that would be great would be a birth center for the province. I think Truro would be ideal, it's right in the middle! If they get it up and running by January, I will be there with bells on.

[NSmomtobe]

Originally Posted by Bluegoat

One thing that would be great would be a birth center for the province. I think Truro would be ideal, it's right in the middle! If they get it up and running by January, I will be there with bells on.

Again, with the new hospital as the priority, I don't see this happening any time soon, but if you know how to get that ball rolling... particularly, how to get it established by January, I'd love to join you!

Truro IS the hub of Nova Scotia.

[Bluegoat]

Would a birth center be privately owned? They are in at least some provinces. If so, then one could be opened without the help of the health region. But then you would need midwives to work there, either on staff, or independent, or ones employed by the region would have to get permission to work there. It could be tricky.

[Lily Bea]

I understand your frustration with this issue. We had a home birth last year, prior to the midwives being implemented in the public system. We are outside the immediate area of the IWK, but still HRM. I personally was happy to pay out of pocket for the service, which was amazing all around and more than worth it. I find it very frustrating that this option has been taken away... however I am happy that those who are unable to pay may have better access to midwives.

I am currently trying for baby #2 and strongly want another home birth, however I think that even if the homebirth option is sorted out and available in the next few months, my location would place me outside the allowable distance from the IWK. I believe I would still be eligible for midwife care if I could get through the waiting list...

I understand you not wanting to birth at the IWK too. Not sure what it would be like at the hospital in Truro. A birth centre in NS would be great, wouldn't it? I agree with the other advice to stay home as long as you can and for sure get a doula. I didn't have a doula the first time, but I would want one definately if I had to go to the hospital.

I hope things improve soon in this province with regards to access to midwifery services, and home birth in particular. I need to get off my butt and write letters too.

Good luck to you!