New NS midwifery rules. - Mothering Forums
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Canada > New NS midwifery rules.
Bluegoat's Avatar Bluegoat 02:47 PM 03-24-2009
OK, so I went looking to find midwives who will do births in Truro NS. The biggest practice in Halifax can no longer move out of the Cpital health region, so I am out of luck there. The other midwife in Annapolis is closing her business because of the new rules. I am so upset!

Alison's Avatar Alison 03:17 PM 03-24-2009
That sucks. They're now employees of the various health districts, and only three health districts are participating for just now. Did they give you any suggestions for what you could do?
Bluegoat's Avatar Bluegoat 03:31 PM 03-24-2009
Talk to my MP was her only suggestion. She said that the health district here was interested in having midwives, but that they weren't ready to act because they are in the middle of building a new hospital. I can understand this, but it is crazy that it is now impossible to get a midwife in much of the province!
mandib50's Avatar mandib50 03:41 PM 03-24-2009
that does suck! crummy when regulations make midwifery inaccessible to women
Bluegoat's Avatar Bluegoat 03:51 PM 03-24-2009
I have emailed my MLA, Jamie Muir. My question now is what am I going to do about a birth? I'm TTC now, but I DO NOT want to go to the hospital.
Alison's Avatar Alison 04:35 PM 03-24-2009
Yeah, my midwife did say that regulating midwifery would make things worse before they got better. E-mail more than just your MLA though. E-mail everyone else too, the health minister, the local health authority etc etc. Probably won't help for you this time around, but at least it'll let them know the demand is there.

I don't know what you can do about this next birth though. Get a really good doula, and stay home as long as possible?
mandib50's Avatar mandib50 04:39 PM 03-24-2009
are there midwives who will not be working in the new system? maybe they could help you.
Bluegoat's Avatar Bluegoat 03:02 PM 03-25-2009
Quote:
Originally Posted by mandib50 View Post
are there midwives who will not be working in the new system? maybe they could help you.
nfortunatly, there were only 7 or so in the province. One is retiring due to the new regs, the others are all employed by other health regions. I guess maybe I will just labour at home as long as possible; before it was tricky as I was an hour away from the hospital. I won't be at the IWK either which is better.
oursonend's Avatar oursonend 11:52 PM 05-23-2009
That REALLY sucks. I remember a few years ago it was hard to find someone who would travel to small towns/rural areas. And this is way worse. My only suggestion is to rent an apartment or sublet for a month or two in an area that has MWs, or make arrangements to stay with friends.

Get a plan in place of what city (wherever you get in, but Halifax would likely be easy to sublet or short-term-rent in), register with an address from the city you will be in, and go to appointments like usual. Then pack your bags and relocate for a month. Huge PITA but I personally would not do it any other way. (I'm from Truro, btw... )

ETA The other thing you might consider is that if you ever had to transfer, you might want to head to the IWK anyway.

Good luck!
cupcakeladybug's Avatar cupcakeladybug 07:46 PM 05-24-2009
Just for further reference, where are all the MW's and doulas located in Nova Scotia?

LittlePeanut's Avatar LittlePeanut 12:31 AM 05-25-2009
Quote:
Originally Posted by cupcakeladybug View Post
Just for further reference, where are all the MW's and doulas located in Nova Scotia?
There are 2 FT an 2 PT midwives that work for the IWK. 2 other FT midwives are in the South Shore District. NOt certain about all the others.

LP
cupcakeladybug's Avatar cupcakeladybug 12:46 AM 05-25-2009
Thank you, LP! I suppose there are none in Cape Breton. I haven't heard of anyone using a midwife here.

LittlePeanut's Avatar LittlePeanut 09:24 AM 05-25-2009
No unfortunately not Sorry.

The other 2 FT miwives are in Antigonish. I guess that's the closest locale for you. Is privately hiring a doula an option for you?

You could also join the Yahoo group "Birth Connections" which is run by one of the South Shore midwives (Maren) to keep up with the MW regulation news.

LP
cupcakeladybug's Avatar cupcakeladybug 03:00 PM 05-25-2009
Antigonish is a great option. I am just planning early for when the time comes. Thank you so much, LP!

brandybehr's Avatar brandybehr 11:07 PM 05-25-2009
Lack of midwifery services is the reason I have had two unassisted births. Is this an option for you?
cupcakeladybug's Avatar cupcakeladybug 12:10 AM 05-26-2009
That could be an option. I am just researching everything before I make a decision.
I want to make sure that I know what my options are concerning midwives/doulas/unassisted before I actually decide to get pregnant. I know, I probably seem a little insane to organize it this early. : I just like to plan ahead.

Bluegoat's Avatar Bluegoat 03:23 PM 05-27-2009
I'm looking now at maybe using my parents or in-laws address in Halifax to get in with a midwife at the IWK. Whether or not I could do a home birth at one of those places I am not sure - as far as I can see now, it looks like they haven't got their home birth protocols written yet, so aren't doing them. (And then I'd have to work it out with the family - my mom would likely be driven insane with anxiety!) It's rather ass-backwards, since the new legislation has been coming for a while, but I guess they couldn't do anything until they actually had the midwives hired.

As far as I know, there are so far no midwives working in Antigonish yet - they seem to be advertising positions though, if anyone qualified here is looking.
clutterbug's Avatar clutterbug 07:17 PM 05-27-2009
My understanding is that the IWK midwives are fully up and running, including homebirths.
LittlePeanut's Avatar LittlePeanut 09:41 PM 05-27-2009
I spoke with Theresa Pickart a few weeks ago and as of then, homebirth were still out. They can and are doing HB in the South Shore region. Kelly Chisholm said they expect to be doing HBs by July/Aug. I may have missed an announcement though.

LP
Magali's Avatar Magali 02:28 AM 05-30-2009
Quote:
Originally Posted by Bluegoat View Post
I have emailed my MLA, Jamie Muir. My question now is what am I going to do about a birth? I'm TTC now, but I DO NOT want to go to the hospital.
I feel the same way. I am in New Brunswick and I really feel I have limited birth options.
nsmomtobe's Avatar nsmomtobe 09:50 PM 08-27-2009
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's Avatar Bluegoat 10:25 PM 08-27-2009
Quote:
Originally Posted by NSmomtobe View Post
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's Avatar Pam_and_Abigail 10:49 PM 08-27-2009
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's Avatar Bluegoat 11:40 PM 08-27-2009
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's Avatar nsmomtobe 10:19 AM 08-28-2009
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's Avatar Bluegoat 10:26 AM 08-28-2009
Quote:
Originally Posted by NSmomtobe View Post
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's Avatar nsmomtobe 03:33 PM 08-28-2009
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's Avatar Bluegoat 03:57 PM 08-28-2009
Quote:
Originally Posted by NSmomtobe View Post
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's Avatar nsmomtobe 04:13 PM 08-28-2009
Quote:
Originally Posted by Bluegoat View Post
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's Avatar Bluegoat 06:37 PM 08-28-2009
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.
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