Funding Q & A

Lack of Access to Midwifery in Alberta – Q&A

Funding for midwifery care in Alberta started in April 2009 by Alberta Health Services, along with a plan to establish and grow midwifery, especially in rural and underserved areas. More midwives began to establish practices in Alberta and a new four-year university program saw its first graduates in 2015. Although the funding system was not designed nor intended to be a barrier to growth, demand for midwifery care soon soared, while Alberta also experienced a baby boom. Funding fell behind demand, and even when a bump-up in funding was added, the number of families without midwifery care kept growing. In the fiscal year starting April 1, 2015, Alberta funded a total of 2,774 midwife-attended births, yet 1,300 families were unaccommodated. The Alberta Association of Midwives is in discussions with Alberta Health Services and Alberta Health to address the problem. The current agreement expires March 31, 2016.

Q: How many midwife-attended births is AHS offering to fund for 2016/17?

A: The same number of births as last year - which is 2,774. The number of babies born in Alberta is continuing to rise, so the percentage of births attended by a midwife will actually decrease.

Q: What percentage of births are attended by midwives in Alberta?

A: In 2014 the number of births attended by midwives was 4 per cent, and it grew to almost 5 per cent in 2015. This number is low compared to B.C. where the number is 19 per cent, and the national rate which is 9 per cent. Click here to see midwifery rates across Canada.

 Q: Is there a goal for the percentage of Alberta births attended by midwives?

A: No. The number of births in Alberta continues to grow with over 57,000 births projected for 2015. The AAM’s goal in previous years was 20 per cent by 2020, but funding hasn’t allowed growth to meet demand, and this goal was not met and no new goal has been set. In addition, the gap is increasing between Alberta and other provinces with midwifery services. In B.C. where almost 20 per cent of births are attended by midwives, the goal is 35 per cent of all births by 2020. Ontario has a similar goal. Some midwives cannot stay in Alberta if they cannot work at capacity, and Alberta will fall further behind in our ability to serve the growing demand from Alberta families for midwifery care.

Q: What does the Alberta Association of Midwives want when the current agreement expires on March 31, 2016?

A: The Alberta Association of Midwives wants to meet the demand from pregnant Alberta families by having current Alberta midwives and the 12 graduating students coming on-stream in June 2016 working at their full capacity. Pregnant Albertans want to choose their caregivers and more than a thousand will not have access to a midwife with the current inadequate funding situation.

Q: How many births can the current midwives and students accommodate?

A: The Alberta Association of Midwives estimates midwives and the graduating student class can accommodate 3,800 births this upcoming year. That is still less than the current demand from consumers, and would represent 7 per cent of births in Alberta.

Q: What about in subsequent years?

A: There is an urgent need to plan now to grow midwifery responsibly, especially in rural and underserved parts of Alberta. Community leaders, consumers, and other healthcare professionals are asking for access to midwifery care. A sustainable funding model and long-term agreement is needed. The Alberta Association of Midwives expects demand for midwifery care to continue to grow at a rate similar to that in other provinces. B.C.’s rate of midwife-attended birth was 6 per cent 10 years ago, and it’s now approaching 20 per cent.

Q: What is the plan in Alberta to increase midwife-attended births, especially in underserved areas?

A: Alberta Health Services has a workforce plan for growth that focuses on rural and underserved areas. The Alberta Association of Midwives supports the plan, but without stable funding, the plan cannot be implemented. There are also other opportunities to explore serving more families by collaborating with federal or other funding partners.

Q: What happens in communities where there is not enough, or no midwifery care?

A: A lack of action to meet consumer demand means midwifery consumers will continue to be underserved, and midwives will continue to be underutilized with some unable to work, even part-time. Midwives, especially newly graduated students, may have to leave the province. Pregnant Albertans will be forced to seek undesired, more expensive care options. Some will even choose to birth outside of hospitals, without obstetric care.

Q: Why can’t people just pay out of their own pocket for midwifery care, as they were able to in the past?

A: There are no regulations or laws preventing registered midwives in Alberta from accepting payment outside of the current system and the current agreement with Alberta Health Services is silent on private payment options. It is possible that some midwives will respond to consumer demand by accepting direct payment, creating a two-tiered midwifery system in Alberta.

Q: What does the Alberta Association of Midwives recommend for subsequent years?

A: The Alberta Association of Midwives recommends a one-time bump in funding to catch up to the baby boom and ensure current capacity in the system is utilized. We also recommend working to develop and implement a sustainable funding model and to achieve a long-term funding agreement to accommodate reasonable growth to bring the percentage of pregnant Albertans served by midwifery care to 10 per cent from the current five per cent by 2020.

Click here to read about Sustainable Funding for Midwifery

 

Contact AAM

Alberta Association of Midwives
2632 24th Street SW
Calgary, AB T2T 5H9
Phone: 1-888-316-5457
Hours: Monday to Friday (8:00am-4:00pm)
Website https://www.abmidwives.ca/
Email: [email protected]