Midwifery advocates call for more choice

For Megan Heckrodt, the decision to have a home birth with a midwife in attendance boils down to choice.

Birth choice: Megan Heckrodt holds her son Arlo immediately after his home birth

For Megan Heckrodt, the decision to have a home birth with a midwife in attendance boils down to choice.

Heckrodt gave birth to son Arlo earlier this month, in the Salmon Arm home she shares with husband Luke and her two older children, four-year-old Eden and two-year-old Will, who was also born at home with the care of a midwife.

She sought a different option of childbirth after delivering her daughter in a hospital setting in the United States.

“It was very clinical, medical and with a lot of interventions like induction. When we moved to B.C., I was thrilled to find out there was the option of a midwife and that it is covered by the BC medical plan. I jumped at the opportunity because I felt it would give me more choice in my maternity care and control of how my labour played out.”

Choice is the  key theme echoed by a group of women in Salmon Arm who are promoting midwifery care in the Salmon Arm area.

Spearheaded by Holly Malashewsky, a mother and birth doula, a petition has been started and a rally is being organized to demonstrate to health officials the desire for increased access to midwifery care in this area.

“Women have the right to choose where and with whom they give birth. Those that know, care and love them need to support and respect that,” says Malashewsky.

Registered midwives are recognized medical professionals, who specialize in healthy pregnancy and birth, and are an established part of the B.C. health-care system.

Midwives offer services from early pregnancy, through labour and birth, following up with care and breastfeeding support until approximately six weeks postpartum, at which point care reverts back to a family doctor.

“There seems to be a belief out there that there is no demand for midwifery services in Salmon Arm, but I know there is. As a doula and breastfeeding counsellor, I see many pregnant and new mothers who expressed an interest or desire for midwifery, but feel they have to choose another route because of the barriers in Salmon Arm.”

Malashewsky says one of these barriers is the need for more midwives to have hospital privileges at Shuswap Lake General Hospital. Currently only one midwife, Sylvia Nicholson, who is based in Vernon, has medical privileges at the local hospital. This means if a home-birth transfer to the hospital is necessary, Nicholson’s clients can be admitted by her and remain under her medical care in conjunction with physicians at the hospital.

Without privileges, midwives can not offer mothers the opportunity to have a midwife-assisted birth in a hospital setting, or if a transfer to hospital is needed, the midwife can no longer be involved in the medical care of their clients, and can only act in a supportive role for the mother.

Nicholson says the demand for midwifery services in Salmon Arm speaks for itself.

“All I can say is people call me from Salmon Arm at 12 weeks pregnant or less, and I’m not doing any marketing in the area at all, and I have to say ‘Sorry, I’m full.’”

Joanna Nemrava, a Kamloops-based midwife, will accept home birth clients from the Salmon Arm area, however, while she has hospital privileges at Royal Inland Hospital in Kamloops, she does not have them at Shuswap Lake General. As with doctors, hospital privileges are granted at individual facilities, not across the province or the Interior Health region.

Heckrodt’s younger two children were both born at home with Nemrava in attendance. Heckrodt initially would have preferred the option to give birth in hospital with a midwife, but this option was not possible in Salmon Arm. In the end, she was deeply satisfied with having her babies at home with her midwife’s assistance.

“A home birth was not on my radar to start with, but afterwards I was blown away by the experience of being surrounded by my family and supports, in the comfort of my own home.”

Interior Health officials say there may be a perception of impediments to midwifery care at Shuswap Lake General Hospital, but it is more about a process of determining the needs and how to best meet them while keeping the safety of mothers and babies of the utmost importance.

Peter DuToit, area director of acute services for Interior Health, says accrediting midwives is the same process as with physicians. This includes a review by a committee composed of Interior Health administration and physicians, before going to the Interior Health board for approval.

DuToit notes the process is more complex when the care provider delivering the service is from out-of-town.

“Certainly our preference is to have someone who wants to live in the community be the one to provide the service… Right now we are not aware of anyone who wants to live in Salmon Arm and practise midwifery here.”

Both Nemrava and Nicholson agree that a midwife located directly in Salmon Arm would be the preferred option.

“Absolutely it would be best to have someone right in Salmon Arm, as with travel there are increased risk factors,” says Nemrava, who does not advertise in Salmon Arm or even hope to draw from this area.

“But I couldn’t look myself in the mirror if there was a woman here who was going to have an unattended home birth if I didn’t help out, so that is what has brought me to the area,” she says.

Nemrava was recently involved with a meeting with Interior Health to discuss the issue of privileges at Shuswap Lake General both on a short-term and longer- term basis.

She says there is interest from a UBC midwifery student possibly locating in Salmon Arm in a few years, which would allow for time to ensure the appropriate plans could be put in place.

“It went really well as an ongoing discussion. It was really positive and I feel like the issue is moving forward. From this last discussion, I have the sense that the tide is turning.”

Rally and petition drive

There is a public rally to show support for midwifery care at Shuswap Lake General Hospital being held on Saturday, Dec. 3 from noon to 2 p.m. at the plaza in front of Askew’s Foods on Lakeshore Dr.

All are welcome to come and show support.

A petition designed to demonstrate the desire for midwifery care options in Salmon Arm and calling for increased access to the option of Midwifery care at Shuswap Lake General Hospital is also underway.

There are petitions at the following locations in Salmon Arm: Growth Spurts – Gear for Kids, Snuggle Bugz Consignments, Dakshina Hot Yoga.

The petition can also be accessed online at http://www.petitiononlinecanada.com/petition/families-for-midwifery-care-in-the-shuswap/524.


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