Midwives applaud funding for expansion, but details still lacking

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The head of an advocacy group for New Brunswick’s midwives is lauding the extra funding in this year’s provincial budget to expand the midwife program, but says details on the expansion plan are needed.

The Department of Health also hasn’t said why it’s taken seven years since the program launched in Fredericton to expand it, or when or where the announced expansion will happen.

Brittany Stairs, president of the New Brunswick Midwives Association, said she was pleased to see $562,000 set aside in the 2024-25 budget to expand midwifery services in Fredericton and roll them out in another two communities.

And while it’s unclear what the expansion plan will entail, Stairs said she hopes to eventually see midwifes practising province-wide. She said it’s “disheartening” that it’s taken seven years to expand the program after it was launched in Fredericton in 2017 with a demonstration site on MacLaren Avenue.

“We’ve been looking forward to this announcement,” she said. “There was an evaluation done on the midwifery program a couple of years ago on the Fredericton Midwifery Centre and it seemed overwhelmingly positive, with a lot of really good feedback.

“We’re thrilled that it’s finally here and there’s a commitment to expanding midwifery services at the Fredericton site and hopefully to other communities.”

Midwives are trained to provide primary care and support for expectant women during their pregnancies, the delivery process, and for them and their babies for several weeks postpartum. They’re also qualified to administer vaccines and screen for cervical cancer, although their regulations only allow them to provide those services to pregnant and newly postpartum women.

Kelly Ebbett, executive director and registrar of the New Brunswick Midwifery Council, said the Fredericton Midwifery Centre currently operates with four registered midwife positions.

Concerns about the Fredericton program’s future were raised in the legislature last fall by Green MLA Megan Mitton, who said the program should be expanded and made permanent.

“(The review) found that 99 per cent of clients were satisfied or very satisfied with the midwifery care they received and that those receiving midwifery services had much lower levels of labour induction, despite New Brunswick’s overall induction rate having increased over this period,” she said.

Department of Health spokesperson Sean Hatchard said more than 547 families in the Fredericton area have received midwifery services since the program’s launch in 2017, including 463 midwife-assisted births as of the end of February 2024. Of those, 334 were in hospital, and the other 129 were at home.

When asked why an expansion plan wasn’t developed sooner and why details on the current one haven’t been shared yet, Hatchard said the department was reviewing the findings of a third-party evaluation and considering “the lessons that can be learned from the Fredericton midwifery pilot initiative.”

“This process has included having discussions with other impacted stakeholders across the health-care system,” he said in an emailed statement. “Should changes be made to midwifery services in the province, we want to ensure that they be done in an effective manner with a collaborative approach.”

When asked for details on the expansion plan and which communities will be included, Hatchard sent a video of Health Minister Bruce Fitch speaking on his department’s budget at the legislature’s committee on main estimates. Fitch didn’t say either which communities are expected to receive midwife services. Brunswick News asked Hatchard again for details on the plan, but didn’t receive a response.

Stairs said her association has been contacted by patients from around the province asking about midwifery services and being disappointed when learning they can’t get any because of where they live, or there aren’t enough midwives in the capital region to meet the demand for care.

“It’s been a challenge to see families wanting and benefitting from this service while others haven’t been able to access it,” she said. “Based on the research that shows such positive outcomes, it seems like a no-brainer that this is a wise area for the province to invest and it to help alleviate the burden on other primary-care providers.”

Stairs said she hopes this year’s funding boost is the first step toward midwifery care eventually being offered in the Moncton and Upper River Valley areas, where demand is also high, and in other parts of the province.

Ebbett said the money to expand the program is good news. She said she hopes the funding will allow more midwives to be hired, as the program has had long waiting lists lately.

“We’re happy to see that the government is announcing more funds for midwifery in New Brunswick,” said Ebbett. “However, it remains unclear if this announcement simply means an extension of the pilot project in Fredericton or if it’s confirmation that midwifery is here to stay in the province.”

“The hope is that, with more funding, we’ll be able to do more.  The province needs more midwives and more access to midwifery care.”