A copy of my letter to Dr. Ashok Sharma, Chief of Staff for Grand River Hospital re: midwifery services in Waterloo Region [email protected] Board of Directors Grand River Hospital September 30th, 2014 Re: Midwifery Services in Waterloo Region Dear Dr. Sharma et. al., The community appreciates your thoughtful response to our current enquiries regarding the availability of midwifery services in this community and your role in this. Your comparison between Grand River’s ratio of midwives to # births to other communities highlights the problem as this community sees it. At present, local midwifery clinics are turning away up to 50% of women who enquire after their services. This community is not London, nor Toronto. Waterloo Region has a long relationship with midwifery that predates regulation both in our rural community and our urban families. The fact that GRH has managed to keep the ratio of midwives to birthing families so low in light of this long history, the wishes and requests of your constituents and the availability of qualified midwives is frankly shocking. The families you serve are asking for lower-intervention and more evidence-based midwifery services. Adding 2 midwives in the last year to your professional staff has not met the needs of this Region. The addition of family practitioners to this roster also limits out-of-hospital births, as your residency training for physicians does not equip them to serve homebirth clients. A family practice physician cannot contribute significantly to the high demand for maternity services in this Region in the way midwives are able. In keeping the ratio of midwives to # births so low, you are redirecting families back to obstetrical care that they did not want. Further, you are limiting the option of families to have a midwife-attended homebirth and again are redirecting families back to your facility. Your current staffing decisions are largely self-serving in maintaining a high volume of high-intervention services that are delivered by high-cost providers at your facility. Further, your staffing decisions are being made under the advisement of parties who have a vested financial interest in the outcome. The working group you’ve formed to consider changes in practice, preferences of your clients and future recruitment needs doesn’t include a single consumer advocate, doula or client. It’s disingenuous to assume that you are meeting client preferences when you’ve excluded anyone who speaks for your clients. It is no coincidence that the birthplace of Birth Trauma Ontario, a resource for families who have experienced a traumatic birth, is Kitchener-Waterloo. Emerging research indicates that the greatest predictor of maternal trauma is the degree of coercion she experiences during her birthing experience, not emergency procedures, unexpected outcomes or prior experience with trauma. Your staffing decisions, which redirect women into high-intervention obstetrical care when they asked for midwifery care, are part of this picture of loss of autonomy. Client preferences include access to midwifery care far above current levels. Client preferences often include an end to non-evidence-based routines such as forced supine delivery, forced fasting, an admission NST, habitual episiotomy, early cord clamping and institutional hostility towards doulas. Clients who go to L&D for treatment and return at a later date with their doula are stunned by the change in behaviour by some staff towards them and their doula, contributing to a perception of coercion. GRH is known across Ontario and beyond for their discussion on an illegal policy to ban doulas. It’s unfortunate that whilst Birth Trauma Ontario serves families across Canada, the United States and Europe, Waterloo Region is its home. It’s time to reevaluate who is making decisions regarding client care and what perspective they bring to their decisions. Grand River Hospital is being offered an opportunity to work with community members in providing the services that the birthing families of Waterloo Region want. It would be a shame to miss this opportunity. Regards, Billie Harrigan Co-Founder & Co-Director, Birth Trauma Ontario Co-Founder & Co-Director, Kitchener-Waterloo Doula Collective International Student Support, Administrator & Trainer, Childbirth International (you can read Dr. Sharmas letter in the comments)
Posted on: Wed, 01 Oct 2014 00:25:23 +0000
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