MONTREAL — They can provide reproductive and sexual health advice, prescribe certain medications, perform screening tests on women and babies, and of course, perform childbirth. Midwives are real health professionals, but the Quebec network is content to ignore them.

Under the Midwifery Act, these bachelors are considered authorized to engage in full-time employment, but only between the beginning of pregnancy and the sixth week after delivery. They are prohibited from providing services one day before or one day after.

“Our field of activity is an episode of care,” summarizes the President of the Order of Midwives of Quebec, Julie Pelletier. We have built up a huge field of activity in a very short time.

Given the severe labor shortage that Quebec is struggling to make its healthcare network more efficient, midwives could certainly be more involved.

“To really be part of the solution, for example in the areas of sexual and reproductive health, contraception, screening and treatment of STBBIs, we should be able to use our skills at any time and not just with pregnant people,” says Ms. Pelletier, who believes she is listening to the government on this issue.

This option may seem counterintuitive, but midwives could also potentially help promote greater access to abortion. Currently, these medical professionals are authorized to prescribe the medications needed to evacuate the fetus in the event of a miscarriage.

This procedure is very similar to performing a medical abortion by taking medication in the first trimester. The resolution has already advocated incorporating this law into the sphere of activity of its members.

Magali Béchard, director of the bachelor’s degree in midwifery at the Université du Québec à Trois-Rivières (UQTR), also believes that its graduates “could probably do better” despite being trained to do the work required of them under the current model .

“If we wanted to expand the field of practice, further training or additional training would have to take place,” she believes. However, Ms Béchard emphasizes that in other regions of the world, midwives do not even give birth, but provide women with medical care throughout their lives.

The fact is that in the current situation of the health network, we have “reached a point where we need everyone to participate in the care,” analyzes the professor. “I think it helps a bit with the reflection to open up the field of practice,” she adds.

promote the profession

Ironically, one of the biggest obstacles to expanding midwifery practice is labor shortages. As Professor Magali Béchard points out, midwives are not even able to meet all of Quebec’s prenatal care needs.

This understaffing also explains in part why in Quebec, little more than 4% of births are performed by midwives. A statistic that caused a great reaction from parliamentarians when it was quoted in a parliamentary committee on the reform of the health system proposed by Minister Christian Dubé.

In accordance with the target set in the Perinatal Policy 2008-2018, the government aimed to achieve 10% of births attended by midwives. According to the Order’s President, Julie Pelletier, the government has taken too long to promote the profession and provide services in the regions.

This slow start made access to the profession difficult. Since then it has been difficult to train recruits as they have to have a midwife by their side during their internship. In recent years, the government has stepped on the gas to roll out the service in all regions, but there are still backlogs in training professionals.

The UQTR would like to do its part to remedy this problem. As the only midwifery education program, the university expects to announce actions to strengthen its cohorts shortly.

But if it’s true that we need to educate more female students, we also need to curb the exodus of midwives who are leaving their profession, reminds Julie Pelletier. She explains that the job is demanding and that there are few options other than postnatal care.

The President of the Order again believes that wider practice would allow midwives to explore other aspects of women’s or infant health and remain in the network rather than give up.

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