Regulated midwifery services coming to Yukon by next year, minister says

The Yukon government says it will hire and license midwives to start delivering babies next year.

It will follow decades of promises by various governments to regulate and fund midwifery in the territory. Yukon is among the last jurisdictions in Canada to not offer midwifery services through its health-care system.  

"Everybody has wanted to see it move faster, but they also were very committed to making sure that it would happen in a positive way," said John Streicker, Yukon's minister of community services.

Streicker says his department will be responsible for licensing. The Department of Health will implement the program and hire the midwives. 

Draft regulations have yet to be finalized, but the government has now settled on a model of care — or, "how we integrate midwifery into our health care system," according to Streicker.

"The recommendation came to us from the Midwifery Advisory Committee, and from midwives nationally and locally, that we ought to do this [with midwives] as employees within the system, rather than as contractors from outside."

He says the government's midwifery program will initially be focused on Whitehorse. There are about 400 births every year in Yukon and most are in the capital, Streicker said.

"If you're going to start midwifery, you want to start close to where the hospital is so that if there is a problem you know you're going to have that backup," he said.

"And then in the future, we'll move out to the communities."

The issue of midwife regulations in Yukon is decades old. The Yukon Party began looking at midwifery legislation in the late 1990s. Then, in the early 2000s, Pat Duncan's Liberal government promised to introduce legislation governing midwives, but did not bring it forward.

In the 2016 territorial election, all three major parties campaigned on promises to fund and regulate midwifery. Premier Sandy Silver then promised in his 2017 throne speech to license midwives by the following year.

Some provinces have had midwifery regulations in place since the early 1990s. In the North, the N.W.T. and Nunavut have regulated midwifery since 2005 and 2011, respectively. 

P.E.I. is the only other Canadian jurisdiction without regulated midwifery, although the provincial government there has promised that will change this year. 

Local midwifery association 'very excited' 

"We're very excited to be taking some steps forward," said Kathleen Cranfield, the president of Community Midwifery Association Yukon. The organization advocates for regulated and funded midwifery.

For Yukon, offering the services in Whitehorse is a "good start," but Cranfield said she hopes it doesn't take too long to be offered elsewhere.

"I think that a lot of the desire for midwifery comes from the communities," she said.

Cranfield said right now she provides midwifery services outside of the territory, but she would like to offer services in Yukon in the future.

Cranfield said there is only one person that she's aware of who's now providing midwifery services in Yukon: Christina Kaiser.

Kaiser — who is part of the same organization, but spoke on behalf of herself — said she has offered the service in the territory since 2000. She's looking forward to there being a greater sense of legitimacy for people who provide the service in the territory, and she hopes the new system will help her provide better care.

"I think it will be great to be able to collaborate with other health care professionals," Kaiser said. "The dialogue is just different."

Kaiser is originally from Germany, and that's where she trained to be a midwife and earned a diploma. 

She estimates that she's delivered about 90 babies in Yukon. Her fee for 20 appointments plus the delivery is $2,500.

Still 'lots of questions'

Even after years of study and consultation, and a model of care now selected, Streicker said there are still "lots of questions to work through."

The government plans to hire a midwifery consultant to figure out how to implement the program. That consultant will lead an implementation advisory committee made up of "a wide variety of stakeholders," according to a news release.

"The whole purpose there is to make sure that when we introduce funded and regulated midwifery, that it's going to be safe for all Yukoners," Streicker said.

"The public will have assurance that midwives are trained and able to do the work within our health care system — and that if they've got concerns [there's] a mechanism for dealing with them."

Streicker said the government wants to "get it right."

"It's taken us longer than we wanted to, but I'm really happy with where we've gotten to now," he said.