Bill C-608 (Historical)

National Day of the Midwife Act

An Act respecting a National Day of the Midwife

This enactment designates the 5th day of May in each and every year as “National Day of the Midwife”.

National Day of the Midwife Act

[Rosane Doré Lefebvre, NDP, Alfred-Pellan, QC]

moved that BillC-608, An Act respecting a National Day of the Midwife, be read the second time and referred to a committee.

Mr. Speaker, I am very happy today to speak to my BillC-608, An Act respecting a National Day of the Midwife .

Introducing this bill in the House and having an opportunity to debate it this evening is a very great privilege for me. While it was I who introduced this important bill, many people worked to make it possible, and I would like to take a few minutes of the time allowed me in order to thank them.

First, I wish to thank my friend and colleague, the member for Parkdale—High Park. It is thanks to the work she did that we are able to talk in the House about establishing a National Day of the Midwife in Canada. Following numerous meetings with stakeholders and discussions with various parliamentarians, the member for Parkdale—High Park decided to introduce an initial version of Bill C-608 in the House of Commons during this Parliament. I thank her for trusting me to introduce a new version of the bill so that we can debate it as quickly as possible.

Over the weeks, many people I have had the good fortune to meet have shown their support for Bill C-608. I would first like to thank the Canadian Association of Midwives, which rallied its members in support of this important issue. My thanks to the current president, Emmanuelle Hebert, and the outgoing president, Joanna Nemrava, vice-president Katrina Kilroy, treasurer Jane Erdman, secretary Nathalie Pambrun, executive director Tonia Occhionero and the entire board of directors drawn from across Canada. A big thank you also goes to the president of the Canadian Midwifery Regulators Consortium, Kris Robinson.

It is thanks to their involvement and support that I was able to submit my bill to their members and, in so doing, learn more about the work midwives do on the front line. We had valuable and very instructive discussions, which only confirmed the need to move forward with the idea of a National Day of the Midwife.

I would also like to thank the Quebec group, Les sages-femmes du Québec, which also answered the call. Many thanks go to their president, Claudia Faille, and her board of directors and members. Their energy and enthusiasm about the bill encouraged me to press on and make sure that I had the necessary support to secure its passage.

I also spoke a number of times with Lysane Grégoire, executive director of a birthing agency in Laval called Mieux-Naître. Lysane has been working for years to promote midwifery in Laval, through the numerous books she has co-written, the establishment of perinatal care, and the opening of a future birthing centre in Laval. I have had the good fortune to work with Lysane since I was elected, and I have to say that for me, it is a privilege to be able to count on her support.

Lastly, I would like to thank the National Aboriginal Council of Midwives. The support for this bill was essential in order for us to proceed. My thanks to Kerry Bebee, Ellen Blais, Evelyn Harney and all members of the NACM. The situation of aboriginal midwives is a very special one in Canada. I could not have gone ahead without their support, which is essential to this debate.

Why is it important to have a National Day of the Midwife in Canada, and why choose May 5 as the date? Our Parliament is changing, and it is gradually becoming increasingly representative of the population. In every party in the House, we now find young parents. Having given birth myself to a little girl just over 18 months ago, I can understand the importance of having a choice when deciding how to give birth to a child. I had the opportunity to go with my preferences and those of my spouse with regard to the monitoring of my pregnancy, childbirth, breastfeeding and, in particular, the early weeks.

I think the key word here is “choice”. Choosing how we want to bring a child into the world should not be a privilege, but a fundamental right. Unfortunately, for too many women in this country, particularly those in aboriginal or remote communities, that right is all too often denied.

This is where the practice of midwifery comes into play. There are currently 1,300 practising midwives in Canada. While the number is growing yearly, midwives are finding it difficult to meet the need because of the growing demand for their services. Only 2% to 5% of women have access to the services of a midwife. Too many regions, such as Prince Edward Island, New Brunswick, Newfoundland and Labrador, and Yukon offer little or no access to such services. However, midwives play a vital role within our health care system, with the comprehensive monitoring of maternity they provide.

The results are also there to see. There is no increase in risk when a woman is monitored by a certified midwife, and there are fewer caesareans. A number of Canadian studies have shown that women using the services of midwives are very satisfied with the overall experience.

Canadian midwives are recognized internationally for the quality of their work and for their expertise. Through various agencies, they are training new midwives around the world and helping many countries to achieve a substantial reduction in infant mortality. Midwives receive very rigorous training before they can practise. A number of bachelor-level programs are available in Vancouver, Toronto, Hamilton, The Pas and Trois-Rivières. There are also specific programs in aboriginal midwifery.

I would like to talk about the special situation of aboriginal midwives in Canada. For our first nations, it is essential to have access to midwives’ services, particularly in the more remote regions. People living in large urban centres have little awareness of the situation, but women in such communities have to travel thousands of kilometres in order to give birth. They are separated from their people at a time when having them near is really important. I will quote what the NACM says on the subject:

Aboriginal communities across Canada have always had midwives. It has only been in the last 100 years that this practice has been taken away from communities. This occurred for a number of reasons, including colonialism and changes in the health care system in Canada.

As a result of losing midwifery, many women in rural and remote aboriginal communities are currently required to deliver their babies and to access care outside their communities. In many northern and remote settings, pregnant women have to leave their families and communities for many weeks, or even months, prior to giving birth. This means that many women often give birth without any family support.

The National Aboriginal Health Organization's 2008 report entitled Celebrating Birth: Aboriginal Midwifery in Canada provides a very accurate description of this occupation within aboriginal communities. In this report, Julie Wilson said:

It’s really nice to see true citizens of our territory, babies that are born on our land. It really does give them a sense of connection to the land, to our people. So I think that’s very important, being born here on our land.

She went on to say that an aboriginal midwife not only works in her community but is also chosen by her community. In addition to providing care, she also incorporates a lot of the traditional practices, ceremonies and medicine into her community. That service goes well beyond the birthing process. It is the very essence of community self-governance and a voice of hope when it comes to the health of first nations.

Carol Couchie said:

Birth is the fundamental ceremony of our tribes. It is the most sacred ceremony that we have. And it is innate in women’s bodies. So nobody has to say a prayer, nobody has to smudge, nobody has to set out a rattle, or do anything. It just happens. So we have never lost it. It always happens, babies are always born, and women are always doing that, and they are caring for them. We don’t have to get back birth because it has never left us, but we have to get back in control of that ceremony. We have handed over the control of that ceremony to other people, and it has to be brought back home to us.

Although midwifery services in remote aboriginal communities are growing, there are not nearly enough of them to meet existing needs. Access to health care is an ongoing challenge for remote rural communities. Many stakeholders have indicated the importance of returning birth to communities. The Society of Obstetricians and Gynaecologists of Canada mentions just that in its report entitled Returning Birth to Aboriginal, Rural and Remote Communities, which indicates:

The support of the community is important, and women, community leaders and elders all need to be involved in promoting the return of birth to their communities. The advocacy and the promotion of holistic care and spiritual, mental, emotional and physical health will help to bring about normalization of giving birth in the community.

We should also note that having access to midwives in their own communities is not only efficient, but also a financially sound idea for the government. Women in isolated communities must travel by airplane and be housed and fed somewhere else for several weeks, or even months. This is a huge cost to the government every year. A study of the pilot projects involving midwives in Quebec between 1994 and 1999 showed that complete care cost as little as $2,000 to $3,000.

That is a substantial difference, and the government could save millions of dollars per year by investing in the services of midwives in rural, isolated communities and first nations communities.

We must consider the health of our rural, isolated communities, where the reality is often very different from ours. Recognizing midwifery as a profession would be an important benefit for those communities.

I would like to explain why we should choose the date of May 5. May 5 is recognized as the International Day of the Midwife by dozens of countries around the world. Recognizing it here in Canada would emphasize the importance of our midwives and their networks everywhere in our nation, in all provinces and territories.

Finally, I thank all the members of Parliament and all the groups that support this bill. I sincerely hope that the House will move forward with Bill C-608, An Act respecting a National Day of the Midwife, so that we can recognize the valuable work done by the midwives of Canada.

[Mike Allen, Conservative, Tobique—Mactaquac, NB]

Mr. Speaker, my colleague from Alfred-Pellan shared some very interesting information regarding some of the provinces, including my province of New Brunswick, in which midwives are not very well represented. The question I have for her is about this recognition process and some of the good work that midwives do in various rural and remote communities.

Can she share with the House what enacting this day would mean for increasing the number of midwives? Would such recognition grow service by midwives in Canada, and potentially in rural communities and areas like New Brunswick?

[Rosane Doré Lefebvre, NDP, Alfred-Pellan, QC]

Mr. Speaker, I thank my colleague for his question.

New Brunswick, in fact, unfortunately does not have enough midwifery services. Truthfully, there are practically none at the moment.

As I have come to know the various groups of midwives and met many of their members, I have seen that they are working very hard to have their profession recognized everywhere in Canada, in all provinces and territories.

Thus, let us ensure that all women across the country have access to the services of a midwife if they so desire. Not every woman wants to have a midwife's care, but it is very important to provide it to all those who want it.

The National Day of the Midwife in Canada could change things greatly for midwives. For one thing, as parliamentarians we would recognize that profession and the important place these women occupy in our lives. We would also be recognizing the importance of blood ties in rural or isolated communities, especially when birth is becoming a less-natural phenomenon, despite its importance to us.

Indeed, I feel strongly about this important bill, but so do hundreds and thousands of midwives all across the country.

[Djaouida Sellah, NDP, Saint-Bruno—Saint-Hubert, QC]

Mr. Speaker, I would like to thank the hon. member for Alfred-Pellan for her valuable bill, Bill C-608, which is about raising public awareness about the contribution midwives make to the health of mothers, newborns and infants. Only 2% to 5% of Canadian women have access to midwifery services.

Could my colleague explain why so few Canadians have access to these services?

[Rosane Doré Lefebvre, NDP, Alfred-Pellan, QC]

Mr. Speaker, I would like to thank the hon. member for Saint-Bruno—Saint-Hubert for her question. She was right to talk about the contribution made by midwives.

Why do only 2% to 5% of Canadian women have access to midwifery services? It is because there are not enough midwives. It is as simple as that. Unfortunately, that is the case across the country.

I would like to share a bit about my experience. As soon as I found out I was pregnant, I had to decide if I wanted to use a midwife. If I had not made the decision right away, I would have lost my chance and would not have had the option.

There are not enough midwives in the country right now. Of course, more are always being trained and there is hope that their numbers will continue to grow, along with the necessary resources. Establishing a national day of the midwife would help midwives in that fight, which sadly has only just begun.

[Eve Adams, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I would like to thank the hon. member.

Maternal, newborn, and child health remains a top international development priority for our government. We are committed to working with Canadian and international partners towards the goal of ending the preventable deaths of mothers, newborns, and young children.

I would like to highlight that our government is ensuring that moms in Canada get the support they need. Each and every year we invest $27 million in the Canada prenatal nutrition program, an important initiative that seeks to improve the health and well-being of pregnant women, new mothers, and babies. It provides 59,000 new moms in over 2,000 communities with important nutritional and health information across Canada. We also provide over $2.4 billion each and every year for aboriginal health, including access to midwife services and prenatal care.

Through Canada's leadership, global attention has been drawn to this issue. In June 2010, under our Prime Minister's leadership, the G8 launched the Muskoka initiative on maternal, newborn, and child health with the aim of saving the lives of mothers, newborns, and children. As part of this initiative, Canada committed $2.85 billion between 2010 and 2015 to help women and children in the world's poorest countries.

Midwifery training and service provision is also a key component of our government's support through the G8 Muskoka initiative.

For example, through the strengthening midwifery services in South Sudan project, we are providing support to train midwives and other health workers at four national health training institutes across the country. A total of 540 health workers are expected to graduate during the project, including 315 midwives.

Maternal mortality is estimated at 2,000 for every 100,000 live births in South Sudan. The midwives Canada is helping to train will be vital in reducing maternal and infant mortality. More than 20,000 babies are expected to be born in the hands of a midwife or a midwifery student over the course of this particular project.

Another example points to Afghanistan, which currently has one of the highest levels of maternal mortality in the world. In addition to all of the other challenges faced by women in Afghanistan, 50 women die every day in Afghanistan from complications related to pregnancy. Dedicated delivery or examination rooms are scarce, and trained health care professionals can be hard to find.

I am pleased to say that we are working in partnership with the Afghan government, the United Nations, and non-governmental organization partners to train midwives and establish 49 family health houses in the province of Daikundi. Each family health house has a delivery room and an examination room in which a trained community midwife can safely work. Midwives in these communities will be trained not only to provide maternal and essential newborn care services but also important health information and immunization services. These centres will be equipped to provide health care services for up to 4,000 people.

Our government has also supported a project to reconstruct Haiti's national school of midwifery and local maternity clinics. Each new maternity clinic has two certified midwives and aims to provide increased access to qualified, preventative, and basic emergency obstetric and neonatal services to approximately 230,000 women and girls affected by the earthquake, including 25,000 pregnant women.

Finally, as part of its commitment to the Muskoka initiative for maternal, newborn, and child health, Canada has partnered with UNICEF, the World Health Organization, and the United Nations Population Fund in support of the project for accelerating the reduction of maternal and newborn mortality, a five-year, $21 million initiative. This project has assisted 15 Nigerian states and the federal capital territory to strengthen the delivery of key maternal, newborn, and child health services. It seeks to ensure that health workers have the skills, equipment, supplies, and medicines to provide care.

Since 2010, the project has achieved impressive results, including the training of 248 nurse-midwives to provide life-saving care to an estimated 100,000 pregnant women, and 280 community health extension workers have also been trained and equipped to provide community-based newborn care.

These are but a few of the numerous examples of the work that Canada is undertaking internationally.

Thanks in large part to the Muskoka initiative in 2010 and subsequent global action, maternal mortality rates are declining and millions more children are celebrating their fifth birthdays. Access to health care and nutrition is up, and millions of lives continue to be saved each and every year.

This important work will continue. This government will seek continued progress toward ensuring that the nearly 40 million women internationally who give birth without trained help receive skilled care, decreasing the risk of death and disability both to the mother and the newborn. In May of 2014, the Prime Minister hosted the Saving Every Woman, Every Child: Within Arm’s Reach summit. At the summit, Canada committed $3.5 billion in support for the period of 2015 to 2020 and renewed global momentum to advance maternal, newborn, and child health as a global priority beyond 2015. Canada will continue to work with its country partners to fill system gaps by investing in improved service delivery at the local level, training more health workers, and increasing access to adequately equipped local health facilities.

Since 1991, the International Day of the Midwife has been recognized on May 5 by organizations such as the United Nations and the World Health Organization to raise awareness of the importance of the role midwives play and the care they provide. Our government believes that all mothers, newborns, and children in Canada or anywhere in the world have the right to be healthy and safe. The declaration of a national day of the midwife would further demonstrate Canada's commitment to maternal care on the international stage. I would like to offer our government's support for Bill C-608, which would increase awareness of the contributions that midwives make in improving the health and well-being of women and their families, both domestically and internationally. I am pleased to support this initiative.

A national day of the midwife will certainly help to increase awareness of the value of this important profession in providing maternal care services to women and their families, both domestically and internationally. Our government will support Bill C-608, which seeks to designate May 5 each and every year as the national day of the midwife.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Mr. Speaker, Bill C-608 designates May 5 each year as a national day of the midwife. I rise to support this bill.

However, I want to make a side comment. We seem to be debating more and more bills that recognize a particular day for a profession or a cause. While these are all very useful in bringing awareness and importance to the cause, I hope we are not in danger of watering down the effect by having a day for everything. Sooner or later we will not pay attention to the days anymore.

This is an important issue, though. I believe this bill is important in recognizing the role of the midwife as part of a health care team in low-risk deliveries. In fact, we now know that most low-risk deliveries should be delivered by a primary care provider. In some areas that could include a midwife and in other areas it could include a nurse practitioner trained in midwifery. In others it could be a family physician who is trained in midwifery.

Midwifery is a way of providing quality, timely, cost-effective, patient-centred care, and I want to stress more than anything else the use of these primary care providers in terms of low-risk deliveries.

Women with high-risk pregnancies obviously should be handled in a hospital setting by an obstetrician, but in Canada more and more people with low-risk pregnancies are going directly to obstetricians. This increases the cost of care, and it does not give the quality of care and the continuity of care that a primary care provider such as a nurse practitioner, a family physician, or a midwife can provide to a patient.

Midwives play an essential role in promoting health and reducing maternal and infant mortality globally. Members have heard from my colleague from the Conservatives speak to that point just now. In fact, midwives are expert primary care providers in low-risk pregnancies and births and can optimize the childbirth experience for women at all risk levels.

It may be useful, however, to look at home birth statistics in Canada.

A lot of midwives I know prefer home birth and promote home birth. In some hospitals in some parts of Canada, they are an essential part of a team within the hospital setting.

Midwives performed 2,360 home births in 2008, which is an increase in home births of 25% in only five years. There are no national home birth statistics, but the percentage of non-hospital births in Canada more than tripled between 1991 and 2007. This increase coincides with the sudden rise in use of midwives within a low-risk birth experience.

Healthy women who are pregnant, however—and this is just me speaking as a physician—should always know that there is a 40% chance during actual birthing of having some kind of high-risk intervention necessary. In very large busy cities, it is often difficult at that point to get a person who has a complication from home to a hospital setting to deliver safely.

According to the chief of maternal-fetal medicine at Toronto's Sunnybrook Health Sciences Centre, women must therefore look carefully at home births as an option.

However, in countries with very high infant and maternal mortality rates where there is no basic health system in place, a midwife, and in some cases not even a fully qualified midwife, is an option in some faraway villages to have somebody with some training, no matter how small, available to provide a birthing at home. In the rainy season in many developing countries, a passable road cannot be found to get to a birthing centre that has all of the equipment.

Midwives have had a huge role in bringing down infant and maternal mortality, globally and especially in the developing world. Here in Canada, home births account for approximately 2% of all births in Canada, the U.S., and most western European countries, with the exception of the Netherlands, where home births account for one-third of all births.

I think it is appropriate to say that in Canada we only have midwives registered in B.C., Alberta, Manitoba, Ontario, Quebec, and the Northwest Territories. It might be interesting for other provinces to look at the role of the midwife as part of a primary care team in low-risk pregnancy and delivery.

There are currently seven midwifery education programs available in Canada. The program is a four-year baccalaureate program.

Midwives are and should become a larger part of health-care systems not only here in Canada but around the world.

Between 2000 and 2010, the number of births attended by midwives in the United States rose by 41%. Bangladesh, one of the few countries that have actually met millennium goals four and five on infant and maternal mortality and morbidity, actually committed to training an additional 3,000 midwives to reach the millennium goals, which is an extraordinary thing to happen.

Afghanistan has committed to increasing the number of midwives from 2,400 to 4,500 in a short period of time. Ethiopia has committed to increasing the number of midwives from 2,000 to 8,000. Rwanda has committed to training five times more midwives, which increases the ratio, sadly, from one to 100,000 to one to 20,000. It would be really nice to have a better ratio. In some of these countries, the ability of midwives to train to deliver babies is a core and essential part of looking at mortality and morbidity during pregnancy and childhood.

In 2010, the global strategy for women and children's health noted that an additional 3.5 million health workers, and that includes midwives, are required to improve the health of women and children substantially in the 49 lowest-income countries. The World Health Organization recommends one skilled birth attendant for every 175 pregnant women. I refer back to the fact that Rwanda is moving from one for 100,000 women to one for 20,000, when we know that the ideal ratio is one for 175.

There is much work to be done in looking at the role of midwives, not only in the developing world and not only globally but here in Canada and in some of our isolated areas.

I want to thank the member for bringing this issue forward. The more Canadians understand midwives and what they do and we look at better community care models of care, we will see midwives playing an essential role in that compendium of care and in that comprehensive list of caregivers.

[Djaouida Sellah, NDP, Saint-Bruno—Saint-Hubert, QC]

Mr. Speaker, all over the world maternal mortality has decreased by 50% in the past two decades. According to the World Health Organization, the WHO, the number of midwives grew by 15% over the same period, and two out of three births in the world are now attended by a qualified health professional.

Access to good-quality health care is a basic human right. However, every year nearly 40 million women give birth without a qualified attendant, which increases the risks of mortality and morbidity for both the mother and child.

Midwives do more than birth babies. A midwife is a trained health professional who takes complete responsibility for care and services for the mother and the infant during pregnancy, birth and the postnatal period. Midwifery plays an important role in society, and the bill introduced by the hon. member for Alfred-Pellan will raise public awareness of the contribution midwives make to the care and well-being of mothers, newborns and infants.

At present, only 2% to 5% of Canadian women have access to midwifery services. That means two things. First, it means that few Canadian women are aware of the existence of such a sexual and reproductive health service. Second, it means that Canadian women cannot have access to a midwife when they want to have such a person by their side throughout their pregnancy. There are 1,300 midwives in Canada, 136 of them in Quebec and 11 in Montérégie, where my riding is. That is not enough.

We must encourage the practice of this profession and the use of midwifery services, especially because we know that this Conservative government's budget cuts are putting more pressure on hospitals and that the same cuts are causing health care centres in our ridings to close. In my riding, in Saint-Bruno, two clinics have closed in three months, and a third is in critical condition.

The Conservative government is doing nothing to help improve and maintain good health care for the people of this country. The people do not know how to face such shortages. Soon there will be no clinic. It is a scandal. If, by encouraging the use of midwifery services, we can offer young mothers an alternative for their reproductive health, the government ought to support the creation of a national day of the midwife.

The International Day of the Midwife was first celebrated in 1991 and is sponsored by the WHO. Now, more than 50 countries celebrate this day. Here in the House, members help mark the day during members' statements. Why not go farther and make it a national day? It is not enough to honour the birth attendants who work all over the world. It is time to recognize our Canadian midwives, all over the country.

This national day of the midwife would honour all the dedicated midwives who go beyond the minimum required of them, who work in difficult circumstances and with limited resources to provide maternal and neonatal health care to women and girls across Canada. We in the NDP are affirming our commitment to supporting midwives across the country, and I invite all members of the House to do the same by supporting Bill C-608, as introduced by the hon. member for Alfred-Pellan.

[James Lunney, Conservative, Nanaimo—Alberni, BC]

Mr. Speaker, I have enjoyed the debate so far this evening. I want to congratulate the member from Alfred-Pellan for introducing Bill C-608 and for the great speech she gave explaining her reasons for doing so.

It seems that I am the first male to stand to address this matter, so I want to say that I very much appreciate all of the contributions by the various women who have participated in the debate so far. However, as the token dad here, at least the first one on the male side of the House, to address the issue, I have to admit that I often say that children are a conspiracy to make their parents feel older. We live 25 or 30 years during which we feel we have not aged, and then our kids start pressing up into that area and the math does not work anymore.

My first child was born 38 years ago in Toronto at St. Michael's Hospital. It was completely natural childbirth. Amazingly, it seemed as if the medical staff, who did a fine job, had never actually seen a natural childbirth at that time.

My second one was born four years later in our own home. There was a medical doctor in attendance and a nurse who was trained as a midwife who did all the work. He just caught the baby. Childbirth is not a state of sickness for most women. It is a state of health if women have appropriate information, are well informed about the birthing process, and have someone nearby. Midwives have filled this role throughout history in most cultures.

It is very refreshing to see a move toward re-establishing midwifery in Canada. We can see from the comments made already why the need is really important. The health and well-being of pregnant women, infants, and children is of vital importance to our government. I am therefore pleased to support Bill C-608, which would increase awareness of the significant contributions of midwives to safeguarding and improving the health and well-being of women and their families.

The parliamentary secretary spoke just a few minutes ago about Canada's leadership in maternal and child health worldwide through the G20 initiative, helping to train and advance midwives in birth attendance in developing countries where maternal mortality is at alarming rates. Canada is acting to make a difference there.

Meanwhile, right here at home, midwives provide high quality care for women before, during and after childbirth. They ensure safe deliveries and provide essential newborn care. They are key primary care providers who seek to optimize the childbirth experience for women and families and work collaboratively with other health professionals. Having access to these skilled professionals to provide needed care for women, newborns, and families during the prenatal period, labour, birth, and postpartum is critical to their collective health and well-being.

Aside from the supports provided by our government enumerated by the parliamentary secretary a few moments ago, our government is also providing the largest health care transfers in Canadian history to provinces and territories to support health care services, such as midwives. These historic transfers have increased by almost 60% since we formed government and are set to reach $40 billion by the end of the decade.

Canada had 381,598 births registered last year. The overwhelming majority, 98.5%, took place in a hospital. In fact, child birth is the number one cause of hospital admission in Canada. I find that statistic astounding. Of 381,598 births, 98.5% actually took place in a hospital.

[An hon. member]

That's good.

[James Lunney, Conservative, Nanaimo—Alberni, BC]

One of my colleagues said “That's good”. Let me explain. He perhaps was not at the luncheon I attended today where the guest speaker was the head of the Canadian Medical Association, Dr. Chris Simpson.

Dr. Simpson made an excellent presentation, basically around a national strategy for seniors' care, something that I would personally be very pleased to support. However, the keynote part of his address was about what is an increasingly common phenomenon in hospitals, something they call “code gridlock”. Code gridlock happens when the hospital is so jammed by people coming in that they have no room to admit new patients, and no room to move patients from an emergency ward up to another ward where their care would be more appropriate. They have no room to move people out of intensive care to other wards and there is no place to move patients to other institutions that might be able to handle a chronic care condition.

One hospital he mentioned set a record of seven weeks of gridlock. That backlog sabotaged the efficiency of the entire hospital.

The vast majority of childbirths are not high risk childbirths. There are very good reasons for high risk people to give birth in hospital, but the majority are low risk and midwives can provide those services in a variety of settings. Many hospitals are providing birthing rooms that have low lighting, quiet music, and room for the dad to be there.

I experienced a home birth with my second child. I can tell members that for me and others who have experienced home births, being able to hold that baby in one's own home and for the siblings to hold that baby minutes after he or she is born is an experience that not only the parents will never forget but also neither the children and the siblings. So there are other ways, and midwives are organizing in a variety of ways to see that women get the type of birth care they prefer. Some of those are water births.

I want to speak to something else that occurs in Canada. It is a disturbing trend that has been occurring for years because of hospitalization for a normal, natural process like childbirth for most women. Canada has one of the highest rates of caesarean sections in the world. I wonder why that is. Are Canadian women somehow inferior to other women? C-sections are a surgical intervention. The World Health Organization recommends maximum targets of 10% to 15%. In Canada it was 17% in 2010, and by 2010 it was 10% higher, at nearly 27%. In fiscal year 2011-12 in Ontario, it was nearly 29%, and some provinces and regions in the country were over 30%. There are legitimate reasons for the increased number of C-sections, including an older demographic, with women delaying childbirth in many cases; a trend toward more obesity, with many young mothers now more obese than they were 10 or 15 years ago; larger birthweight babies; and increasing fertility treatments, which lead to multiple births. Those all may be reasons why a C-section might be considered.

A low risk, normal pregnancy and a vaginal birth should be encouraged, which is better for the mother and the baby. Some women may wonder how I know that. Statistics confirm, as will I am sure some of the others who have spoken here, including two who are physicians, that it is undeniable that having a C-section is a much higher risk than a vaginal birth for most women. They are also more expensive. The Canadian Institute for Health Information estimates that a C-section costs about $4,600 compared to about $2,800 for a vaginal birth.

Midwives can practise in a variety of settings. They can accommodate a variety of needs not only of what the mom wants but also the dad to make that experience much more meaningful and at a much more affordable cost. We do not know what the average cost is because it varies across the country, but I understand that it is somewhere between $850 and above. That is very cost-effective compared to $4,600 for a surgical intervention. I think at a time when we are facing a health care financial crisis because our health care system is simply not sustainable on the path we are on, we need to look at cost-effective ways of delivering service. This is not just about saving dollars, but about giving women the choices they want and making childbirth a normal and healthy thing for more women.

I want to thank the member for introducing a very thoughtful bill and one that I think would not only help contain costs but also help give women, children, and families a better birthing experience.

[The Deputy Speaker, NDP, Joe Comartin]

The hon. member for Alfred-Pellan now has five minutes for her reply.

[Rosane Doré Lefebvre, NDP, Alfred-Pellan, QC]

Mr. Speaker, this evening all I want to do is thank all of my colleagues in the House for their wonderful support for Bill C-608, An Act respecting a National Day of the Midwife.

I will not repeat what my colleagues have said, but I would first like to thank the Parliamentary Secretary to the Minister of Health, who is a young mother on the Conservative side. I know how important this issue is to her.

I also want to thank the member for Vancouver Centre, who is always passionate about health issues. I also appreciate her support for Bill C-608.

I also want to thank my NDP colleague from Saint-Bruno—Saint-Hubert, who is a doctor by training. I am very pleased to know that she supports us on this. I know that the national day of the midwife was also important to her.

I would like to thank my colleague on the Conservative side who just spoke, the member for Nanaimo—Alberni, the only man who spoke to this bill. I must say that his speech on his personal experience with midwives was extremely interesting.

I know that he did not make a speech, but I would also like to thank my Conservative colleague from Tobique—Mactaquac for talking about what was going on in New Brunswick and for showing how important it is for his community to have midwives.

I saw how important this issue was to everyone. We all have extremely different experiences, especially as parents. Our birthing experiences—as fathers, mothers, grandfathers, grandmothers, sisters or cousins—are wonderful, and it is important to share these experiences with each other.

I thank my colleagues for their support for Bill C-608, An Act respecting a National Day of the Midwife.

Let us continue moving forward.

[The Deputy Speaker, NDP, Joe Comartin]

Is the House ready for the question?

[Some hon. members]

Question.