National Day of the Midwife Act

An Act respecting a National Day of the Midwife

This bill was last introduced in the 41st Parliament, 2nd Session, which ended in August 2015.

Sponsor

Rosane Doré Lefebvre  NDP

Introduced as a private member’s bill. (These don’t often become law.)

Status

In committee (Senate), as of May 12, 2015
(This bill did not become law.)

Summary

This is from the published bill. The Library of Parliament often publishes better independent summaries.

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

Elsewhere

All sorts of information on this bill is available at LEGISinfo, provided by the Library of Parliament. You can also read the full text of the bill.

Votes

Nov. 19, 2014 Passed That the Bill be now read a second time and referred to the Standing Committee on Health.

National Day of the Midwife ActPrivate Members' Business

February 6th, 2015 / 1:30 p.m.
See context

NDP

Rosane Doré Lefebvre NDP Alfred-Pellan, QC

moved that the bill be now read the third time and passed.

Mr. Speaker, I have the honour to be in the House today to debate my Bill C-608, the National Day of the Midwife Act.

This has been quite the saga. I am extremely proud that all parties in the House voted unanimously at second reading to send the bill to committee. That was good teamwork, and it is wonderful to see that our Parliament can function and that we can work together on great bills such as the one to establish a national day of the midwife.

First of all, I must thank my colleague from Parkdale—High Park, because in the beginning, she was the one who decided to introduce this bill in the House of Commons. She brought forward the first version and began the debate with members of other parties in the House—Conservatives, Liberals and independents—and with experts and the people directly affected, the midwifery associations. I must commend the work done by my colleague from Parkdale—High Park, because she does not take much credit for it. However, because of her groundwork, today we are talking about a national day of the midwife.

I would like to provide a bit of background, because it shows that MPs are very good at doing the groundwork, representing their constituents and bringing their ideas to Parliament. When my colleague was going door to door, she met a woman belonging to a midwifery association who told her about the important work midwives do. She told the member for Parkdale—High Park about their intentions and the fact that midwifery was not yet recognized in every Canadian province and territory, but that they were working on it.

Canadian universities have some of the best midwifery training programs in the world. We can also be proud of that. There are currently 1,300 midwives in Canada, and only 2% to 5% of the population has access to their services. It is thus very difficult and the demand is growing. However, every year, more and more midwives are entering the workforce, and we can only be very proud.

My colleague saw all that potential. She was determined that we should recognize the work of midwives and help them further themselves. She decided to work with people in her riding and across the country to establish a national day of the midwife. I am extremely proud to take up the torch and ensure that this bill is passed as soon as possible. However, I would be remiss if I did not acknowledge her tremendous work on the ground.

As I said, all the parties in the House voted in favour of this bill. We had the chance to go to committee. I presented my bill to the hon. members of the Standing Committee on Health, where it was very well received. They also agreed to hear from witnesses directly affected by this bill. I had the opportunity to appear with the Canadian Association of Midwives and the National Aboriginal Council of Midwives, which also does extraordinary work.

I want to take few minutes to talk about the NACM, because this bill affects them a great deal. Access to midwifery services is particularly crucial in rural and remote communities, including among first nations.

Currently, when a women living on reserve becomes pregnant, the delivery process is not necessarily the same as in large urban centres. Here, the choice is much simpler. We can choose to be seen by a doctor, we can go to the hospital and be accompanied by a doula, or we can give birth at home or at a birthing centre with a midwife. We have a lot of options. Access to some of these options is still limited, but we have them.

For first nations, it is much more complicated.

A few weeks before giving birth, a pregnant woman has to be airlifted to a large urban centre. She is alone. She does not have her family, her spouse or her children with her. She is far away from her family during those final critical weeks. It is not only extremely sad, but downright terrible that these sorts of things are happening in a country as big and as rich as ours.

A good example that I was given was to imagine a woman who is giving birth to her first child. Like my colleague from Beauharnois—Salaberry and all of the other members who are parents, I know that you do not really know what to expect when you are expecting your first child. It can be extremely stressful. You ask yourself a thousand questions. You read books, watch films and talk to people you know to find out how it is going to go. The last weeks are extremely critical, as are the first few days after the delivery.

Women who are sent to large urban centres are alone. They do not have their family, friends, grandmother, mother or aunt to talk to and consult to find out if what is happening is normal. When they give birth, they are isolated in a large urban centre where they do not know anyone. They are not with their spouse.

The days following delivery can be very difficult. For example, a woman who wants to breastfeed may have breastfeeding problems or questions about breastfeeding in general. She cannot be with her own mother who could have shared her own experience. That is very difficult on these women. They return to their communities, where there is no connection to the birth or to what happened. It is extremely difficult for the family, the woman and the community in general.

We are trying to reintegrate the birthing process into communities, because about 95% of pregnancies are considered normal. There is therefore no need to send women who are preparing to give birth to major urban centres. They can give birth in their community with midwives. This issue is slowly being addressed, based on the province or area where the community is located. However, there is still a long way to go.

I am very pleased to see that all of Parliament has decided that it is very important to acknowledge the incredible work that midwives do. Whether we are talking about midwives in first nations communities or midwives in general all across the country, it is extremely important to acknowledge the work that they do.

Today I simply wanted to rise in the House to thank my colleagues for the good work they are doing and for their goodwill on this bill. I noticed that there was a significant interest in continuing the debate on funding for midwives and in perhaps reviewing the birthing process for women from rural and remote communities.

I saw that all parties in the House showed openness on this issue, and I am extremely proud. I hope that this will continue. If my colleagues once again vote in favour of this bill at third reading, the next step will be the Senate. That will be a whole other experience. For now, I would like to thank Parliament. Why not take this bill as an excellent example of how the opposition and the government can work side by side, and why not continue in this direction for future bills?

National Day of the Midwife ActPrivate Members' Business

February 6th, 2015 / 1:40 p.m.
See context

Green

Elizabeth May Green Saanich—Gulf Islands, BC

Mr. Speaker, I would like to thank my colleague very much, because this bill is very important. Like my colleague, I had a midwife when I gave birth to my daughter. It is such a wonderful experience. I was lucky to be able to do so. This bill is very important for women and as a way of showing respect for this profession. I simply wanted to say that she has my support for this bill, and I hope everyone in the House will support this important bill.

National Day of the Midwife ActPrivate Members' Business

February 6th, 2015 / 1:40 p.m.
See context

NDP

Rosane Doré Lefebvre NDP Alfred-Pellan, QC

Mr. Speaker, I thank my colleague from Saanich—Gulf Islands for supporting Bill C-608.

Many of my colleagues in the House have stopped me here in the House, in the hallways or even at the Standing Committee on Health to tell me about their experiences during a birth with a midwife. It is so nice to be able to share that experience together, so that we can better understand midwifery and what that profession entails, and see that it is an option. People do not have to adopt the traditional model. I am paraphrasing here because I think the hospital model is considered to be traditional. It is just great to see how those birthing experiences can vary from one person to another and that they are often wonderful experiences.

I thank my colleague from Saanich—Gulf Islands. She is right: we need to reclaim the birthing experience.

National Day of the Midwife ActPrivate Members' Business

February 6th, 2015 / 1:40 p.m.
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Essex Ontario

Conservative

Jeff Watson ConservativeParliamentary Secretary to the Minister of Transport

Mr. Speaker, I commend the member for this motion.

I am a father of six children, five biological children. My wife was proud to deliver five children with midwives present. In fact, for our fourth child, because we were moving between Windsor to Victoria and then on to Ottawa, all in the span of a week, we had midwives in Windsor, on Salt Spring Island, and in Ottawa, where our son was ultimately born during that transition, all with expert care.

I want to commend the member for pointing out, first, that midwives are professionals. They are trained professionals. They have been delivering woman-centred care for centuries, for millenniums, long before there were ever health care systems, and it is about time that they had recognition.

I want to signal to the member that I will be supporting the bill, and I commend her for it.

National Day of the Midwife ActPrivate Members' Business

February 6th, 2015 / 1:40 p.m.
See context

NDP

Rosane Doré Lefebvre NDP Alfred-Pellan, QC

Mr. Speaker, I would like to thank my colleague opposite for sharing his experience with us. It is very touching to hear the experiences that some of my colleagues have had with midwives.

I completely agree with the member. It is fitting that we recognize the incredible work done by midwives by establishing the national day of the midwife here in Canada, as I believe all of us in the House want to do, and that we also recognize that these women have an incredible knowledge of birthing. Midwives go through a lengthy university training process and have incredible experience in the health field. They are recognized around the world for their services. They often give speeches in other countries, and they even go to other countries to teach all the skills they have acquired here.

We are very fortunate in Canada to have such experienced health care professionals who have such a diverse university education. I thank them for that.

National Day of the Midwife ActPrivate Members' Business

February 6th, 2015 / 1:40 p.m.
See context

Conservative

David Wilks Conservative Kootenay—Columbia, BC

Mr. Speaker, I congratulate the member opposite on this bill. When she came to the health committee with the witnesses, they did a fabulous job. It was very honourable of her to get to this point, and I am looking forward to it going to the Senate.

I have a significant speech I prepared, but I am going to stray from it a bit and highlight some of the points on midwifery.

In August 2013, the Cochrane review, which involved 16,242 women in models of care, including where midwives provided care through pregnancy, during labour, and after birth, and which has one of the highest standards of evidence, confirmed the safety and efficacy of midwifery-led care. It is very important to understand that there is a lot of data on this in Canada, and we are starting to get a lot better at what we do.

Certainly midwives save lives, some 300,000 women each year and 10 times as many infants. That is important to understand too. As midwifery evolves and we get far better at it, we are going to be able to save millions of lives around the world. It is thanks to members opposite and others who have brought this to light that we will be able to do much more in years to come.

According to the Canadian Association of Midwives, a little over 1,300 midwives attend approximately 10% of births in Canada. While these numbers may seem small, it represents tremendous growth.

The practice of midwifery is relatively new in Canada, with the first midwives regulated to practice in 1994. We are only 20 years out since it started. As of 2014, midwives are recognized to practice in eight out of 10 provinces and in two of three territories. We still have a little work to do, but I am sure with the collective work in the House, as well as with the members opposite, we can make that 10 out of 10 and three out of three.

While the government recognizes that primary responsibility for the provision and delivery of health care services in Canada rests with the provinces and territories, we remain committed to a strong, publicly funded, universally accessible health care system for all of Canada.

An evaluation of the midwifery approach to maternal health care in Ontario noted that midwives have lower rates of invasive procedures, fewer re-admissions to hospital, and shorter hospital stays. This translates into a cost saving of $800 per midwifery-attended hospital birth and a saving of $1,800 for home births when compared with family physician care for women with low-risk pregnancies.

Federal recognition of midwives will help to increase the value of this profession in providing maternal care services to women and their families as well as the potential role of midwives in promoting a high-quality and sustainable health care system.

Maternal, newborn, and child health care remains Canada's top international development priority, and we are committed to working with Canadian and international partners toward the goal of ending the preventable deaths of mothers, newborns, and children under the age of five.

In June 2010, under the Right Honourable Prime Minister's leadership, the G8 launched the Muskoka initiative on maternal, newborn and child health, which aims to save 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. Thanks in large part to the Muskoka initiative 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 year. This important work will continue.

In May 2014, the right hon. Prime Minister hosted the Saving Every Woman, Every Child: Within Arms's Reach summit. At that summit, Canada committed $3.5 billion 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 our country's partners to advance progress on international maternal health by investing in improved service delivery at the local level, training more health workers, increasing access to adequately equip local health facilities, and expanding access to services.

Since 1991, the International Day of the Midwife on May 5 has been recognized 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 careful care they provide. A national day of the midwife would help to increase awareness of the value of the profession in providing maternal care services to women and their families, both domestically and internationally.

Therefore, I support Bill C-608, which seeks to designate May 5 of each and every year as the national day of the midwife. I invite my hon. colleagues to do the same.

National Day of the Midwife ActPrivate Members' Business

February 6th, 2015 / 1:50 p.m.
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Liberal

Carolyn Bennett Liberal St. Paul's, ON

Mr. Speaker, it is my great pleasure this afternoon to support a good bill introduced by the member to establish a day in honour of the role that midwives play in births and the health of mothers, newborns and children. This day will raise people's awareness of the work midwives do and the important role they play in our health care system. Nevertheless, they should be authorized to carry out only those functions within their scope of practice.

Midwives have an important role to play in our health care system for low-risk, healthy pregnancies. Women carrying high-risk pregnancies should be triaged. Still, midwives play an essential role overall in promoting health and reducing maternal and infant morbidity and mortality. We need to recognize and promote midwives' potential to enhance the well-being of women, families and society.

Even though midwives play an important role, they can offer only the types of care authorized within their scope of practice. Midwives provide specialized primary care for women whose pregnancies are planned and who are expected to have low-risk births.

It is amazing to be able to support this today, and to remind all members that it was the International Confederation of Midwives that drew attention to the fact that in the millennium development goals we were falling way behind in the area of maternal, newborn, and child health. I remember a round table here, and that we were very pleased that the government was able to attend and to hear the words of the midwives and how important it would be that Canada get behind this important issue of maternal, newborn, and child health going forward. Now we celebrate the work of the midwives in their work around the world, not only in improving maternal and child health, but also in the fight against female genital mutilation.

As my colleague said, midwives have been practising here in Canada for as long as people have lived here. As the immigrants and the settlers brought midwives with them to the new country, it then became a problem. There seemed to be a turf war, and midwives were made illegal. They were practising their craft, but in a very uncertain time.

The Government of Quebec, in 1691, established three autonomous branches of medicine: physicians, surgeons, and midwives. In 1861, in King's College, a school for midwives opened in England. It was opened by Florence Nightingale, but closed two years later. It seems that midwives have somehow always ended up doing just what they do best, but often in an uncertain legislative framework.

It was interesting that it was Sir Wilfred Grenfell, of the Grenfell Mission, who began the first civilian hospital in St. John's, in Battle Harbour. It was staffed by nurses with midwifery skills from Britain, and the British midwives were the nurses who continued to staff other hospitals around the country.

I myself am hugely grateful that in the Canadian winter of 1973, I had the opportunity to go and learn midwifery and obstetrics and gynecology from the midwives in Barbados. I remember being very grateful that I learned these skills first from the midwives in Barbados, who really did believe that birth was a normal thing to happen, before I came back and did my rather medical-model rotation at a hospital where it seemed, in those days, that birth was taught as a disaster waiting to happen.

It has been an amazing relationship with midwives. In 1987 the Government of Ontario published its first report of the task force on the implementation of midwifery in Canada, and I was very proud that I was later asked, as the law came into effect, to chair the midwife implementation committee at Women's College Hospital in Toronto.

As well, at the international convention on midwifery in Vancouver in 1993, we were extremely proud to celebrate what midwives were bringing to us in the research community in terms of qualitative research. Hearing the narrative of women's experience in real qualitative research was of huge assistance to us in changing our ways and being able to move to what is now known as family-centred maternity care, the ability to create an atmosphere centred around mothers and babies, not the convenience of physicians.

After that, I was very pleased to see British Columbia bring in their law in 1998 that allowed midwives to register to practise. We seem to have gone on from there.

At this time, I would like to thank all the midwives who taught me so much. It is so exciting to have this opportunity to thank them. The Vicki Van Wagners and the Holliday Tysons and the Mary Sharpes and other people went on as soon as it was legal. They scattered across Ontario to become professors at places like Laurentian, McMaster, and Ryerson University.

I am so thrilled to have been able to see in practice the new birthing centre on Dundas in Toronto, run by the Seventh Generation Midwives of Toronto, with the beautiful birthing rooms designed by Christi Belcourt, the amazing Métis artist, who was able to put an indigenized approach to midwifery right in the core of Toronto. It makes us all so proud.

Research is imperative, as always. Midwives have always been very keen on the research that accompanies the process. At the centre it was interesting to see the transfer rates, the triage indicators of acceptable clients, and the ability to carry through the birth in a good, safe way being documented. It is extraordinarily good research.

The original goal in Ontario was to give women and their families real choices about where they would want to give birth, whether in their home, in a birthing centre, or in the hospital. Those choices are now there.

As the critic for aboriginal affairs, I was equally thrilled when the first students were admitted into the midwifery program at Tsi Non:we lonnakeratstha Ona:grahsta' on the Six Nations in Ohsweken, Ontario. With this three-year program of 10 months of academic and clinical practice each year, we are finally able to have indigenous midwives practise in indigenous ways, which speaks to the medicine wheel instead of the medical model.

We on this side of the House are very pleased to accept this bill, and we will be celebrating the first national day to acknowledge midwives along with everyone else in this House.

National Day of the Midwife ActPrivate Members' Business

February 6th, 2015 / 2 p.m.
See context

NDP

Rosane Doré Lefebvre NDP Alfred-Pellan, QC

Mr. Speaker, today, I would like to once again thank my colleagues in the House, including my Conservative colleague from Kootenay—Columbia and my Liberal colleague from St. Paul's. They have just given excellent speeches about what midwifery is, the impact it has on our society and all of the positive effects it has on the health of the mother and the child.

I would also like to thank all of my colleagues who shared their personal experiences. It is really nice when we manage to pass something in the House, and to see that we all agree on a bill that seeks to advance an issue as important as midwifery in Canada.

I would therefore like to thank my colleagues on all sides of the House, on the government side, the Liberal side and all of the independent members. The vote was unanimous. I hope that this will happen again. Let us continue to work together like this on important issues in the hopes that we can continue to make a lot of progress in the future.

National Day of the Midwife ActPrivate Members' Business

November 18th, 2014 / 6:45 p.m.
See context

NDP

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.

National Day of the Midwife ActPrivate Members' Business

November 18th, 2014 / 6:55 p.m.
See context

Conservative

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?

National Day of the Midwife ActPrivate Members' Business

November 18th, 2014 / 6:55 p.m.
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NDP

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.

National Day of the Midwife ActPrivate Members' Business

November 18th, 2014 / 7 p.m.
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NDP

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?

National Day of the Midwife ActPrivate Members' Business

November 18th, 2014 / 7 p.m.
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NDP

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.

National Day of the Midwife ActPrivate Members' Business

November 18th, 2014 / 7 p.m.
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Mississauga—Brampton South Ontario

Conservative

Eve Adams ConservativeParliamentary 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.

National Day of the Midwife ActPrivate Members' Business

November 18th, 2014 / 7:10 p.m.
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Liberal

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.