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

[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.

[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.

[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?

The House proceeded to the consideration of Bill C-608, An Act respecting a National Day of the Midwife, as reported (without amendment) from the committee.

Health

[Ben Lobb, Conservative, Huron—Bruce, ON]

Mr. Speaker, I have the honour to present, in both official languages, the eighth report of the Standing Committee on Health in relation to Bill C-608, An Act respecting a National Day of the Midwife. The committee has studied the bill and has decided to report the bill back to the House without amendment.

[Ellen Blais, Co-Chair, National Aboriginal Council of Midwives]

Good afternoon. My name is Ellen Kanika Tsi Tsa Blais. I am an aboriginal midwife from the Oneida Nation of the Thames, which is one of the six nations of the Iroquois Confederacy. I am from the Haudenosaunee territory, the people of the longhouse, and I am honoured to be here today as co-chair of the National Aboriginal Council of Midwives, otherwise known as NACM. I want to thank the peoples of the Algonquin nation whose unceded territory I am visiting today.

Thank you, Mr. Chairman and committee members, for the opportunity to appear today to testify as part of the committee's study on Bill C-608, an act respecting a national day of the midwife. I would also like to thank the sponsor of the bill, member of Parliament Rosane Doré Lefebvre, who introduced this bill, and who has personally championed the cause of midwifery in Canada and is helping bring to light the challenges we face in our communities. We also extend our gratitude to member of Parliament Peggy Nash for the work she has done to establish a national day of the midwife in Canada.

NACM believes that Bill C-608 is an important step in showing appreciation for the vital contribution that midwives make to the delivery of maternity care in Canada. NACM also believes this bill will bring much needed visibility to the work of aboriginal midwives in supporting health and healing within our communities. Aboriginal midwives have always worked in the community, carrying the cultural knowledge for safe childbirth, yet our work has become almost invisible over the past 100 years due to the medicalization of childbirth. We are working hard to reclaim our role, and legislation such as Bill C-608 offers further support to this essential work.

We would like to thank committee members Dr. Colin Carrie, Dr. Hedy Fry, and members of Parliament Lois Brown and Peggy Nash, who have echoed this appreciation in their statements in the House of Commons. NACM is also grateful to all political parties for the unanimous support the bill has received to date.

NACM's vision is to see aboriginal midwives practising in every aboriginal community. We believe that aboriginal midwives working in every aboriginal community is a safe and cost-effective way to deliver maternity services. Our knowledge and role in protecting, caring for, and honouring women as life-givers are essential for community healing and connect us all.

NACM is a diverse group of indigenous midwives, midwife elders, and student midwives from all regions of Canada. Members include both registered midwives and midwives practising under certain exemption clauses of provincial health legislation. We promote excellence in reproductive care for Inuit, first nations, and Métis women. We advocate for the restoration of indigenous midwifery education and choice of birthplace for all aboriginal communities, consistent with the UN Declaration on the Rights of Indigenous Peoples.

Aboriginal midwives bring wellness back into the community and enable the creation of sacred, powerful healing spaces. An aboriginal midwife is a committed primary health care provider who is fully responsible for clinical decisions and the management of low-risk prenatal, intrapartum, and postnatal care. She promotes breastfeeding, nutrition, and parenting skills. She is a leader, mentor, and keeper of ceremonies. Aboriginal midwives work with other health care professionals, including doctors, pediatricians, or other specialists when needed, and advocate for culturally safe care.

In 2012, NACM was recognized by the Health Council of Canada as a promising practice in aboriginal health. There are currently 11 midwifery practices in Canada dedicated to providing care in aboriginal communities. Our work is promising, but the road ahead is long. Today, very few aboriginal communities have access to midwives, and most women give birth outside their communities.

I invite you to take a moment and imagine your families. You are about to become a grandparent for the first time. You are thrilled. You have been waiting for this moment for months, helping your daughter prepare for this beautiful time. You are eager to meet your first grandchild. Your daughter is nervous about the birth and you reassure her. You have made a small gift for the baby and you give it to your daughter when you see her off at the airport. She is flying to Thunder Bay to have her baby as per the evacuation policy, since the community you live in does not have maternity services. You bid her an emotional goodbye. You try to stay in touch by phone over the weeks while she waits for labour to begin and you worry about how you are going to pay for phone bills you cannot afford.

Your family gathers at the home of her husband and awaits the news of the baby's arrival. The next afternoon, you learn that the baby was born by C-section that morning. It's a girl. You and your daughter's husband long desperately to hold the baby, to welcome her. You are told that you will able to in about a week's time.

When your daughter returns, she is emotional and exhausted after a long and lonely four weeks away. She thought that she would breastfeed her baby, as she learned it was the best choice to make, but she was not able to find the support she needed while so far away. You know that she has started to formula-feed her baby, and you once again worry about the cost. You thought you would be overjoyed to meet your grandchild. Instead, you think about how much you have already missed.

This is what birth looks like today in most of our communities. Every day families are separated and women give birth alone, even as a growing body of research points to the health and social costs of this practice.

Developing maternity services closer to home is an integral part of the healing process in aboriginal communities. Aboriginal midwives respect birth as a healthy physiologic process, and honour each birth as a spiritual journey. We believe aboriginal women have the inherent right to choose our caregivers and be active decision-makers in our health. Working closely with women to restore identity and health from the time of birth enables us to heal from historical and ongoing trauma, addictions, and violence. When birth is absent, so is the power and joy of the birth story, and within it, the threads of connections to oneself, family, community, and the cosmos.

In many cases aboriginal midwives are the first and only health professionals a woman sees throughout her pregnancy. We have a unique opportunity to build trusting relationships with the health care system that have a ripple effect into the health of the family and the community. For example, the success of the Inuulitsivik Health Centre, one of three Nunavut birthing centres, has been recognized on several international platforms, including the World Health Organization. Since 1986, locally trained Inuit midwives have been providing cost-effective care along the Hudson Bay coast. Birth evacuations have since dropped from 91% in 1983 to just 9% in 1998, drastically cutting costs. Bringing birth closer to home is possible.

In federal jurisdictions such as reserves, communities face significant barriers when attempting to implement midwifery services. At this time there is no federal funding for midwives to practice on reserve except for reallocated funds transferred to the First Nations Health Authority in British Columbia.

I once had the honour of being involved in a young woman's healing through the transformative power of birth with aboriginal midwives in Toronto. This woman was from one of the Cree nations from western Canada. She had already given birth to several babies, each one apprehended into the child welfare system while living out west. She had sustained a childhood full of sexual abuse from family members who, while attending residential school, had not experienced a healthy and loving childhood but had experienced only sexual, physical, and emotional abuse from their teachers. She began taking drugs to numb the pain. When she arrived in Toronto she was pregnant, and was supported to connect with aboriginal midwives for her birth.

She was convinced she did not have the capacity to care for her baby, and was planning to relinquish him at birth to the Children's Aid Society. The aboriginal midwives surrounded her at the birth with care and compassion, singing and drumming her baby into the world. She told me that at that time she felt like all of her ancestors were there at this birth. Her baby was born at sunrise. Later on his spirit name was given to him by an elder who was not aware of the time of his birth but through the connection of spirit gave him the name “He who brings in the light”. From that moment on, she began to learn how to care for herself. After a year of hard work, inspired and supported by her aboriginal midwives, she brought her son home to stay.

Globally, NACM is among the first national professional associations of indigenous midwives. Worldwide, other indigenous midwives look to NACM as leaders. In 2017 the global midwifery conference will be hosted in Toronto, and NACM will have the opportunity to showcase our groundbreaking on the global stage.

Bill C-608 is a first step to recognizing the essential role that midwives play in ensuring the health of our communities. It is one action that continues to bring visibility to our work of creating strong identities for our children, strength for our women, deep bonds in our families, and a healthy future for our communities.

I want to close with a prayer by Katsi Cook, a mentor midwife, that we use in our medicine circle for blessing births: Relax where you are and feel your weight supported by Mother Earth. Breathe in the oxygen. It is part of the sky and part of each one of us. I give thanks, for peacefully you are born. I pray that peacefully your life will be ongoing, because as I think of you clearly, I know you will always be loved.

Thank you for the opportunity to appear before this committee, and I look forward to any questions you may have.

[Emmanuelle Hébert, President, Canadian Association of Midwives]

Thank you Mr. Chair and committee members for the opportunity to appear today to testify as part of the committee’s study of Bill C-608, An Act respecting a National Day of the Midwife. I would also like to thank the sponsor of the bill, member of Parliament Rosane Doré Lefebvre who introduced this bill in the House of Commons and who has personally championed the cause of midwifery in Canada. We also extend our gratitude to member of Parliament Peggy Nash for the work that she has done to establish a National Day of the Midwife in Canada.

The International Day of the Midwife was formally established in 1992 by the International Confederation of Midwives (ICM). Since then, every year, May 5 marks the day of celebration for midwifery globally, a day that reminds the world of the essential role that midwives play in ensuring healthy outcomes for mothers and their newborns. Statements in support of International Day of the Midwife have been issued by the United Nations Population Fund (UNFPA), the International Federation of Gynecology and Obstetrics (FIGO) and by the World Health Organization (WHO).

The Canadian Association of Midwives firmly believes that Bill C-608 is an important step in showing appreciation for the vital contribution that midwives make to the delivery of safe, quality maternity care to Canadian families and to the important role that midwives play in delivering thousands of healthy Canadian babies.

We would like to thank committee members Dr. Colin Carrie, Dr. Hedy Fry and members of Parliament Lois Brown and Peggy Nash who have echoed this appreciation in their statements delivered in the House of Commons in 2013 and in 2014 in recognition of May 5 as the International Day of the Midwife. And of course, CAM is very grateful to all political parties for the unanimous support the bill has received to date.

The Canadian Association of Midwives is the national organization representing midwives and the profession of midwifery in Canada. CAM's mission is to provide leadership and advocacy for midwifery as a regulated, publicly funded and vital part of the primary maternity care system in all Canadian jurisdictions.

CAM also works to support the interests and objectives of 13 provincial and territorial midwifery associations, as well as the National Aboriginal Council of Midwives (NACM). There are currently just over 1,300 practising midwives in Canada. Midwifery in Canada provides a model of care that is evidence-based, women-centred, safe, and cost-effective. Registered midwives are health professionals who provide primary care to women and their babies during pregnancy, birth and the postpartum period. They are often the first point of entry to maternity services, and are fully responsible for clinical decisions and the management of care within their scope of practice.

Midwifery models of care vary across the country, but all are based on the principles of continuity of care provider, informed choice, and choice of birth place, such as hospitals, birth centres and homes.

Midwives provide a complete course of low-risk prenatal, intrapartum and postnatal care and services for mothers and their newborns. These include physical examinations, screening and diagnostic tests, the assessment of risk and abnormal conditions, and the conduct of normal vaginal deliveries.

Midwives work in collaboration with other health professionals, and consult with or refer individuals to medical specialists as appropriate. In jurisdictions where midwives work to the fullest scope, midwifery practice includes epidural monitoring, induction for post-term pregnancy and augmentation of labour by pharmacological means, prescription or fitting of contraceptives, baby care beyond the six-week postpartum period, and many other aspects of primary care.

Midwives are experts in normal births and therefore help to reduce high rates of interventions. Women who experience midwife-led continuity models of care are less likely to experience antenatal hospitalization, regional analgesia and episiotomy, and their newborns are more likely to have a shorter hospital stay and fewer readmissions.

Midwifery services also help to reduce wait times in emergency rooms because midwives are on-call and directly accessible to their clients 24 hours a day, seven days a week.

According to statistics from Ontario, midwives currently achieve caesarean section rates that match the World Health Organization's recommended rate of 15%. If midwifery care was widely instituted, this reduction alone could potentially save millions of dollars a year in health care spending.

There are seven universities in five provinces offering a four-year midwifery education baccalaureate program, and a number of community-based midwifery education programs in first nations and Inuit communities. In spite of this, only 2% to 5% of women in Canada currently have access to midwifery care services.

And why is this? In New Brunswick, Prince Edward Island, Newfoundland and Labrador, and in the Yukon, the profession is still unregulated and unsupported by the public health care system, so families do not have access to midwifery care.

In federal jurisdictions, such as on reserve, penitentiaries and military bases, communities face numerous barriers when attempting to implement midwifery services. These attempts most often result in failure to improve health services and to offer birthing services closer to home.

The World Health Organization, UN agencies and other global partners have identified midwives as key to achieving reductions in maternal and infant mortality. Through the Muskoka initiative and more recent investments by the government in international maternal, newborn and child health, Canada has played a role globally in helping to increase women’s access to quality maternity care.

However, a 2013 UNICEF report found that Canada domestically ranked 22 out of 29 developed countries for infant mortality rates. This concerning figure is mostly attributed to the higher rates among aboriginal communities where women must leave their community for weeks to give birth in urban centres, away from their families and support systems.

Midwifery can play a significant role in ensuring better access to care for women and their babies and CAM looks forward to opportunities to work with the federal government and with the provinces and territories to improve access to maternal and newborn health care in Canada.

In June 2017, Canada will host the world’s triennial global midwifery congress in Toronto. Over 4,000 midwives and maternity care providers from around the globe will be in Canada to learn and discuss on issues regarding global maternal, newborn and child health. This will be a one of a kind opportunity for us to demonstrate to the world Canada’s contributions and to share what Canada is doing within its own borders to ensure fair and equitable maternity care for all Canadians.

Evidence from around the world demonstrates that midwives are essential to improving the lives of mothers and babies. Let us work together to ensure that in June of 2017, when midwives and health professionals from around the world gather in Toronto, that Canada is seen as a leader in the delivery of safe, equitable and cost-effective community-based maternal, newborn and child health services for all Canadians and continues to be a global leader in this area.

We applaud the government's Muskoka initiative and more recent global investments in maternal, newborn and child health that have helped to train midwives and skilled birth attendants, and increased women's access to quality midwifery services internationally.

The Canadian Association of Midwives continues to play an important role in ensuring Canadian expertise is being fully utilized to strengthen midwifery globally.

In closing, Canadian midwifery is a model of maternity care that provides excellent patient satisfaction, while decreasing rates of intervention and providing cost-effective care. This model is especially suited for providing care in rural and remote communities where transportation costs to transfer patients are staggeringly high.

Midwives benefit from flexibility and sustainability when they work to their fullest scope of practice, which is why this model should be explored and expanded by those looking for innovative models of care.

We are thrilled to be hosting the ICM global midwifery congress in Canada in 2017 and see this as an opportunity for Canada to shine even more on the global stage. Bill C-608 is an important step towards recognizing the growing profession of midwifery and the essential role midwives play in the delivery of maternity care and its potential to enhance our health care system across the country.

Thank you for the opportunity to appear before the committee and I look forward to any questions you may have.

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

Thank you very much, Mr. Chair.

I would first like to thank the hon. members of the Standing Committee on Health for taking the time today to study my bill, Bill C-608, An Act respecting a National Day of the Midwife. I would also like to thank the many midwives who worked with me on this matter.

The reality of midwifery is quite different from coast to coast, be it in the heart of the Northwest Territories or in downtown Toronto. Their openness and generosity have enabled me to better understand their world and the impact their work has on our society. My special thanks go to the Canadian Association of Midwives, the National Aboriginal Council of Midwives and the Ordre des sages-femmes du Québec for their contribution.

Last fall, the House of Commons was unanimously in favour of the bill. As parliamentarians, we were able to show our support for Canadian midwives and our commitment to recognizing May 5 as the National Day of the Midwife.

As you can see, the title of Bill C-608 really reflects its intent: recognizing midwifery by designating May 5 as the National Day of the Midwife.

The World Health Organization introduced the International Day of the Midwife in 1992. That day is recognized in a number of countries around the world. That is why May 5 has been kept as the date for the National Day of the Midwife.

Whether here or abroad, the work of midwives is needed to keep mothers and children healthy. Although the number of midwives is going up every year in Canada, less than 5% of the population has access to their services, which is not enough to meet the demand.

The situation is even more desperate in aboriginal or remote communities, where giving birth is completely different from the reality of big cities. The presence of midwives in remote areas helps communities reconnect with the ancestral practices they hold dear.

It is also important to point out that Canadian midwives are recognized internationally for the quality of their work. We can be very proud of them.

I sincerely believe that the main thing here is to highlight the invaluable work that midwives accomplish daily. That is why I brought forward Bill C-608.

I will be pleased to answer any questions members of the committee may have.

Thank you.

[The Chair, Conservative, Ben Lobb]

Good afternoon, ladies and gentlemen. Welcome back. We're ready to begin our meeting.

In our first hour we're going to be looking at Bill C-608, an act respecting a national day of the midwife. The author of the bill is here today.

Thank you very much, Ms. Doré Lefebvre. You have 10 minutes to bring some remarks. Go ahead.

Midwives

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

Mr. Speaker, the third petition is about my bill, Bill C-608. Many people have signed this petition to make May 5 the national day of the midwife.

Tougher Penalties for Child Predators Act

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

Mr. Speaker, I would like to thank my colleague from Edmonton—Strathcona for her extremely important question. I am happy that she mentioned the specific situation facing first nations communities.

I agree that the government is unfortunately neglecting many files. With regard to the schools she mentioned, the government is completely neglecting its duty and is not honouring the treaties it has signed with first nations. It is so sad to see this. I truly hope that this will get the attention it deserves and that it will be included in the bill, because often the reality facing isolated first nations communities is forgotten.

This brings me to a parallel I would like to draw with the bill we voted on. I introduced Bill C-608 in the House of Commons. It passed second reading. Members voted unanimously in favour of a bill to establish a national day of the midwife. That bill is very important to first nations in particular, because the whole birth experience has been altered among first nations. Women often have to fly out of their communities for weeks, if not two or three months, in order to give birth to their child, when instead we could simply sit down with first nations communities and look at what they need for women to be able to deliver their babies in their own communities.

This bill is along the same lines. We need to make sure that we work in partnership with first nations and that the government has an open dialogue with those communities.

National Day of the Midwife Act

[The Acting Speaker, Conservative, Bruce Stanton]

The House will now proceed to the taking of the deferred recorded division on the motion at second reading stage of Bill C-608 under private members' business.

The House resumed from November 18 consideration of the motion that Bill C-608, An Act respecting a National Day of the Midwife, be read the second time and referred to a committee.

[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.

[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.

[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.

[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.

[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.

[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]

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.

Parliament of Canada Act

[The Acting Speaker, Conservative, Barry Devolin]

The time provided for the consideration of private members' business has now expired, and the order is dropped to the bottom of the order of precedence on the order paper.

Pursuant to Standing Order 37, the House will now proceed to the consideration of Bill C-608 under private members' business.

[The Chair, Conservative, Dave MacKenzie]

Next is Bill C-608.

National Day of the Midwife Act

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

moved for leave to introduce Bill C-608, An Act respecting a National Day of the Midwife.

Mr. Speaker, at a time when the health of mothers and children around the world is one of our biggest concerns, I am honoured to introduce this bill, which is calling for the creation of a National Day of the Midwife in Canada. I would like to draw attention to the hard work that the hon. member for Parkdale—High Park has done on this file.

Since 1991, the World Health Organization has recognized May 5 as the International Day of the Midwife, which is celebrated in more than 50 countries. There are over 1,300 midwives in Canada who support women in every region of the country during pregnancy, childbirth and recovery. It is time to acknowledge the valuable contribution that midwives make to our society.

(Motions deemed adopted, bill read the first time and printed)