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”.

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.

National Day of the Midwife Act

[The Acting Speaker, Barry Devolin]

There being only one motion at report stage, the House will now proceed without debate to the putting of the question on the motion to concur in the bill at report stage.

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

moved that the bill be concurred in.

[The Acting Speaker, Barry Devolin]

The vote is on the motion. Is it the pleasure of the House to adopt the motion?

[Some hon. members]

Agreed.

[The Acting Speaker, Barry Devolin]

(Motion agreed to)

[The Acting Speaker, Barry Devolin]

When shall the bill be read the third time? By leave, now?

[Some hon. members]

Agreed.

[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?

[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.

[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.

[Jeff Watson, Conservative, Parliamentary 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.

[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.

[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.

[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.