I think that while we do have Canadian midwifery competencies that are standardized and we do write a national exam, you do see small variations from jurisdiction to jurisdiction in the scope of practice, and those relate somewhat to regulations. Depending on the body involved in setting the midwifery regulations, there can certainly be politics and, I would say, gender discrimination and maybe some territorialism that's at play in determining who gets to provide what services.
The great irony is that we have Canadians who have unmet needs for sexual and reproductive health care, whether that's trans-inclusive care or access to long-acting reversible contraception or terminations, and yet at the same time due to the somewhat siloed nature of care, we have conversations about protectionism and about how one health care provider cannot steal a piece of the pie from another health care provider.
I think it's very important that we're breaking down silos and that we're providing care that's really family-centred care and based on the needs of the individuals receiving it. If we focus on that shared goal of meeting those needs, I believe we'll come to better solutions.