Good evening, Madam Chair, and committee members.
My name is Jasmin Tecson. I'm a registered midwife, and I speak to you today as the president of the Association of Ontario Midwives, the largest regional association of midwives in Canada.
We are proud to be a part of a profession that is deeply valued by families, one that we believe is essential to improving health outcomes for pregnant people and their babies. Currently, there are approximately a thousand midwives in Ontario delivering about 18% of the babies in the province. We are autonomous primary care providers. Our midwifery education program, the first of its kind in Canada and respected internationally, confers a bachelor of health science in midwifery. Our comprehensive, rigorous training includes tests; commonly prescribed medications; care management of healthy, low-risk pregnancy and birth and postpartum; as well as emergency skills and assessment, and clinical care for healthy newborns.
Our model of care has proven to be a highly successful method for delivering perinatal care with strong clinical outcomes, exemplary client experiences and efficiency in the delivery of evidence-based care. Our model incorporates the development of a working relationship as well as a trust relationship. The support for informed choice that comes from this leads to levels of client satisfaction that are outstanding for a profession, from 97% to 100%. High levels of client confidence and support combined with continuity of care lead to lower rates of interventions and shorter hospital stays.
In 2019, the c-section rate for midwifery clients was 20%. In contrast, the provincial average was 29%. For midwifery clients who planned home births, the rate was an impressive 7%. By offering safe, skilled birth attendance at home or at birth centres, and follow up care postpartum in the community, Ontario midwives effectively reduce hospital admissions, further reducing health care costs and saving hospital resources for those who need it most.
These facts clearly make the case that midwifery is worth investing in. Yet, there is a price for midwives' dedication. Even without the additional stress of frontline work during a global pandemic, our profession suffers from the underfunding of our education programs, discriminatory pay and demanding work conditions that contribute to increasing burnout and the loss of skilled, dedicated professionals from attrition and disability.
The closure of the midwifery education program at Laurentian is devastating to Canadian midwifery. One third of the student midwives in Ontario were enrolled in the program. Its graduates have gone on to become leaders in regional midwifery associations across the country and in the National Aboriginal Council of Midwives. Closing the program ends bilingual midwifery education in Canada and essentially closes the door to Franco-Ontarians seeking midwifery education in their first language. The program made education accessible to a host of indigenous and northern students who otherwise would not have become midwives. The loss of this access point is a loss that will significantly impact the health of indigenous and northern communities.
Now, we have the risk of a reduced cohort of midwifery graduates who will care for tens of thousands of families in Ontario. The demand for midwifery across the province is great. Fewer graduates will mean that families who choose midwifery care will be unable to access it, far more so in the north.
In a 2015 analysis and report, the AOM made several recommendations for strengthening care in rural, remote and northern communities. The Laurentian program prepared midwives to work in such areas across Canada. Among the recommendations included are that women should have access to high-quality maternity care as close to home as possible. Local perspectives and needs should be taken into account in health care planning. The right to self-determination and culturally safe care must be upheld in indigenous communities. Training opportunities for new and experienced health providers need to be offered within these communities. Rural and remote midwifery funding frameworks must reflect the realities of practising in these areas.
With its integrated, person-centred approach throughout the provision of excellent perinatal care, midwifery is uniquely positioned to address social determinants of health such as gender, culture, race and access to health services. Midwifery in Canada is growing, but it needs coordinated efforts in policy and funding from provincial and federal levels for sustainability.
Thank you for your attention.