Good afternoon, Madam Chair and honourable committee members.
I am here to talk about the concerns of francophone communities outside Quebec that feel aggrieved by the closure of the Laurentian University Midwifery Education Program. I thank everyone who has contributed to my testimony today.
I am a francophone midwife who grew up in northern Ontario, and I graduated from the Laurentian University Midwifery Education Program, where I have been a professor since 2007. I am one of the only francophone midwives outside Quebec to have earned a post-graduate degree.
Here is our main message: to enhance the education of francophone, indigenous and northern midwives, including midwives who identify as black or racialized, we must strengthen the integration of this profession at all levels of the public sector, across policies and health care systems.
The current closure of the midwifery education program has to do with the lack of understanding of midwifery by government and academic decision–makers. That underscores our recommendations at the federal level to increase the profession's impact across the country.
We want the committee to recommend to the province that: a midwifery education program be reinstated in northern Ontario; that it contain a francophone option; and that an indigenous midwifery education program be created in northern Ontario.
As for the federal government, we recommend that it create a position of chief administrator for midwives within the Public Health Agency of Canada and that midwives be included in decision–making wherever physicians and nurses are invited. We recommend investing in programs or creating programs at the federal level, such as the Consortium national de formation en santé, or CNFS, which improves the midwifery education capacity for northern and francophone communities. We recommend that those programs prioritize the education of indigenous and racialized midwives. Finally, we recommend supporting midwives' ability to complete their post–graduate studies, which enables them to be educators and researchers, in order to generate data for the profession and to increase the sustainability and impact of that profession over time.
The midwifery education program at Laurentian University has more than fulfilled its mandate to increase community services [technical difficulties] to monitor or increase our efforts. Those positive impacts will be cancelled out. Midwifery services in those communities, which are already difficult to obtain, will become inaccessible, and our families will suffer the consequences.
According to Mélanie Guérin, a midwife who graduated from Laurentian University, the communities of Hearst and Kapuskasing, which she has been serving for 15 years, are 95% francophone. Midwives who settle in small northern communities are rare, unless they come from there or from a similar community.
Pascale Alexandre, a student attending the Laurentian University Midwifery Education Program is a black francophone woman. She said she decided to become a midwife to help people in her community give birth in a context of cultural safety. According to her, eliminating the midwifery program's francophone component is an attack on black francophone minority groups and on people giving birth. She adds that, in a context where it is proven that racial discrimination has a negative impact on the provision of health care, reducing access for racialized and linguistic minority groups maintains that disparity, at best, and exacerbates it, at worst.
Carine Chalut, a client of the East Ottawa Midwives—a clinic that is almost completely francophone and whose midwives are Laurentian University graduates—says that she had francophone midwives for her three pregnancies and that having access to health services in her language was not only an advantage, it was a necessity. She adds that, when a woman is in a situation as vulnerable as that of giving birth, she cannot be expected to interact in a language that is not her mother tongue, as that puts her in a precarious, even dangerous, situation. She thinks it is important for francophone women to continue having access to that care in the language of their choice, as that is not only a matter of rights, but also of quality of care.
Although university education is a provincial responsibility, we feel that the federal government has a role to play in strengthening the impact of our profession. There are current examples of the federal government funding programs to improve the health staff through education and research programs. For instance, Health Canada has an official languages health program that funds the Consortium de formation en santé, the CNFS. Such programs can be implemented to improve the midwifery education capacity, especially in francophone, indigenous, black and northern communities, as well as in communities of colour.
In summary, the federal government has an opportunity to innovate and create structures that show an investment in midwifery through leadership, initial education and research in the field. That would increase our profession's capacity and impact.