Status of Women Committee on May 10th, 2021

[Sonia Sidhu, Liberal, Brampton South, ON]

Ms. Bacon, you were talking about the impact of midwifery on rural communities.

Are there any international policy approaches to midwifery that are better serving rural families?

[Alixandra Bacon]

Actually, Canada along with Australia, I think, are really leading the way in terms of evidence, looking at rural midwifery practice. What we haven't seen are the investments that follow the evidence.

We know that midwives are more likely to go to rural areas; they're more likely to stay in rural remote areas. In terms of the percentage of people they can keep close to home for birth, midwives can maximize the percentage of people who can stay in their home community without having to travel, in comparison to other health care providers.

The evidence is there, and Canada and Australia lead in this evidence. You can look up the rural birthing index work by Jude Kornelsen.

What we need to see are investments that follow that evidence. In particular, this is going to look at salaried models of care and expanded scope, which are going to be essential to this.

These areas have care that's low volume, but that doesn't necessarily mean it's low input. You can spend an incredible amount of time, particularly when the midwife is replacing the role of several health care providers. The midwife in a rural remote community may also be serving as an ultrasonographer. They may also be the lab tech, drawing blood samples. They might be the infant hearing screener, the lactation consultant.

They're providing an enormous value. But we need to be investing. We need to look at alternate models of care. As well, as I mentioned, we need to be getting that Treasury Board distinction that would facilitate midwives working in federal jurisdictions, because several of these rural and remote areas, such as on reserve, fall under federal jurisdiction.

[Sonia Sidhu, Liberal, Brampton South, ON]

As a quick follow-up, Ms. Bacon, each year, 40,000 women in Canada travel outside of their communities to give birth, due to a lack of services in rural Canada.

How are different provinces across Canada addressing this gap?

[Kim Campbell]

In B.C., there are two provincially funded programs that are looking at trying to sustain rural obstetrical programs, by providing mentorship, providing access to training that's close to home, building confidence and building the competence in providing emergency services. They've individualized eight communities in B.C. as part of their rural obstetrical program, which is funded, unfortunately, through the Doctors of BC. However, they've been very inclusive, including midwives and nurses in their training platforms. We're hoping that increases capacity and impacts the communities to keep those providers there.

It's difficult to stay in a community if you lose or you start.... There's a critical mass, and if you take away one key player, the whole house of cards can fall down. They're trying to build a system. There are people who feel they want to stay there because they feel well supported and well funded to do so.

[The Chair, Conservative, Marilyn Gladu]

That's very good.

We now go to Ms. Larouche for two and a half minutes.

[Andréanne Larouche, Bloc, Shefford, QC]

Thank you very much, Madam Chair.

I thank you once again, Ms. Campbell and Ms. Bacon, for your testimony, which sheds some light on the profession for us.

Ms. Bacon, I would now like you to talk to us about the importance of Laurentian University in francophone education outside Quebec and even its importance, as you mentioned, in terms of the disparity in midwifery services between rural and urban communities.

I would like you to talk about Laurentian University's role in that respect.

[Alixandra Bacon]

Thank you.

Yes, I am very concerned about the closure of Laurentian University because of its unique mandate. Laurentian University was the only bilingual midwifery education program in Canada, and the only French language midwifery education program accessible to non-residents of Quebec.

Its loss will be felt profoundly across the country in francophone communities. It also happened to be the only northern university-based midwifery education program—and, to be frank, rural care, remote care, northern care are specialty kinds of care. You can't fly just any midwife into a rural community and assume they will have this unique and expanded full-scope skill set to be able to provide care in these areas.

We are very concerned to see that northern specialty lost, and in particular I am deeply saddened to hear of the loss of the program that was the first in Canada to openly welcome indigenous students. So many of Canada's indigenous midwifery leaders were trained at Laurentian University and that was because they openly and explicitly welcomed indigenous students.

Again, indigenous care, as well as an educational program that's tailored to meet the needs of indigenous students and to set them up for success, is a key focus if we're going to meet our commitments to UNDRIP and the TRC.

[The Chair, Conservative, Marilyn Gladu]

That's very good.

Now we'll go to Ms. Mathyssen for two and a half minutes.

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

Thank you.

I just wanted to use my final time on postpartum care. You've touched on it a bit but we haven't heard a significant amount about your postpartum care and what that means to women and the services that are provided—the difference in care that it provides.

[Alixandra Bacon]

I think you see Kim and me smiling because you have touched on what is perhaps the biggest selling feature of midwifery care. We look after birthers and their babies until approximately six weeks postpartum—or at least we're compensated in my jurisdiction to six weeks, and care for them of up to 12 weeks, so there is that continuity of care. In the first week postpartum, those visits happen in the house. We do not expect you to pack yourself and your new baby into the car and drive to our office at five days postpartum, and we're coming the very next day. We will see you each day that you're in hospital, if you are in hospital, until you are discharged, and your very first day after discharge we're coming to you at home.

I can tell you both as a midwife and as a mother that if you are hoping to breastfeed, it is not as easy as it looks. It is extremely difficult, and your success is dependent upon receiving care early on. If I had had to wait until day five postpartum, my son would not have been fully breastfed or perhaps been a child who was not breastfed at all.

That is a place where our care really shines. It's also where we really have an opportunity to impact families as a whole in recognizing and responding, for example, to family-based violence or child neglect. We are very privileged to be able to enter people's homes and it really deepens the trusting relationship and is one of the most beautiful and heartfelt parts of our work.

[Kim Campbell]

It is the favourite part of my job.

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

I'll gift my 30 seconds.

Thank you, Madam Chair, and thank you to the witnesses.

[The Chair, Conservative, Marilyn Gladu]

Thank you.

I think we're going to leave it there, because I have a couple of things that we have to clear up.

I want to thank the witnesses for excellent testimony. You've helped us with our study, and thank you also for your service to all the women in the country.

For the committee, I need to get approval for the budget to do this study. It's $2,550 for all of the headsets, etc., that we need for the study. Can I have approval from the committee for that?

[Some hon. members]

Agreed.

[The Chair, Conservative, Marilyn Gladu]

Very good.

The other thing is that you need to have your dissenting reports on our pay equity study submitted in both languages by this Friday.

Tomorrow we will be completing our study on sexual misconduct within the Canadian Armed Forces. On Thursday we're going to start, and hopefully finish, our consideration of the report on women's unpaid work. That's what's on our agenda.

Don't forget that tomorrow we meet at 11 until 1 o'clock, and Thursday is from 6:30 until 8:30. Is it the pleasure of the committee to adjourn?

Seeing that it is, we'll adjourn.