Local midwife disappointed over ministry’s rejection of new practice

A local midwife is asking women in the community to share their experiences with midwifery care and any obstacles they have encountered while searching for care.

Andy Mills is a registered midwife (RM) who, until recently, was working with the Barrie Midwives. In January 2020, she and a handful of other registered midwives, Kerstin Helén, Janet Rooney, Andy Mills, Karey Goheen, Amy Nelson, and Katelin Goheen, submitted a request to the ministry of health about opening a separate practice. The request was denied in early October 2020.

Mills says she and the others want to work, but aren’t able to because their contracts at the Barrie Midwives weren’t renewed past July 2020.

“This unprecedented decision was not a result of any misconduct or clinical incompetence on the part of these midwives,” Mills says.

The Ministry’s decision to deny a second practice was due to “insufficient demand”.

“That decision is based on historical data which was taken when the six of us were working,” Mills explains. “As a result of those losses, the waitlists are growing and women are having a harder time getting their choice of prenatal care in Barrie and Innisfil.”

Over at Barrie Midwives, RM Ami Nunn, says there were a few months where there was a client waitlist, noting, “Some of the midwives who left were working with us until July, so we had a lull the last few months while waiting to see what our budget would be. We couldn’t bring on more midwives until we knew what our budget was.”

“If the Ministry approved a new practice, that could potentially divide the resources,” she adds.

Last week, the midwives received their budget after pandemic-related delays. Now, Nunn says, Barrie Midwives can move forward and re-build to meet demand in the community: “We’ve only been down in midwives for a few months. We currently have eight workers and are working to get that number up, but first, we have to look at the numbers and decide how many we can accommodate to meet demand.”

Nunn adds that the need for midwives is an ebb and flow system, explaining,  “In the past, when we tried to go bigger, we found we didn’t have enough clients. Now, we might have some months where we’re short on clients and some months where there’s a bit of a waitlist. So we need to find a balance between need and not over saturating.”

That said, Mills believes Barrie is big enough to accommodate another practice. One thing she hopes to see is a change to Ontario’s funding model, which currently restricts midwives from providing care to families without a contract. Unlike physicians, midwives cannot bill the healthcare system directly or set up a practice, even in an area with demand for their services, without prior approval. 

“The funding model was created more than 26 years ago when we were first regulated in Ontario. To have a practice, you needed to demonstrate a need in the community, then apply for a practice,” Mills explains.

“Fast forward to today,” she continues, “and that structure hasn’t changed.”

A registered midwife is a primary care provider for pregnant, low-risk, healthy women from eight weeks to delivery with an additional six weeks postpartum care for the mom and baby.

Midwives are supporters of home births and hospital births and a lower-cost provider overall with excellent outcomes. So the question among the midwife community is why are these restrictions in place?

Mills encourages families to reach out to their Barrie & Area MPP’s Doug Downey and Andrea Khanjin to express their thoughts: “Both are huge supporters of midwives, but since our application wasn’t approved, we’re asking them to act on our behalf on communicating to the ministry of health about the reality of the situation and look at the data as it is now.”

This is why Mills is asking for the community to reach out to her and your local MPP.

“Share your experiences with us, especially over the last six months.  Let us know if you haven’t been unable to obtain your care provider of choice or no care provider at all close to home.”

For more information, visit Advocates For Pregnancy Care Choice in Barrie-Innisfil on Facebook.

We have yet to hear back from the ministry of health.