Public feedback sought on introducing regulated midwifery to Yukon

Regulated midwifery services in Yukon

What do midwives do?
Midwives are health professionals who provide maternity care during pregnancy, labour, birth, and after delivery. They typically work with general practitioner physicians and/or obstetrics and gynecology specialists, as well as social workers and other allied health professionals, as part of a care team to provide additional options for pre- and post-natal care, as well as low-risk births.

What is the current situation for midwifery in Yukon?
Yukon does not currently regulate midwifery, or formally integrate midwifery services into the healthcare system. Some midwives do, however, practice in Yukon, with families arranging private contracts and paying midwives directly.

What exactly is the Government of Yukon working on?
The Government of Yukon has committed to regulate, fund and integrate midwifery into Yukon’s healthcare system, with a current target of fall 2019 for initial implementation. The goal of this initiative is to provide Yukoners additional options within a range of healthcare services that support healthy pregnancies, childbirth and post-natal care.

The government is working to ensure regulation, funding and integration of midwifery can be introduced at a similar time. Community Services is responsible for developing a regulatory framework and Health and Social Services is responsible for integrating midwifery into the existing healthcare system, as well as funding considerations.

When did the Government of Yukon start work on this project?
In January 2017, mandate letters for the ministers of Health and Social Services and Community Services identified the regulation and funding of midwifery as a priority. In October 2017, the Government formed a Midwifery Advisory Committee to gather input from local health professionals on bringing regulated midwifery into Yukon’s health system. Initial work with this committee was recently completed.

Why regulate midwifery?
Yukoners have expressed interest in regulated midwifery services for several years. Regulating midwifery will accomplish three key things:

It will introduce rules for midwifery that support safe professional practice.
It will provide the public with assurance that a licensed midwife in Yukon meets set qualification standards.
 It will establish a mechanism for dealing with concerns if they arise.

A key part of regulation is introducing professional standards. Standards could identify such things as minimum education requirements and what services midwives can offer in the territory.

What does integrating midwifery into the healthcare system involve?
Integrating regulated midwifery into Yukon’s healthcare system is a complex endeavor and will require changes to the way that services are currently provided in the territory. This will include planning for sustainable funding and staffing, how midwives will work with hospitals, physicians and other health professionals, and changes that must be made to the healthcare system so that midwifery is integrated in a safe, efficient and feasible way. The development of a Yukon model will require looking at other comparable jurisdictions in Canada, as well gathering health data to understand the current pre-natal, post-natal, and birthing that occurs in Yukon to ensure a model is developed that reflects the capacity of Yukon’s healthcare system, and is aligned with the need of Yukoners.

Why fund midwifery?
Funding midwifery services will provide Yukoners additional options within a range of services that support healthy pregnancies, childbirth and post-natal care.

What has the Midwifery Advisory Committee accomplished?
The Midwifery Advisory Committee was formed to advise the Government of Yukon on this initiative, and has met over 25 times on a range of topics. A summary of the topics that have been discussed can be accessed here: https://yukon.ca/en/midwifery-advisory-committee-executive-summary-of-di....

What is the government’s proposed approach?
There are unique factors that need to be taken into account in Yukon that increase the complexity of providing regulated midwifery services. These challenges include the low number of annual births, a healthcare system that is currently set up for Yukoners to deliver and receive emergency obstetrical services in Whitehorse, and large geographic area between communities.

In light of these realities, the Yukon government is planning to initially introduce regulated midwifery (pre- and post-natal services and midwife-attended births) as an option in Whitehorse, where processes and emergency services that support pregnancies and birth are already in place. We are also considering introducing some regulated pre- and post-natal midwifery services in other communities, and working to identify options to support similar services in Dawson City and Watson Lake.

What does the government hope to get out of public and stakeholder input?
Integrating midwifery into Yukon’s health system is a complex endeavor. Input on the regulation, funding and integration of midwifery into the health system will help us to better understand Yukoners’ needs and perspectives on regulated and funded midwifery, refine our approach to implementing midwifery and learn more about the opportunities and considerations for midwife-led births outside Whitehorse.