Midwives: A Critical Workforce to Save Lives

Bridget Lynch  YWCA Toronto Woman of Distinction 2012

It is a tremendous honour to be named as one of Toronto’s Women of Distinction by the YWCA in the category of Health. This award is especially meaningful as it is given by women to women and recognizes the essential importance of the ongoing need to improve the lives of women and girls in this city and beyond.

I see many parallels between the work of midwives and the work of the YWCA. Much like midwives here in Ontario, the YWCA believes in providing the necessary support so that women can transform their own lives. The new apartment towers on Elm Street in the heart Toronto are an innovative solution to provide housing for women affected by violence, poverty, addiction, or mental health issues so that they can move on in their lives. As I reflect back on my decades-long career as a midwife, it becomes clear that creating woman-centred responses – whether in health care or social services – is the best way to empower women.

Midwifery Model: Woman-centred Care

Offering women choices is a key midwifery value. During almost three decades of providing midwifery services in Toronto, I have seen pregnancy and birth as a life-changing event for countless women. I have had the privilege of serving women from diverse communities providing woman-centred care, where the woman is the primary decision maker and the midwife serves as her expert guide, providing care through pregnancy, birth and the first six weeks after birth.  Midwives practice a model of informed choice, providing information to allow women to be the primary decision- makers in their pregnancy and birthing care. I have experienced first-hand the positive ripple effect that women experience when they make decisions about their health. The experience informs the way in which they take control of improving the health of their families.

For women who have experienced addiction, poverty, violence or mental health issues, the importance of taking control of decisions that affect their lives is equally important.

Prior to 1994 when midwifery was recognized as a health care profession here, women in Ontario had access to only a handful of midwives. We worked out of our homes and we were paid by our clients – sometimes by an exchange of services. My front porch was built by two carpenters in exchange for my midwifery services to their families.

Today, midwives in Ontario are primary caregivers, fully integrated into the health care system and providing care free of charge to pregnant women and their newborns. We are particularly proud of the fact that Ontario was the first jurisdiction in the world to regulate midwives to follow women to their choice of birthplace, either at home, the hospital or in a birth centre. Our women-centred model of care is highly valued by the women of this province and is recognized as one of the best models of midwifery in the world.

It’s an exciting time to be a midwife. I derive immense satisfaction from teaching students in the Midwifery Education Program at McMaster University, one of three universities in the province offering a Bachelor of Science in Midwifery. Our students are getting clinical training in midwifery clinics across the province and are passionate about supporting and serving women from all sectors of society.

Here in Ontario, we started the midwifery profession with only 60 midwives in 1994. Today, there are over 500 midwives in clinics across the province and we currently have 400 students in our midwifery education programs. The Ontario government continues to support the growth of midwifery and recently announced the funding of two midwife-led birth centres to be opened in the coming years. (http://goo.gl/cwWz2.)

As one of the first midwives to be regulated in the province in 1994, it has been my privilege to not only to contribute to the development of midwifery here in Toronto, but to expand my horizons and share this model of care with midwives around the world.

Midwives: A Critical Workforce to Save Lives

At the global level, the United Nations has now recognized the critical role midwives play in improving the health of women and newborns. In some areas of the world, childbirth is still a dangerous event. Every year 350,000 women in low-resource countries die from complications suffered during pregnancy and childbirth. Millions more suffer life-long disabilities. This suffering and death is taking place because these women lack access to safe and humane care.

For a dozen years, the international aid community has struggled to find the solution to end these needless deaths. While addressing the need to develop functioning health care systems in all our countries globally, the United Nations and global partners have also recognized midwives are a critical link in the chain to improve maternal-child health globally. The World Health Organization has identified that in order to address the need, we must train over 350,000 more midwives.

In response to this crisis, during my tenure as president of the International Confederation of Midwives, the Confederation committed to develop global standards for the education and regulation of midwives. In 2011, at the ICM Congress in Durban, South Africa, we launched these global standards. These standards serve to guide governments in both low and high resource countries to develop high quality midwifery services. They define the profession of midwifery on a global scale – a profession dedicated to improving the lives of women, their newborns and families, wherever they live.

Bridget Lynch was one of the first 60 midwives to work in Ontario when the profession was regulated in 1994. She is a founding member of the Canadian Association of Midwives (CAM), a former president of the Association of Ontario Midwives (AOM), and past president of the International Confederation of Midwives (ICM), which represents more than 250,000 midwives in 98 countries. She continues to practice midwifery in Toronto.