Midwifery cut has ripple effect

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Ontario will lose one-third of graduates with axing of LU program

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Gaelle Nyamushara Ishimwe entered the midwifery program at Laurentian University in Sudbury right out of high school.

“I fell in love with the miracle of life,” said Nyamushara Ishimwe, who is bilingual and would like to work in a francophone community. “It’s a beautiful thing.”

Laurentian is one of only three Ontario universities that offers midwifery as an undergraduate program and the only one that offers the program in French.

Recently the university, which has been grappling with insolvency, announced it was cutting more than 60 academic programs, including midwifery.

Nyamushara Ishimwe considers herself lucky. She has completed the academic requirements and has only a practicum that starts in May and runs until next year to complete in order to graduate.

“It’s not a serious setback for me, but it is for others,” she said.

Laurentian’s decision will have a ripple effect in Ottawa, said Elise Banham, executive director of the Ottawa Birth and Wellness Centre.

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Only 90 students graduate from the three Ontario programs every year. With the Laurentian program being cut, the province will lose one-third of its midwifery graduates at a time when the services of midwives are increasingly in demand.

“There is definitely a larger demand for midwives than there are midwives,” Banham said. “Unless we’re able to reinstate the program, we’ll be choked off in terms of that pipeline.”

Midwifery is a regulated health profession in Ontario. Midwives provide care to healthy women and their babies throughout pregnancy, birth and for six weeks after that, referring mothers and newborns to family doctors or specialists if care becomes complicated.

Ottawa has six midwifery practices, and there are about four more practices in towns outside the city. About half the midwives in Ottawa have privileges at the Montfort Hospital, which requires them to speak French, Banham said.

According to a maternal newborn health services capacity plan for the region, released in April 2019, obstetricians and family physicians conduct about 90 per cent of the region’s 15,000 annual births, with most of the remaining births supported by midwives.

The report noted that, at multiple consultations across the region, women expressed a desire for better access to midwifery services. In 2017, Better Outcomes Registry and Network reported that 237 women requested midwifery services, but could not be accommodated.

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In 2019, Ontario announced it was spending an additional $28 million to expand midwifery services in the province on top of the $178 million it was already spending annually.

Banham fears that closing the Laurentian program will have repercussions for francophone and Indigenous mothers and remote and rural communities.

The BIPOC (black, Indigenous and people of colour) population also has a large francophone component, and it is already underserved, she said.

“There is a general need, but there is also a specific need. This is really going to affect Ottawa and our region more than the province in general.”

There are 300 to 400 applications for 30 annual spaces in the Laurentian program, said Jasmin Tecson, president of the Association of Ontario Midwives. All of the graduates find jobs.

“There is demand to get in and demand for hires,” Tecson said. “This is a profession that needs to grow, that people want to grow.”

She is puzzled as to why Laurentian program cut the midwifery program. It receives “envelope funding” from the province, as well as tuition from the students, and actually brings money to the university, she said.

Montfort spokesperson Genevieve Picard said the hospital was concerned by the Laurentian cuts.

“Closing any francophone program, especially in the health sector, has a significant impact for the province, francophones and Montfort,” Picard said.

Between 3,200 and 3,400 babies are born at Montfort’s birthing centre every year. Midwives care for about 10 per cent of these mothers, although some of the babies are born at home.

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There are currently three Laurentian interns who occasionally come to Montfort when they are working with mothers who choose to give birth at the hospital, Picard said.

Laurentian declined to answer questions about the future of the midwifery program. However, in a statement, the university said its senate voted to close programs that had “historically low enrolment.”

The university expects that 10 per cent of undergraduate students will be affected by overall program cuts.

“For most students, particularly if they are close to completion, this will mean they will be able to complete their degree making use of all or parts of the modules in terminated programs, either through course substitutions at Laurentian or through letters of permission.”

Tecson believes midwifery students will be redirected to other universities. Another university might be interested in taking over the program, but that would take at least a year.

“How that will play out, we don’t know. There is so much that’s unclear at this point,” Tecson said.

“We need an emergency plan to take care of the existing students,” Banham said.

“It would be short-sighted not to reinstate a program for francophone, Indigenous and rural students. If it doesn’t happen, we will struggle to serve these communities.”

sud.editorial@sunmedia.ca

Twitter: @SudburyStar

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