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Results: 76 - 90 of 666
Kirsty Bourret
View Kirsty Bourret Profile
Kirsty Bourret
2021-05-10 19:27
I have to jump in and speak here, because this is an area of interest of mine.
It's important to point out that it actually isn't an expansion of our role. In Ontario it is, but when you look at our global definition of midwifery, we have it within our scope to provide all sexual and reproductive health care, which includes contraception, which includes access to abortion. This is something that's well known and that we are trained to do.
Again, around the world, I am working with Global Affairs Canada to ensure that midwives have the capacity to do this within their scope, which means increasing access to sexual and reproductive health care, especially in very, very remote and rural areas. We've been arguing for that for a really long time. While in Ontario it might look like an expanded scope, really the vision of midwifery at the national level is to be able to provide these services across Canada.
You know, this will have a huge impact on our ability to impact this issue around our overall lack of access to contraceptive and reproductive health care, especially with indigenous and other populations that are at a disadvantage. I think there is an opportunity here to have this discussion and to raise awareness of midwives' capacity to function in that way.
View Anju Dhillon Profile
Lib. (QC)
My God.
Ms. Bacon, I have a question for you.
You've done considerable work in sexual health education. Can you share with us how midwifery services support the provision of sexual and reproductive health care in Canada?
Alixandra Bacon
View Alixandra Bacon Profile
Alixandra Bacon
2021-05-10 19:55
Thank you so much.
This is an area where midwifery is greatly underutilized, as Dr. Bourret alluded to earlier.
It is within the scope of a midwife to provide cervical cancer screening, to be providing contraception, including the placement of intrauterine devices and the new Implanon contraceptive insert. It's in our scope of practice to be testing and treating for sexually transmitted and blood-borne infections.
However, in some jurisdictions, this is with an advanced scope of training. It is not accepted in all jurisdictions. There are also constraints, in that we are limited to providing this care, in most cases, though not all, to people who are pregnant or in the first three months postpartum.
This is an area where midwives could be providing a much larger role and having a bigger impact in helping to meet that unmet need for contraception in Canada, for long-acting, reversible contraception in particular, and that culturally safe component of care.
There are pilot projects, in Ontario in particular, such as the MATCH program, where midwives are working with delegation of function to be able to provide these services to people outside of that child-bearing year, as well as to provide abortion services. These are areas where we can expand.
View Jag Sahota Profile
CPC (AB)
You both spoke about this, but I think it was more Ms. Bacon who spoke about the C-sections and hospitalization admissions being low when there are midwives involved. What are some of the contributing factors for that ? That's actually quite interesting.
Kim Campbell
View Kim Campbell Profile
Kim Campbell
2021-05-10 20:12
You bet. It is my wheelhouse. That's the evidence-informed practice for midwifery care.
We have evidence that supports the fact that the role of the midwife contributes to several decreases in interventions, caesarean sections being one of them. We think it's the continuity of care. We think it's the relationships we build and the trust and the comfort that people have when they're with someone they know. It's quite simple: It lets their body do the work. Anxiety stops that, so when you create a soft landing spot and a safe place for people, the body does what it needs to do. It's very simple. That's it.
Alixandra Bacon
View Alixandra Bacon Profile
Alixandra Bacon
2021-05-10 20:12
I would add that midwives picture birth as a normal life event. We do not pathologize birth. Also, we've learned the art of watchful waiting.
There's the cliché of midwives knitting in the corner, but it's for a very good reason. If we're knitting, we're not intervening needlessly. I think that's a real unique midwifery skill set that contributes to the decreased caesarean rates, as well as the time with our clients to make sure they're really well informed and prepared for what to expect in a birthing process.
Also, they have that continuous support in labour. We don't just sweep in at the end and catch a baby. We are with them from the onset of active labour until an hour or two after they birth, and that means that sometimes I might spend 14 hours straight with someone in supporting them. I believe it's that quality time that we spend one-on-one that makes the difference.
View Jag Sahota Profile
CPC (AB)
You've just said that you can spend up to 14 hours with someone. Do you come up with specific solutions for the clients depending on their needs and accommodate them? Let's say they're a high-risk client. Does the care start earlier than it does for others and end later as well? How is that managed?
Kim Campbell
View Kim Campbell Profile
Kim Campbell
2021-05-10 20:14
I can jump in a bit here.
We have a system of risk assessment and we make sure that we individualize the care to meet the risk and the needs of the person. We always have our antennae up. We're always checking the environment. We're always situationally aware, and we pivot constantly.
View Lindsay Mathyssen Profile
NDP (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
View Alixandra Bacon Profile
Alixandra Bacon
2021-05-10 20:22
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.
View Lindsay Mathyssen Profile
NDP (ON)
Thank you, Madam Chair.
We heard in this panel and the last, as well, about the importance of the relationship that women have with their midwives, and that is a special relationship because it is fully about trust. Delivering in the best of situations is very stressful—not that I've done this yet but so I've been told by many friends.
To have services in your own language, to be able to be serviced in ways that are culturally appropriate and culturally sensitive.... Could the witnesses talk about the importance of that, in addition to—and I know that Ms. Recollet and Ms. Wolfe are in more of an urban centre—the special needs for northern remote, as you also mentioned before, communities and women having access to those culturally sensitive, traditional knowledge-based practices with indigenous or aboriginal midwives?
Angela Recollet
View Angela Recollet Profile
Angela Recollet
2021-05-06 12:42
We're not just going to talk about Ontario and Quebec. We need to talk about what you now call Canada as a whole.
I'll give you an example. With the Inuit nation, those mothers, those expectant mothers, have to be displaced from their communities and their families, with only one individual to accompany them as a support system, and have to travel hours and hours, sometimes 40 hours, in order to get to a nursing station to have a non-Inuit or non-native practitioner provide care that is unsafe, lacking cultural bias to their birthing right. That in itself has to be recognized. A solution-based policy would be to provide access in our traditional territories. We do not want to be displaced anymore, and that goes from coast to coast to coast when it comes to our circle of life.
Even here in an urban setting, as you're asking, it wasn't by choice that we were located to urban settings, but I can say that 80% of the indigenous population in what we now call Canada has been displaced to urban settings so that they can have the same access to care that all of you on this call have.
We continue to have to fight for this, to reclaim who we are as indigenous people in these first territories with limited access to resources and constantly needing to justify why we require it. Right from birth to death, this is our ongoing struggle and our ongoing education that we need to provide to newcomers, to government officials, to everyday people walking down the street, to break down what you've learned and provide you with a different education so you know the true history in Canada.
View Salma Zahid Profile
Lib. (ON)
Thank you, Ms. Hart.
I have one more question.
Are there any gaps between the support services which are offered in the rural areas and the urban areas? Also, could you throw some light on how health care services for women living in rural areas could be improved, because that's also one of the very big issues.
Maybe Ms. Anderson wants to talk, or—
Traci Anderson
View Traci Anderson Profile
Traci Anderson
2021-04-27 11:58
Thank you for the question, Madam Chair.
We are seeing a big increase in some mental health challenges. There are definitely gaps in rural communities around women accessing...and primary health as well.
My community is 100,000 and people are on wait-lists for doctors, so I can only imagine it in smaller communities. Some of them are travelling four or five hours to get access just to primary care.
We definitely are seeing a huge increase, especially in young women, around mental health concerns. That's also due to the pandemic. We are seeing some youth who are really losing hope around their future. That's very challenging and disheartening to see happening. There are not a lot of resources and access to supports in rural communities, mental-health wise and primary care.
View Sonia Sidhu Profile
Lib. (ON)
Thank you, Madam Chair.
Thank you to all the witnesses for being here.
I know that Punjabi Community Health Services is providing important services to Bramptonians. Thank you for that.
I would like to direct my question to Ms. Dhillon.
Ms. Dhillon, we live in the same community. We see the impact of the pandemic every day in Brampton. We have heard in this committee how racialized communities have been disproportionately impacted by the pandemic. How can we ensure that they have access to health services and are supported as we recover economically?
Results: 76 - 90 of 666 | Page: 6 of 45

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