Association of Ontario Midwives Summer 2012

Rural and Remote Practice
Locum Program fosters sustainability and growth of rural and remote practice
In many rural, remote and northern
communities, midwifery care is
provided by a solo midwife or by
a small practice. Rural and remote
midwives accept the challenges of
working in smaller and sometimes
isolated communities, and the
additional strain of being completely
tied to their work. Unlike midwives in
larger midwifery practice groups, they
can’t rely on their colleagues to access
time off-call. The Locum Program
provides much needed vacation and
emergency relief for rural and remote
midwives, allowing them to recharge
and relax or to tend to pressing
personal matters. This in turn helps
midwifery to remain strong in small
communities.
In 2009, the AOM introduced a
program to respond to the needs
of rural and remote midwives with
funding from the Ministry of Health
and Long-Term Care. The AOM Rural
and Remote Locum Program provides
relief for midwives for holidays,
illness, emergencies, continuing
education or parental leave. It
enables midwives to turn off their
pagers with the confidence that their
clients are in the experienced hands
of another midwife.
For Natalie Kirby, who usually
works at Midwives Nottawasaga in
Collingwood, a locum placement
allowed her to support a solo midwife
in Powassan, near Kirby’s hometown
of North Bay. While on locum, Kirby
gained insight into the life of a solo
midwife when she was on call for 28
days in a row. During her second week
she attended four births, three in
hospital and one at home.
“Being a solo midwife is an incredible
responsibility,” says Kirby. She says
being able to provide relief to the
local midwife and provide care to her
clients was very rewarding. “Balance
is essential in our career. You need
time to be pager-free so you can sleep,
travel or do whatever you need to do.”
She was also happy to ensure that
clients had the birth experiences
they were seeking. “If a locum didn’t
come, the women might have been
transferred out of midwifery care
and wouldn’t have
had home visits,”
says Kirby.
Susan Wilts, a
solo midwife at
Huron Community
Midwifery Services
in Auburn, uses her
time off to volunteer
with a medical team
in Haiti. For the past
four years, the Locum
Program has enabled
midwife Maggie
Fioravanti to care
for Susan’s clients
while she is away.
Wilts says Fioravanti
(who retired from St.
Jacobs Midwives in 2008) is the ideal
person to relieve her because she has
extensive experience with Old Order
Amish and Mennonite women, who
make up 80 percent of Wilts’s practice.
According to Wilts, Fioravanti also
has the sense of adventure needed to
navigate southwest Bruce County in
the middle of winter. Many of Wilts’s
clients live on rural roads that don’t
appear on maps and aren’t plowed
between 9:30 p.m. and 4:30 a.m. –
even if there’s been a snowstorm. Her
clients don’t have telephones and
Top and above: Collingwood midwife Natalie Kirby provided off-call relief for
a solo midwife in northern Ontario during a locum placement in Powassan,
near Kirby’s hometown of North Bay. She was on call for 28 days straight and
attended four births in one week.
there is limited cell phone service in
the area. Babies are often delivered by
lantern light and using the bathroom
means a cold walk to the outhouse.
“A midwife (working in this area)
definitely has to have a good vehicle,
warm clothes and boots, and a GPS,”
says Wilts.
As midwifery in Ontario grows with
more practices in rural and remote
areas of the province, the AOM Locum
Program will continue to support
midwives and sustain midwifery care
in these communities.
To find out more about the Rural and Remote Locum Program,
please contact the AOM at 416-425-9974 or 1-866-418-3773 x2257.
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ontario midwife • Summer 2012