Fall 2009 - Association of Ontario Midwives

Policy InitiativesResearchMidwives active in shaping health care policyThe Ministry of Health and Long-TermCare has established a new council tofocus on developing a maternal-childhealth strategy.The overall goal of the ProvincialCouncil for Maternal, Newborn, Childand Youth Health Care is to support thedevelopment of a system of care thatprovides timely, equitable, accessible,high quality, evidence-based, familycentredcare in an efficient and effectivemanner.The Provincial Maternal-NewbornAdvisory Committee (PM-NAC) is anarm of this Council. Vicki Van Wagner,RM, sits on the PM-NAC as a midwiferyrepresentative. Eight work groupsare performing work related to thisCommittee’s goals.Eileen Hutton, RM, is a member ofthe Maternal Newborn PerformanceMeasurement and AccountabilityWork Group. This group will focus ondeveloping a “report card” which canbe used to measure or evaluate theprovincial performance in terms ofmaternal newborn health care.Elana Johnson, RM, is a member ofthe Late Preterm Birth Work Group.This group will describe predictorsfor late preterm birth and identifyapproaches to decrease the incidenceof late preterm birth. The group willMidwifery scope ofpractice reviewIn September, the AOM was invited tomake verbal and written presentationsto the Standing Committee on SocialPolicy regarding Bill 179.This Bill would amend variousActs related to regulated healthprofessionals, including midwives, andbring the law more up to date withcurrent practice.At the Committee hearings, the AOMspoke in support of the proposedlaw in general, and added requestsfor clarity and amendments aroundthe section of the Bill that deals withdrugs.In October, the Standing Committeepresented a few proposedamendments to the Bill on the floorrecommend delivery and post deliveryclinical management of the latepreterm birth population and identifyimplications for early and long-termfollow up of late preterm birth infants.Bobbi Soderstrom, RM, is a memberand co-chair of the Maternal-NewbornBreastfeeding Services and SupportWork Group. This group’s purpose is toprovide cost-effective recommendationsand options to support the deliveryof breastfeeding support and serviceswith a focus on improved breastfeedinginitiation and duration rates.Data ManagementMidwives are also active with theOntario Perinatal Surveilance System(OPSS), with Liz Darling, RM, on theSteering Committee and Eileen Hutton,RM, on the Scientific Working Group.Insurance and Risk ManagementRemi Ejiwunmi, RM and Chair of theAOM IRMP Committee, has beenappointed to HIROC’s Claims andRisk Management Committee. Thiscommittee of the HIROC Board ofDirectors focuses on Claims and RiskManagement for all of the memberorganizations who are subscribers toHIROC, including the AOM.AOM Executive Director Kelly Stadelbauer and AOMBoard President Katrina Kilroy, RM, in the OntarioLegislature after their presentation to the StandingCommittee regarding Bill 179.of the legislature, but only minorrevisions were passed.The Bill in its current form has beenordered to third reading. Full text isavailable online here:www.ontla.on.ca/web/bills/bills_detail.do?locale=en&Intranet=&BillID=2189Home and hospitalbirths analyzed inOntario midwiferystudyA new study comparingoutcomes of planned homebirth and planned hospital birthfound no difference betweenthe groups in terms of perinataland neonatal mortality orserious morbidity. All measuresof serious maternal morbiditywere lower in the planned homebirth group as were rates for allinterventions including cesareansection.Published in the September2009 issue of Birth, the studywas authored by Hamiltonresearchers Eileen Hutton, PhD,Angela Reitsma, RM, and KarynKaufman, DrPH.The purpose of the study wasto compare maternal andperinatal/neonatal mortalityand morbidity and intrapartumintervention rates for womenattended by Ontario midwiveswho planned a home birth, witha cohort, stratified by parity, ofsimilar low-risk women planninga hospital birth with Ontariomidwives.Using information obtained frommidwifery client tracking forms,compiled by the Ontario Ministryof Health during the 2003-2006study period, no differences werereported between groups inthe rates of perinatal or seriousneonatal mortality, or in the ratesof serious morbidity. No maternaldeaths occurred in either group.Women in the planned homebirth group experienced fewerintrapartum interventions foreach specific intervention studiedincluding cesarean section.Comparing outcomes for bothmothers and infants, this studyadds to the body of researchsupporting the safety of homebirth with a Registered Midwifewho is well integrated into thehealth care system.www.aom.on.ca09