Fall 2009 - Association of Ontario Midwives
Fall 2009 - Association of Ontario Midwives
Fall 2009 - Association of Ontario Midwives
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Policy InitiativesResearch<strong>Midwives</strong> active in shaping health care policyThe Ministry <strong>of</strong> Health and Long-TermCare has established a new council t<strong>of</strong>ocus on developing a maternal-childhealth strategy.The overall goal <strong>of</strong> the ProvincialCouncil for Maternal, Newborn, Childand Youth Health Care is to support thedevelopment <strong>of</strong> a system <strong>of</strong> care thatprovides timely, equitable, accessible,high quality, evidence-based, familycentredcare in an efficient and effectivemanner.The Provincial Maternal-NewbornAdvisory Committee (PM-NAC) is anarm <strong>of</strong> 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 <strong>of</strong>the 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 <strong>of</strong>maternal newborn health care.Elana Johnson, RM, is a member <strong>of</strong>the Late Preterm Birth Work Group.This group will describe predictorsfor late preterm birth and identifyapproaches to decrease the incidence<strong>of</strong> late preterm birth. The group willMidwifery scope <strong>of</strong>practice 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 healthpr<strong>of</strong>essionals, including midwives, andbring the law more up to date withcurrent practice.At the Committee hearings, the AOMspoke in support <strong>of</strong> the proposedlaw in general, and added requestsfor clarity and amendments aroundthe section <strong>of</strong> the Bill that deals withdrugs.In October, the Standing Committeepresented a few proposedamendments to the Bill on the floorrecommend delivery and post deliveryclinical management <strong>of</strong> the latepreterm birth population and identifyimplications for early and long-termfollow up <strong>of</strong> late preterm birth infants.Bobbi Soderstrom, RM, is a memberand co-chair <strong>of</strong> the Maternal-NewbornBreastfeeding Services and SupportWork Group. This group’s purpose is toprovide cost-effective recommendationsand options to support the delivery<strong>of</strong> breastfeeding support and serviceswith a focus on improved breastfeedinginitiation and duration rates.Data Management<strong>Midwives</strong> are also active with the<strong>Ontario</strong> 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 <strong>of</strong> theAOM IRMP Committee, has beenappointed to HIROC’s Claims andRisk Management Committee. Thiscommittee <strong>of</strong> the HIROC Board <strong>of</strong>Directors focuses on Claims and RiskManagement for all <strong>of</strong> the memberorganizations who are subscribers toHIROC, including the AOM.AOM Executive Director Kelly Stadelbauer and AOMBoard President Katrina Kilroy, RM, in the <strong>Ontario</strong>Legislature after their presentation to the StandingCommittee regarding Bill 179.<strong>of</strong> 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 in<strong>Ontario</strong> midwiferystudyA new study comparingoutcomes <strong>of</strong> planned homebirth and planned hospital birthfound no difference betweenthe groups in terms <strong>of</strong> perinataland neonatal mortality orserious morbidity. All measures<strong>of</strong> serious maternal morbiditywere lower in the planned homebirth group as were rates for allinterventions including cesareansection.Published in the September<strong>2009</strong> issue <strong>of</strong> Birth, the studywas authored by Hamiltonresearchers Eileen Hutton, PhD,Angela Reitsma, RM, and KarynKaufman, DrPH.The purpose <strong>of</strong> the study wasto compare maternal andperinatal/neonatal mortalityand morbidity and intrapartumintervention rates for womenattended by <strong>Ontario</strong> midwiveswho planned a home birth, witha cohort, stratified by parity, <strong>of</strong>similar low-risk women planninga hospital birth with <strong>Ontario</strong>midwives.Using information obtained frommidwifery client tracking forms,compiled by the <strong>Ontario</strong> Ministry<strong>of</strong> Health during the 2003-2006study period, no differences werereported between groups inthe rates <strong>of</strong> perinatal or seriousneonatal mortality, or in the rates<strong>of</strong> 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 <strong>of</strong> researchsupporting the safety <strong>of</strong> homebirth with a Registered Midwifewho is well integrated into thehealth care system.www.aom.on.ca09