Association of Ontario Midwives Summer 2009: Vol. 2 No. 2 AOM ...

Association of Ontario Midwives Summer 2009: Vol. 2 No. 204Health Ministerspeaks tomidwives05Members enjoy2009 conference07IPE serves midwivesand colleagues08Midwives leadinternationaleffort09Scope changes needmidwives’ inputAssociation of Ontario MidwivesAOM President Katrina Kilroy addresses members during theOpening Ceremonies of the Association’s 25th Annual General Meetingand Conference while Minister of Health David Caplan looks on.

AOM News & UpdatesAOM Staff UpdatesThe AOM staff continues to grow inorder to serve members. If you are notsure who best can help you, please callreception and you will be connectedwith the staff member who can bestassist you.A full staff directory can be found onthe AOM website at www.aom.on.ca/AOM/Contact_Us/The AOM is pleased to announce thehiring of two new staff members innewly created positions.Margo Burns joins the AOM as theDirector of Professional and ClinicalDevelopment.Margo’s role will include thedevelopment and implementation ofeducational programs to do with bothclinical and practice managementinformation. Margo has extensivework experience in program planningand adult education in the healthcare sector, with expertise in webbased,e-learning distance educationprograms. Margo is a registeredrespiratory therapist and has aMPH and her PhD in instructional/educational technology.Brenda Natalie joins the AOM as afull-time bookkeeper. Brenda startedin April after three years in a similarposition with the non-profit GirlGuides of Canada (Toronto area office).AOM Benefits Trust staffJoining Rhona Dunwell in the AOMBenefits Trust is Marlene Mahadeo asa Benefits Administrator.Marlene has over 8 years experiencein the area of Human Resources. Herprevious roles include working as anHR Coordinator and Analyst whereher responsibilities included pensionsand benefits administration andHR reporting.Sudbury: Meghann Leonard, RM, is one of the New Registrants who started work quickly upon graduation, thanks to arevised budget process at the Ontario Midwifery Program. Meghann (far right) is seen here with baby Holdenalongside clients Jasmine Beange (mother), Dawson Beange (father), and Tanner (big sister).New Registrants start towork immediatelyAs a result of the AOM negotiationsprocess with the Ministry of Healthand Long-Term Care, practices are nowapproved to hire New Registrants inMay, rather than waiting until latesummer as in past years.This means midwives who have justfinished their education program canstart finding positions immediatelyupon graduating, and begin providingcare to women this summer whomay otherwise have been without amidwife.“Not only is this excellent news forwomen waiting for midwifery care,but it benefits the health care systemand makes sense for midwives too,”says Katrina Kilroy, AOM President.“Graduates who start work rightaway keep their skills fresh and it mayhelp to relieve some anxiety for newregistrants about their job prospects.”It is expected that approximately60 New Registrants will start workin 2009.Welcome new AOMmembers!Joy Allan, Community Midwives ofBrantfordMyriam Badger, Midwife AllianceDiane Beard, Burlington and AreaMidwivesMelissa Bevan, Midwives of MuskokaStella Capisciolto, The Midwives’ Clinic ofEast York-Don MillsIryna Didyk, Access MidwivesSandra Fincham, Midwives NottawasagaLinda Fleming, Community CareMidwivesKaren Hayhoe, The Hamilton MidwivesNatalie Kirby, Ottawa Valley MidwivesDevi Krieger, Midwives Collective ofTorontoMeghann Leonard, Sudbury CommunityMidwifery PracticeHayley Mutch, Thames Valley MidwivesKatherine Nicholl, Stratford MidwivesLaura Parizeau, Talbot Creek MidwivesAmanda Reid, Countryside MidwiferyServices - Palmerston ClinicGenia Stephen, Leeds Grenville Midwives(as of June 17, 2009)02 ontario midwife • Summer 2009

toronto: South-Central region midwives and families gettogether for a friendly game of summer softball.ottawa: RM Diane Parkin and midwifery student GeniaStephen share a smile at the Ottawa Consumers’ Picnicwhile Mariposa, a client’s baby, snuggles in. Dozens ofconsumers attended this annual community event.Ottawa: Information table at the Ottawa Consumers’Picnic. The event includes all the Ottawa practices.The consumers’ group in Ottawa is actively involvedin supporting local midwifery.Members celebrate International Day of the Midwifewith summer eventsMany practices have held picnics, parties and open houses recently to celebratepractice anniversaries and the annual May 5 International Day of the Midwife.Members are invited to submit photos and/or stories of any practice events tothis newsletter.The AOM offers communications support to practices needing assistance withpublicity and event promotion. Recently, Leeds-Grenville Midwives tookadvantage of this and worked together with AOM staff to produce press releasesabout several local information nights and a community picnic to celebrate thepractice’s first anniversary.Send photos and stories by e-mail to comms@aom.on.ca.New Board MembersEsther Willms and Elizabeth Brandeis havejoined the AOM board as Board Secretaryand Member-at-Large, respectively.Esther has been a midwife for ten years. Sheis an AOM ESW instructor and will continuein that role as well as her work as BoardSecretary and on the Executive Committee.Esther is a partner with The Midwives’ Clinicof East York-Don Mills.“Our practice is well underway,” says Esther,“and I have the time and energy for boardwork now. I’m looking forward to learningand contributing to the Association.”Elizabeth has been practicing midwifery forsix years. She is the CAM representative onthe College of Family Physicians of CanadaMaternal Newborn Care Committee andone of the AOM representatives on theAOM/OMA Liaison Group. Elizabeth is anAOM ESW instructor and she will chair theAOM Policy Committee. She is a partnerwith the Midwives Collective of Torontoand is currently co-head midwife at MountSinai Hospital.“I’m interested in being part of shaping thefuture of our profession,” says Elizabeth.“I feel passionate about developingmidwifery.”Many thanks to outgoing board membersMary Ann Leslie and Elissa Press for theiryears of fruitful work.Fall Regional MeetingsMembers can help to set thedirection of the Association forthe next three years by attendingfall regional meetings andcontributing to the strategic plan.Make your voice heard as amember and attend!Meetings will run from 1:00 to4:30 p.m. Contact your regionalrepresentative to add items tothe agenda. Call the AOM officeif you need the contact details foryour rep.South-Central: Monday,October 19• Tracy FranklinSouth-East: Tuesday, October 20• Sara StaintonEast: Wednesday, October 21 •Jane SomervilleWest: Monday, October 26 •Madeleine ClinSouth-West: Tuesday, October 27• Kelly GascoigneNorth: Wednesday, October 28 •Eileen AbbeyMinutes from the Spring RegionalMeetings are now available fordownload from the membersonly section of the AOM website.www.aom.on.ca03

AOM AGM & Conference 2009“Thank you foryour passion”(Exerpted from Minister Caplan’sOpening Ceremonies speech)My government and I recognize thesignificant contribution that midwivesmake to Ontario health.Your commitment and dedicationhas improved the quality of care forthousands of women and newborns.I thank you for your passion. You arevery much part of Ontario’s vision ofhealth care.And midwifery is an important part ofmy plan to expand community-basedprimary care services in Ontario.Starting this year, the Ministry hasrevised the timing of its approvalprocesses so new registrants canbe hired almost immediately upongraduation.And I am pleased to tell you thatthe legislation we have recentlyintroduced [Bill 179] will support anew and more efficient process foradding drugs.Today, most midwife-assisted birthsin Ontario take place in a hospital.But I know that many of you areconcerned with your hospitalprivileges, and that a number of youhave been challenged and had yourprivileges denied in some hospitals.I’m also concerned. Now, more thanever before, we need to support,encourage and expand midwiferyin Ontario.Rest assured…I am on your side.I’m monitoring this situation carefully.And I’m looking for the best way tomake our influence felt. I continueto work with you to foster interprofessionalcare.Recently, I spoke with the Associationof Ontario Midwives. Together weidentified key investments thatwould build and sustain themidwifery sector.I look forward to working with you toensure midwifery continues to be anincreasing available option of care forwomen in Ontario.And on behalf of the women andchildren you help -- thank you.top left: Minister of Health and Long-Term Care David Caplan addresses members at the AOM Opening Ceremonies;top right: Bridget Lynch, AOM member and President of the International Confederation of Midwivesbottom (left to right): HIROC CEO Peter Flattery, Rogers Partners lawyer Anita Varjacic, AOM Director of Insurance andRisk Management Bobbi Soderstrom, and Rogers Partners lawyer Diane CraigYou said it! Member feedback about the 2009 conference• “The conference is always great:getting to see old friends and makenew ones, and to be inspired in mypractice.”• “I always enjoy the opportunity toconnect with my colleagues from allover the province.”• “Opening Ceremonies speecheswere very inspiring!”• “I liked having the original midwiveswho started midwifery 15 years agoattend many of the sessions andshare their experiences.”• “I’m always surprised howrelevant the ‘Lessons Learned’ RiskManagement sessions are. Evenmore cases next time.”• “Dr. Kate Miller was an excellentspeaker about keeping birth close tohome – we should invite her back.”• “I liked the conference focus onnormal birth. The home birthsession could have been a plenary.”• “Loved Katrina’s closing speech withthe quilt. Perfect! Beautiful!”04 ontario midwife • Summer 2009

TOP (left to right): AOM members Annabel Cope (Toronto Riverdale), Jane Flindall(Barrie) and Maxine Vigneault (Ottawa)CENTRE (left to right): Ministry of Health staff Wendy Katherine, Acting Director of theOntario Midwifery Program Jody Hendry, AOM staff Juana Berinstein, OMP staff JoanMongeon, OMP staff Samantha Ball, and AOM staff Alice Ormiston; MEP student JerrylynGuevarra (Ryerson); MEP students Rebecca Johnston and Kristen Dalton (McMaster) tryout the Choices Childbirth Services birth pool; MEP student Crystal Williams (McMaster)BOTTOM (left to right): Keynote Speaker Jane Sandall and OMP staff Rena Porteous;AOM members Mary-Ann Leslie (Thornhill), Vicki Van Wagner (Toronto) and TiffanyHaidon (Uxbridge)All conference photos by Marina Dempsterwww.aom.on.ca05

AOM News & UpdatesOntario MidwiferyProgram releases2007-08 numbersThe Ontario MidwiferyProgram at the Ministry ofHealth has released the clienttracking data for 2007-08.Known as the MidwiferyOutcomes Report, or MOR,this statistical information isavailable for use by individualmidwives and practices toview their own statistics andoutcomes from year to year.The MOR is also used by theMinistry of Health to evaluatemidwifery care and forplanning purposes.The AOM has access to thereport, but only to viewprovincial aggregate data.If members require their loginID to view their practice data,please contact the OntarioMidwifery Program at416-327-7061.To discuss MOR informationwith the AOM, pleasecontact Alice Ormiston atpolicyanalyst@aom.on.caFacts and FiguresDuring this period, which ranApril 1, 2007 to March 31,2008, the number of births toOntario midwifery clients was11,746, up from 10,395 theyear before.This includes 2230 homebirths, up from 2043 in06/07. While total home birthnumbers have increased, thepercentage of home births hasdecreased from 20% in 06/07to 19% this most recent year.The cesarean section rateremained constant at 15% as ithas for the last 5 years.Twenty-six percent of clientshaving a vaginal birth usedpharmaceutical pain relief in2007/08 including 17% withepidurals.AOM releases two new position statements supportingbirth close to home and publicly-funded healthcareResponding to the changing healthcarelandscape in Ontario which is seeing morebirth unit and hospital closures and moreservices threatened by privatization, theAssociation of Ontario Midwives has takena stand on these issues.The AOM Board has approved two newposition statements, one outlining thebenefits of birth close to home and asecond which supports the publicly-fundedhealthcare system. These statementswill be used to guide the actions of theassociation and to educate members andthe public.The full papers are available on theAOM website at www.aom.on.ca/Communications/Position_Statements/Below are excerpts from each paper.Birth Close to HomeThe Association of Ontario Midwivessupports keeping maternity and newborncare as close to home as possible and doesnot support the closing of birth units as asolution to human resource or budgetingdifficulties. Midwives want to work withthe healthcare system to be part of thesolution, ensuring all women have accessto the right provider at the right time in theright place.This principle of accessible maternity careclose to home is supported by OntarioMaternity Care Expert Panel (OMCEP)which states that every woman in Ontarioshould have access to high quality, womanandfamily-centred maternity care as closeto home as possible. Support for keepingbirth close to home requires hospitals orbirthing centres to be available throughoutthe province. In fact, OMCEP has as itsfirst recommendation “declaring amoratorium on maternity care programclosures in communities that havesufficient health human resources tomaintain safe services.”The AOM’s support for birth close to homestems from evidence which demonstratesthat requiring women to travel awayfrom their community to one centralizedhospital for maternity care leads to severalresults, namely:• poorer outcomes for women andnewborns;• the atrophy of other aspects ofwomen’s health care;• withdrawal of family physicians fromthe community;• loss of skill sets in remaining healthcare providers; and• exodus of businesses and residentsfrom the community.Viable, fiscally-sound alternatives to thecentralization of birth are possible.Publicly-funded HealthcareThe Association of Ontario Midwivessupports publicly funded healthcare thatis accessible, portable, universal andcomprehensive, as envisaged in the CanadaHealth Act 1984. We are concerned thatimportant expansions to Medicare arebeing overlooked while at the same timecritical aspects of the existing publicsystem are being shifted to the privatesector. As a result of these concerns, theAOM calls on government to reaffirm theirfinancial commitment to the public healthcare system, to stop all efforts to privatizethe system, and to expand the publicsystem in the following ways:• Invest additional dollars in the publichealth care system• Abandon public-private partnerships(P3s) and alternative financing andprocurements (AFPs) to build andmaintain new facilities and offerservices;• Discontinue privately run clinics thatviolate the principles of the CanadaHealth Act• Expand the public system to coverother essential health care servicesincluding prescription medications,home and community care• Expand the focus on diseaseprevention and health promotion• End the three month wait for newresidents to qualify for publiclyfundedhealth care in OntarioThe current Medicare system hasexperienced significant stress due torising costs associated with an acute careapproach to health, drastically reducedfederal funding of the mid-1990s, andthe failure to restore this funding toadequate levels subsequently. In addition,governments have bowed increasinglyto privatization pressures by developingpublic-private partnerships (P3s),alternative financing and procurements(AFPs), and by turning a blind eye to illegalprivate clinics.In order to protect Medicare, federal andprovincial governments must reaffirm itscommitment to maintain and expand,rather than erode, public funding of theCanadian health care system.06ontario midwife • Summer 2009

Key Maternity Care IssuesInterprofessional Educationsets the stage for betterhospital relationshipsThree programs in Toronto hospitalsare working to improve understandingbetween midwives and other healthcare providers by including midwives inInterprofessional Education programs.While these programs involve differenthealth care professionals at various stagesof their careers, they all have the samegoal: better knowledge of scope and rolesbetween providers leading to more respect,better relationships and ultimately betterclient care in hospital settings.At Toronto East General, new FamilyBirthing Centre nurses hired by the hospitalare required to take a 16-week intensivePerinatal Program. This includes spendinga day at The Midwives’ Clinic of EastYork-Don Mills.“People need to walk in other people’sshoes to understand what they do,” saysShelly Petruskavich, Nursing PracticeLeader for the Family Birthing Centreat Toronto East General Hospital. “Thisprogram builds skills, but also camaraderieand respect.”The four-year-oldprogram has newnurses spend 10 foreign person.”weeks in classes,Christie Kavaratzis, RMlabs and on thefloor to alignwith perinatalcompetencies from the Canadian NursingAssociation. Then nurses spend time withobstetricians, midwives, social workers,breastfeeding consultants and othersinvolved with labour and delivery.Midwives see a benefit to themselves andtheir clients.“The biggest advantage is that they getto see what we do and who we are. We’renot a foreign person,” says RM ChristieKavaratzis. “They get to see what we doat clinic then later they see the resultson the floor at the hospital. It gives thenurses a broader understanding of howwe work when they see us in the clinic aswell as at the hospital. And anytime youimprove Interprofessional relationships,it’s good for the women. The less you haveto explain why you’re with a midwife orclarify roles, the better for our clients.”“At our practice, we try to place theRM Mahnaz Najafian and Nurse Manager Donna Abrahamconfer over hospital paperwork. When midwives, nursesand other health care professionals understand eachothers’ roles and scope of practice, everyone benefits,including clients.hospital nurses with midwives who arenewer, like me, because I didn’t have amidwifery student,” she says. “It’s betterfor the clients not to have so many peopleat appointments, and it was a goodintroduction for me. I’m not teaching, thenurses just observe, but it still feels like afirst step towards being a preceptor.”Nadia Bellio,a midwifewith SeventhGenerationMidwivesToronto, agrees.Her practice ispart of a programat SunnybrookHospital which works with third-yearmedical clerks doing a rotation in Labourand Delivery.“The biggest advantage is that they get tosee what we do and who we are. We’re not aThe Midwives’ Clinic of East York-Don Mills“I haven’t preceptored midwifery studentsyet, so this program is helpful to me asan introduction to teaching and I find itdeepens my personal practice,” says Bellio.“I also find the program has been helpfulin terms of feeling more integrated in thehospital environment. Even though wemight not see the medical students forlong, there’s a sense of familiarity andcollaboration when I run into them onLabour and Delivery.”The medical clerks participate in a day-longorientation at Sunnybrook which includesa one-hour presentation by midwives. Inthe following weeks, clerks rotate throughthe Seventh Generation clinic, about onemorning per week per student.“It’s not a transfer of clinical skills, butfor them it’s exposure to the midwiferymodel of care,” says Bellio. “The studentshave been really keen. They appreciate themodel and how we spend time and build arelationship with clients. And I get a clearerunderstanding of the medical trainingmodel as well.”At St. Michael’s Hospital, a researchstudy evaluating a newly developedInterprofessional Education program formaternity care providers also exposesstudents to the roles, responsibilities andscope of practice of other professionals.The project is led by Dr. Filomena Meffe,OB-GYN (Director, UndergraduateMedical Education, Dept. of Obstetrics &Gynecology, Faculty of Medicine, Universityof Toronto).Funded by HealthForceOntario, theprogram was offered to a small number ofmidwifery, medical and nursing studentswho attended the sessions together. The30-hour program featured teaching DVDsof clinical scenarios, use of standardizedpatients (professional actors), role plays,use of a simulation lab, shadowingexperiences, de-briefing sessions, readingsand discussion. An interprofessional facultydeveloped and delivered the curriculum.Participants completed six modules over afive-week period this past winter.“The shadowing portion of the programwas meaningful to all the students, butmedical and nursing students in particular,as they had the most to learn aboutmidwifery – they had not had very muchexposure before,” says Catherine Moravac,Research Coordinator IPE in MaternityCare at St. Michael’s Hospital. “Studentfeedback was very positive. Studentsvalued the opportunity to learn with, fromand about each other. They commentedon the honest and open dialogue betweenstudents and also among the IPE faculty. Itwas a good experience for everybody.”The project received additional funding tocontinue the IPE program at St. Michael’sHospital and expand it in the winter of2010 to include two other hospital sites.“Midwives have been really dedicated tothis project,” says Moravac. “Vicki VanWagner and Mary Sharpe from RyersonUniversity have been integral to its success,along with Bridget Lynch. We hope thiscurriculum will be helpful to students intheir future professional lives.”www.aom.on.ca07

Consumer ResourcesEvery pregnancy wanted, every birth safeOne June 4, 2009, the Federal Parliament unanimously passedan all-party resolution renewing Canada’s commitment toMillennium Development Goal 5 which aims to:1. reduce by three quarters, between 1990 and 2015, thematernal mortality ratio; and2. achieve, by 2015, universal coverage of skilled care at birth.The Canadian motion reads:That this House renews its commitments to reducing maternaland newborn morbidity and mortality both at home and abroadand supports Canadian leadership within government and civilsociety to work within the G-8 and as partners with UN Agenciesand appropriate global initiatives to achieve this goal.The Canadian Association of Midwives, the Association ofOntario Midwives and the Society of Obstetricians of Gynecologistsof Canada (SOGC) supported this effort to bring a resolutionto Parliament. Even with a shorter timeline than originallyexpected, CAM had great success with a nationwide ‘Mothersand Midwives’ Campaign informing all Parliamentarians of thisissue and asking for a resolution from Parliament.Leaders of the International Federation of Obstetrics andGynecology, the International Confederation of Midwives, theWhite Ribbon Alliance, and the SOGC made compelling presentationsat a Parliamentary briefing meeting chaired by SenatorWilbert Keon. Leaders of all three parties, in both the House andSenate, responded immediately and demonstrated leadership inaddressing preventable tragedies.Over half a million women each year die during pregnancy orbirth, as well as 7 million newborns and stillbirths due to poormaternal health and a lack of skilled professionals attendingbirth globally. The resolution is timely as the G8 leaders willmeet in Italy in July, and next year, here in Canada.“Today, Canada has committed to working with the other G8nations to find solutions to save lives and to ensure that allwomen globally have access to family planning,” said BridgetLynch, President of the International Confederation of Midwives.“When a woman survives childbirth, her children are more likelyto survive childhood. They are more likely to get an education.They are more likely to be well nourished and, thus, they areAOM President Katrina Kilroy, CAM President Gisela Becker and ICM PresidentBridget Lynch present the Mothers and Midwives CAMpaign at the AOM conferencemore likely to make positive contributions to the development oftheir societies.”The President of the International Federation of Gynecologyand Obstetrics, BC physician Dr. Dorothy Shaw, said, “The lackof progress to date in preventing worldwide maternal andnewborn morbidity and mortality is difficult to live with whenthe solutions are not expensive and not high-tech and requirepolitical commitment from all governments. Development ofnations is dependent on how much the lives of its women arevalued.”Representing the White Ribbon Alliance in Canada, MaureenMacTier said, “With this resolution, Canada’s Parliamentarianshave committed to helping us save women’s lives. I am delightedthat our message has been heard and we will work together toachieve the Millennium Development Goals on maternal andchild health.”Dr. André Lalonde, Executive Vice President of the SOGC, said“Canada has the potential to play a leading role and we mustrespond to this human tragedy. Too many women are dyingwithout basic care. With one woman dying every minute duringchildbirth, we need action now. This resolution gives us themomentum we need to join forces to make the world a safeplace for our mothers.’’Maxum Matragen and Maxum Multi-Vite Vitamin-Mineral supplements warningHealth Canada is advising expectantmothers and breastfeeding womennot to take the vitamin-mineralsupplements Maxum Matragenor Maxum Multi-Vite by SeroyalInternational Inc. Maxum Multi-Vitehas been approved as a vitamin-mineralsupplement for only the general publicbut lacks the required cautionarystatement on the label regardingpregnant and/or breast feeding women.The product Maxum Matragen is beingpromoted by the company as a prenatalsupplement; however, neither producthas been authorized for sale by HealthCanada for use by women who arepregnant or breastfeeding.Both products contain ingredients suchas Ginkgo biloba, Green Tea Extractsand Vanadium, whose safe use duringpregnancy or in breastfeeding womenhas not been well established. Productscontaining these ingredients requirea cautionary label warning consumersto consult with a health care practitionerprior to use if they are pregnant orbreastfeeding, neither Maxum Matragennor Maxum Multi-Vite carries sucha warning on their labels.In addition, the daily doses as labelledfor Maxum Matragen and MaxumMulti Vite do not provide the minimumrecommended daily dose of 400 mcg offolic acid and the recommended 16-20mg of iron for expectant, pregnant andbreastfeeding women.Health Canada has not received anyadverse reaction reports associated withMaxum Matragen and/or Maxum Multi-Vite. Pregnant or breastfeeding womenwho may be taking Maxum Matragen orMaxum Multi-Vite are advised to consulttheir health care professional.The company Seroyal International Inc.has voluntarily recalled these productsfrom the market.08 ontario midwife • Summer 2009

Government InitiativesRM Hedrey Chu examines baby Iralyn Gibson with mother Glynnis McNeaney nearbyMidwives’ input needed this summer regarding Bill 179: scope of practice law to be amendedThe Ministery of Health and Long-TermCare is inviting submissions fromstakeholders regarding changes tothe Scope of Practice for health careprofessionals, including midwives.Bill 179 is meant to amend various actsrelated to regulated health professionsIf passed, the Bill will give midwives theauthority to:• Place a finger or instrument beyondthe anal verge to allow for theadministration of suppositorymedications;• Place a finger or instrument beyondthe anal verge to check for 3rd and4th degree tears;• Take blood samples from fathers anddonors from veins or by skin pricking;• Communicate a diagnosis;• Order additional laboratory tests anddiagnosis ;• Perform newborn intubation; and• Administer any substance byinjection or inhalation on order of aphysician.The Association is seeking clarificationregarding:• How the drug approval process willbe improved to allow midwivestimely access to needed medicationsin order to provide safe care; and• Composition of the new expertcommittee that will be involved inthe drug approvals process.What Bill 179 fails to address:• Authority for a midwife to direct anambulance to the most appropriatecare facility; and• Authority to certify for additionalprocedures in order to facilitate IPC,particularly in rural and remote areas(extended class).Bill 179 has now gone through secondreading and has been referred to theStanding Committee on Social Policy.The Standing Committee is a smallworking group of Members of theProvincial Parliament (MPPs) thatis responsible for reviewing and, ifnecessary, modifying the details of the Billafter receiving feedback from members ofthe public.The Standing Committee can still modifythe Bill before it becomes law.Last summer, many AOM membersparticipated in consultations andmeetings with the Health ProfessionsRegulatory Advisory Council (HPRAC)regarding this issue.AOM members, clients, and the public areencouraged to participate in the politicalprocess. Members should watch for moreinformation from the AOM throughoutthe summer.www.aom.on.ca09

National NewsNova ScotiaNova Scotia midwives working in Halifax’s IWK Hospital from left to right: Karen Robb,Kelly Chisholm, Theresa Pickart and Rachel Godwin.As of March 18, 2009, families in Nova Scotia have access topublicly-funded midwifery services as the province beginsthe integration of midwives to primary maternity care teams.There are seven full-time equivalent positions funded. Midwivesare already available in three provincial model sites to providecare to pregnant women. The first funded home birth tookplace just a few weeks after midwives’ services became partof the publicly-funded maternity care system. The MidwiferyRegulatory Council of Nova Scotia has now been established.This council is comprised of three midwives recommendedby the Association of Nova Scotia Midwives, a registerednurse recommended by the College of Registered Nursesof Nova Scotia, a physician recommended by the College ofPhysicians and Surgeons of Nova Scotia, three public members,and the registrar. Midwives are primary care providers asmembers of collaborative practice teams, which include nursepractitioners, family practice nurses, dieticians, social workers,physiotherapists and occupational therapists. It is anticipatedthat each full-time midwife will attend to the care of about40 women each year. In 2007 there were 9,104 births in NovaScotia. Seven midwives will provide care for about 3% ofprovincial births.The AOM had a role to play in Nova Scotia’s integration.The Ontario Association facilitated the introduction of NovaScotian midwives to HIROC, the AOM insurance provider. Inaddition, the AOM is assisting the Nova Scotia midwives withthe administration of their insurance policy. In May, the AOM’sDirector of Insurance and Risk Management Bobbi Soderstromtravelled to Nova Scotia along with three HIROC staff membersto give a presentation about liability, insurance and riskmanagement to the province’s midwives and to meet withrepresentatives of their three hospitals. These presentationswere well received.AlbertaA Calgary college is working to put together a midwiferydegree program to help meet the demand for midwives nowthat midwifery care is publicly-funded (as of April 1, 2009). TheAlberta Association of Midwives is working with Mount RoyalCollege to create a midwifery degree program that could starttaking students as early as the fall of 2010. “What better wayto get more midwives on the ground practising than to have ahomegrown program that is offered and available to womenin Alberta, where they don’t have to leave their families,” saidmidwife Meryl Moulton, who is helping set up the program.Alberta currently has 33 practising registered midwives.New BrunswickMidwives across New Brunswick hope they’ll soon be ableto deliver babies as part of the provincial health system. TheDepartment of Health tabled legislation in June 2008 that saidthe province will regulate midwives. Officials hope to have thesystem ready to go before this winter. New Brunswick is oneof three Canadian provinces without regulated and fundedmidwifery services. Newfoundland and Prince Edward Islandalso do not regulate midwifery.Free online access to Cochrane Reviews & Telehealth archived videos,AOM Clinical Bibliography updatedCochrane Reviews are now available toall Canadians via direct access to theCochrane Library.This nine-month pilot project, endingin December 2009, provides a nationalsubscription for Canadians to have freeaccess to the wealth of information in theCochrane Library at :www.thecochranelibrary.comUntil now, The Cochrane Library has onlybeen available to Canadians throughlibraries across the country which hadsubscriptions to the Cochrane Library.Telehealth’s video presentations maynow be viewed using a webcast recordingarchive through OTN. Previously, theywere only availble for viewing in real-timepresentations. Midwives may access thearchived recordings online at:http://webcast.otn.ca/archives.htmlA recent example is the presentationon Fetal Fibronectin. The title of thepresentation is TSM#4946530_CHEO¬_Fetal FibronectinThe AOM Clinical Bibliography has beenupdated online as of July 3, 2009. Visitthe AOM website Members / ReferenceDocuments/ Seleccted Clinical Referencespage to access a list of relevant articles.Of particular interest to midwives thismonth is the publication of the new SOGCguideline about vaginal breech birth:Kotaska A, Menticoglou S, Gagnoon R.SOGC Clinical Practice Guideline: Vaginaldelivery of breech presentation. JOGC2009;31(6):557-566.10 ontario midwife • Summer 2009

AOM Programs2009 AOM Emergency Skills Recertification Workshops:Date: September 25, 2009City: Sudbury, ONVenue: Sudbury Community MidwivesType: RecertificationDate: October 2009City: Toronto, ONVenue: TBAType: RecertificationDate: December 2009City: Ottawa, ONVenue: TBAType: RecertificationTo register for ESW courses, visit the AOM website or contactevents@aom.on.ca, 416-425-9974 x2255Announcements - more at www.aom.on.ca “Professional Development”Pregnancy and Birth - Current Clinical Issues Annual ConferenceA Conference aimed towards the obstetrician, family physician,nurse, midwife, doula or public health professional.September 11, 2009 in Toronto, ONwww.cmicr.caAssociation of Radical Midwives Annual GatheringSeptember 11-18, 2009 in Kilcronaghan, Northern Irelandwww.radmid.demon.co.uk/retreatposter1.pdfWorld Congress on Ultrasound in Obstetrics and GynecologySeptember 13-17, 2009 in Hamburg, Germanywww.isuog.orgMedicine 2.0 2009 MaRS CentreWorld Congress on Social Networking and Web 2.0Applications in Medicine, Health, Health Careand Biomedical Research.September 17-18, 2009 in Toronto, ONwww.medicine20congress.comAustralian College of Midwives National Conference“Midwives & Women: A Brilliant Blend”September 22-25, 2009 in Adelaide, Australiawww.alloccasionsgroup.com/ACM09Association of Ryerson Midwifery StudentsStudent-Faculty Conference and GatheringSeptember 25-27, 2009 in Toronto, ONContact: mepconsortium@gmail.comMEP - New Preceptor WorkshopOctober 5, 2009 in TorontoSue Watson: 416-979-5000 x7679, swatson@ryerson.caInternational Breech ConferenceCoalition for Breech BirthOctober 15 & 16, 2009 in Ottawa, ONwww.breechbirth.caAWHONN Canada 20th National ConferenceOctober 15-17, 2009 in Winnipeg, MBwww.awhonncanada.orgMEP - New Preceptor WorkshopOctober 16, 2009 in HamiltonSue Watson: 416-979-5000 x7679, swatson@ryerson.caPregnancy-related Issues in the Management of Addictions(PRIMA) Train the TrainerDepartment of Family & Community Medicine, U of TOctober 16 & 17, 2009 in Thunder Bay, ONwww.addictionpregnancy.caMidwives Alliance 2009 (Miwives Alliance of North America andCalifornia Association of Midwives)October 22-25, 2009 in Monterey, California, USAmana.orgCanadian Association of Midwives ConferenceNovember 4-6, 2009 in Winnipeg, MBwww.canadianmidwives.orgHealth Achieve OHA ConferenceNovember 16-18, 2009 in Toronto, ONwww.healthachieve.comThe AOM will have a booth again at this year’s conference.Members interested in helping to staff the booth, please contactJoanna Zuk at comms@aom.on.ca, 416-425-9974 x2261Ontario Midwife is a quarterly publication of the Association of Ontario Midwives. This publication isavailable online at www.aom.on.ca, or you may request a printed copy. All websites listed are “hotlinked”in the digital copy. Scroll over the website address and click to launch the site.Association of Ontario MidwivesAll feedback welcome. Please contact Joanna Zuk, Senior Communications Officer:comms@aom.on.ca, or by phone: 416-425-9974 x2261 or 1-866-418-3773 x2261.Association of Ontario Midwives, 365 Bloor St. East, Suite 301, Toronto, ON M4W 3L4www.aom.on.ca11

CAMACSFCanadian Association of MidwivesAssociation canadienne des sages-femmesJoin us for our9th Annual General Meeting, Conference & Exhibitin Winnipeg, ManitobaNovember 4-5-6, 2009Delta HotelWinnipeg, MBwww.canadianmidwives.org