Ontario Midwives see similarities between Government’s Vision for Health Care and Current Midwifery Care Model

On February 26, 2019, the provincial government announced new legislation that will transform Ontario’s health care system by developing a network of Ontario Health Teams overseen by Ontario Health.

The Association of Ontario Midwives (AOM) supports any initiative that puts patients’ needs first and prioritizes a well-connected, sustainable, and accessible public health care system. Midwives applaud the government’s move to “relentlessly focus on the patient experience” as midwives have been doing for the past 25 years.

“Midwifery can serve as a model for success for health system transformation,” says Elizabeth Brandeis, RM, AOM President. “Midwives have 25 years of experience providing care that keeps clients out of emergency rooms by being on-call 24/7, making home visits for clinical assessments, and offering out-of-hospital options for care. We excel in ensuring seamless transitions between home, community and hospital, while providing a top quality client experience. This model could be particularly helpful in seniors care, mental health care, cancer and palliative care where continuity of provider, informed choice about one’s health care, and a choice of place to receive care can reduce hallway medicine and deliver excellent clinical outcomes.”

As the only province-wide health care professionals who provide continuity across both the hospital and community sector on a 24/7 basis, midwives are uniquely qualified to assist and advise the government and Ontario Health Teams with developing this new system of care.

Midwives urge government to prioritize a strong focus on maternal/perinatal and newborn care in order for a true system transformation to occur: childbirth is the number one reason for admission to hospital in Ontario, with cesarean delivery the number one surgical procedure. The midwifery model of care has provided excellent clinical outcomes, efficient use of hospital resources by decreasing lengths of stay and unnecessary medical interventions, and provided exceptionally high rates of client satisfaction.

“We see parallels to the government’s vision for Ontario Health Teams with how midwives use the principles of continuity of care across place of care, informed choice and client choice of birth place” says Brandeis.

To deliver on this new vision of health care, the government must ensure that all health professionals are able to work in their fullest scope of practice. Current limitations on scope of practice are barriers to this transformation, including existing delays in approving new regulations regarding lab and drug prescribing. Improving access to lab and drug prescribing eliminates the duplication of services and ends unnecessary extra visits for Ontarians.   

“The Ministry must ensure that new Ontario Health Teams will only be approved if they ensure health providers will be optimized in the system and will not restrict their scope of practice, forcing medically unnecessary transfers of care that undermine this government’s vision of a ‘relentless focus on the patient experience,” says AOM President Brandeis.

Brandeis says another key success factor in this transformation is the government’s leadership in appropriate health human resource planning. “This transformation will be best supported by investment in the health care providers who have the experience and commitment to providing this kind of care to Ontario’s families”, says Brandeis. “For example, Ontario’s Registered and Indigenous/Aboriginal Midwives effectively reduce lengths of hospital stays, costly interventions, and free up beds and hospital resources for those who need it most. Ontario Health Teams will need access to a different mix of health care providers than are currently in the province if this vision is to work. A diverse and community-responsive health care workforce is required to meet the unique needs of families and communities.”

Evidence is clear that the health of communities begins with a fully integrated, culturally safe model with families at the centre. We urge government to ensure that health care transformation fully take in to account and work in collaboration with leaders currently addressing Indigenous health.

The AOM looks forward to the government’s actions to increase secure access to more digital health services, including an integrated patient record system for Ontario.  Patient centred digital records are an essential step towards facilitating collaboration and seamless care. Equitable access to this technology across all sectors is paramount to providing a safe and positive patient experience in a system that is truly integrated.

Midwives support the government’s desire to have a healthy workforce to support this major system transformation. To keep this commitment, the AOM expects government to recognize and eliminate gender discrimination, including closing the pay equity gap in health care.

The AOM supports Minister Elliott when she clearly stated “There will be no more for-profit care in the system that we are envisioning.” AOM President Brandeis says, “Midwives will not support further privatization of Ontario’s health care system. Extensive research on privatization of health care demonstrates that this benefits those who will reap the profits from their private enterprise, but does not benefit patients or the health care system as a whole.”

About Midwifery in Ontario

Midwives are registered health-care professionals who provide primary care throughout pregnancy, labour and birth, as well as for the first six weeks following birth. There are more than 900 registered and Indigenous/Aboriginal midwives in Ontario, providing care in over 90 communities across the province. Midwives provide care in hospitals, clients’ homes, community clinics and birth centres in Ontario.

The Association of Ontario Midwives is the professional organization representing midwives and the profession of midwifery in Ontario.

For further comment or to arrange an interview with President Elizabeth Brandeis RM, please contact Christine Allen, Manager, Policy and Communications at christine.allen@aom.on.ca, or by calling (416) 425-9974 ext 2227 or on mobile (416) 560-9499.