M. Haworth-Brockman
Preface
The development and implementation of regulated midwifery in Manitoba
was an enormous undertaking. Its history begins in the early 1980s and
even before that, when women first began to reclaim their births and
found other women who could help them do so. My own involvement began
in the mid-80's, first as a mother seeking a midwife's care, and then
as Chair of the Equity and Access Committee of the Midwifery Implementation
Council. I worked in that capacity for over 5 years, as well as on other
committees, until the College of Midwives of Manitoba opened for "business",
when I became the first Registrar.
It is not possible to cover all aspects of the many pieces that contributed
to the eventual Proclamation of the Midwifery Act in 2000 in anything
less than a book. Besides the involvement of the Midwifery Implementation
Council, there was a concentrated effort within Manitoba Health to see
the work to completion. There was also good political will across the
board - the Bill sailed through all readings, with all parties signing
on without debate!
This paper gives only a mere overview, developed in keeping with the
theme of the Working Symposium, Midwifery: Building Our Contribution
to Maternity Care (Vancouver, 2002). I wish to thank my colleague, Yvonne
Peters, who contributed a great deal to this paper, which we delivered
in an alternative way in Saskatoon in 2001.
Margaret J. Haworth-Brockman
Executive Director
Prairie Women's Health Centre of Excellence
Introduction
In 1994 the Minister of Health for Manitoba announced the formation
of the Midwifery Implementation Council. The Council consisted of 13
hand-picked women who were given 2 and a half years to put into effect
the recommendations from a Working Group Report which was released on
the same day. Six years later, in June 2000, the Manitoba Government
proclaimed the Midwifery and Consequential Amendments Act which
identified midwives as autonomous health care providers. Coincidentally
the Manitoba Government confirmed the mechanisms to make midwifery care
available as a funded service for women, including the means for payment
to midwives and for collaboration with other health care providers.
The presentation will examine some of the steps taken, and the successes
and challenges of making midwifery care available to women, particularly
for those who live outside of Winnipeg. The presentation will include
a brief outline of the policies in place, and the struggles to implement
those policies in rural and remote Manitoba because of challenges in
human resources (recruitment and retention), local acceptance, providing
culturally appropriate care and so on. Finally the presentation will
identify the need for further research and evaluation of the true availability
and accessibility of midwifery as a primary health care service in rural
and remote Manitoba, including women's satisfaction with the newly-regulated
profession.
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