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Midwifery Milestones

1983

• 1983 NS Midwifery Trial (Charges dismissed at preliminary hearing level in November)

1984

• 1984 (Feb 11) Founding meeting of MCNS

1991

• 1991 Ontario passes the Midwifery Act, legalizing the practice of the profession
• 1991 (June) Quebec adopts Bill 4. The law authorizing the evaluation of the practice of Midwifery through a pilot project.

1993

• 1993 (March) Task Force on Primary Health Care (Interim Report) recommends that Conservative Minister of Health (George Moody) strike a Task Force on Midwifery. Minister Moody accepts the report.
• 1993 (March) Election called. Conservative government falls and Liberal Minister of Health (Jim Smith) doesn’t follow up on Conservative initiative.

1994

• 1994 (January) Midwives begin practicing as fully recognized professionals in Ontario.
• 1994 Quebec midwifery/birth centre pilot projects begin operating at eight sites in the province.
• 1994 Alberta regulates midwifery through the Health Disciplines Act.

1995

• 1995 BC includes midwifery in the Health Professions Act.
• 1995 (December) MCNS and other groups address the Law Amendments Committee. We argue—successfully!—against the inclusion of the phrase the "management of pregnancy and parturition" in the scope of practice. Our concern is that this would make the practice of midwifery illegal, because it would become "practicing medicine without a license."

1997

• 1997 Manitoba passes the Midwifery and Consequential Amendments Act.
• 1997 (September) Nova Scotia Reproductive Care Program releases report, "The Potential for Midwifery in Nova Scotia." It recommends (among other, far less positive recommendations) that midwifery be implemented as a regulated health profession in NS and that an Implementation Committee be struck to begin process.
• 1997 (September) MCNS meet with Minister of Health Jim Smith to express dissatisfaction with the process and content of RCP report. Minister agrees to appoint an Implementation committee that will include MCNS and ANSM representatives.
• 1997 (October) MCNS releases detailed critique of the RCP report.

1998

• 1998 (January) Midwives begin practicing as fully recognized professionals in BC.
• 1998 (May) The Interdisciplinary Working Group on Midwifery Regulation begins meeting. Both the MCNS and the ANSM are represented.

1999

• 1999 (March) MCNS website up and running, leading to increasing visibility for the organization.
• 1999 (May) The Interdisciplinary Working Group on Midwifery Regulation completes its report: Midwifery in Nova Scotia. Recommends recognition of Midwifery as an autonomous self-regulated primary health care profession and its inclusion in our health system as an insured service.
• 1999 (June) Minister of Health Jim Smith accepts Working Group recommendations. Tells Department of Health to begin drafting legislation and announces plan to appoint and Implementation Task Force over the summer.
• 1999 (June) Election is called and Liberal government is defeated. New Conservative Minister of Health (Jamie Muir) fails to follow up on Liberal initiative on midwifery.
• 1999 Evaluation of Quebec Midwifery Pilot Project completed with positive results. Quebec decides to legalize the practice of Midwifery

2000

• 2000 (January/February) Correspondence with Minister of Health (Jamie Muir) indicates the government not interested in pursuing midwifery.
• 2000 (March 1) ANSM meets with Minister of Health. Get commitment that government will "keep talking" about midwifery. Receives excellent press coverage for the issue.
• 2000 (June 23) MCNS meets with Minister of Health. Very cordial discussion about overall role of Midwives in Primary Health System. Reiterates assurance that midwifery will be included when primary Health Care Working Group is named.
• 2000 (June 28) MCNS launches it’s video, "What Midwives Do." Mails copies to the Minister of Health and 100 provincial, regional and national recipients including hospitals, bureaucrats, midwifery groups, libraries and District Health Authorities.

2001

• 2001 (May) Carrie Harlow of the ANSM appointed to Advisory Committee on Primary Healthcare Renewal to represent midwifery issues.
• 2001 (June) MCNS invited to participate in a Human Resource Study of the Health Sector in Atlantic Canada that will examine the health human resource requirements and the role of education and training in the provision of needed services. Midwives are being considered as part of an evolving system.

2002

• 2002 Midwife Kerstin Martin participated on the Task Team that was appointed by the Advisory Committee on Primary Healthcare Renewal. Her contribution on midwifery was well received by the other members of the Team.

2003

• 2003 (June) The Advisory Committee on Primary Health Care Renewal released its report recommending the inclusion of midwifery in the province's primary health care. MCNS issues press release in support of report. Health Minister Jane Purves receives the report. Election called within a short time of the report's release. Conservatives return as a minority government. Minister of Health Jane Purves defeated. Angus MacDonald given Health portfolio.
• 2003 (Fall): MCNS undertakes systematic lobbing with the Minister of Health (Angus Mac Isaac) and the two health critics (Dave Wilson, Liberal Health Critic; Maureen Mac Donald, NDP Health Critic) to follow up on the recommendations of the Primary Health Care Renewal report. All parties support midwifery. Minister of Health says it’s no longer a matter of whether midwifery will be implemented, but of how and when.
• 2003 (November): MCNS initiates a letter writing campaign to raise the level of awareness about midwifery among provincial members of legislative Assembly. New by-laws are adopted by MCNS at its AGM to reflect its increasing focus as a web-based organization.
• 2003 (December): MCNS meets with David Gass, Director Primary Health Care
• 2003 (December): MCNS invited to participate in a series of meetings at the IWK to discuss potential projects and directions for implementing midwifery in the Capital District.

2004

• 2004 (March): Department of Health asks for comments on its proposed umbrella legislation for health professions. Plan is to develop legislation for newly regulated health professions initially and later see if it works for already regulated professions.
• 2004 (March): MCNS invited to send a representative to sit on the Primary Maternity Care Working Group. The purpose of the group is “to develop a regulatory framework for the inclusion of midwives in collaborative teams delivering primary maternity care in Nova Scotia.”
• 2004 (June): First meeting of the Primary Maternity Care Working Group.

2005

• 2005 (May): At the request of the Atlantic Centre of Excellence for Women's Health, the Assoc of NS Midwives and the Midwifery Coalition of NS, Premier John Hamm proclaims May 5th the International Day of the Midwife. The proclamation reads:
  "Whereas midwives have been providing care to birthing women in every corner of the globe for at least a century; whereas this is an opportunity to pay tribute to the dedicated and compassionate work of midwives, as well as the many Nova Scotians who are recipients of their care;
  Be it resolved that I, John Hamm, Premier of NS, do hereby proclaim May 5, 2005, as International day of the midwife and acknowledge their role in providing quality health care to Nova Scotians."
• 2005 (June): Primary Maternity Care Working Group submits it’s report recommending that, “Midwifery be a licensed, regulated profession in Nova Scotia” (Recommendation 1); “Midwifery legislation be drafted…” (Recommendation 8): “Midwifery be a publicly funded service…” (Recommendation 9); and “the Department of Health strike a Legislation Committee and an Implementation Committee as described in this report to facilitate the implementation of these recommendations.”
  The report begins working its way through approvals within the Department of Health.

2006

• 2006 (February): The Legislation Committee recommended by the Working Group on Primary Maternity Care begins meeting.
• 2006 (November): "An Act Respecting Midwifery," Bill 107 was given third and final reading in the House of Assembly, passing the bill. The next step is writing the regulations and striking the implementation committee.
  This bill will allow midwives to become part of primary maternity care teams in Nova Scotia once the regualtions and implementation plans are in place.

  Read the government press release upon introduction of the Bill.

2007

• 2007 (September): The Implementation Committee begins to meet.
• 2007 (November 20th): Minister d'Entremont commits to funding midwifery.
• 2007 (September 27): Initial meeting of the Midwifery Implementation Committee. We continue to raise concerns about lack of commitment to public funding.

2008

• 2008 (January): because of the large size of the Implementation Committee, it is divided into two somewhat overlapping groups—the Core Committee (which will deal with the nitty gritty on implementation planning) and the Advisory Committee (which will offer advice). The Core Committee will meet every 2 weeks or as often as necessary. The Advisory Committee will meet every month.
• 2008 (June): Final meeting of the Core Committee. Three model sites have been selected and Planning Tool Kit (to assist Model Sites in integrating midwives) developed.
• 2008 (September): Midwifery Implementation Initiative Advisory Team and Midwifery Implementation Initiative Integration Committee meet. Due to overlapping membership, it’s proposed that these be combined into a Steering Committee with smaller ad hoc committees reporting to it. In the end, the Integration Committee continues to meet often and reports to the Advisory Team every 3 months.
• 2008 (October): The position of Registrar for the Midwifery Regulatory Council (MRC), which will register midwives and develop policies that will guide their practice in Nova Scotia, is posted. The Midwifery Regulatory Council of Nova Scotia will include three midwives recommended by the Association of Nova Scotia Midwives, a registered nurse recommended by the College of Registered Nurses of Nova Scotia, a physician recommended by the College of Physicians and Surgeons of Nova Scotia and three public members, and the registrar.

2009

• 2009 (March): Final meetings of Midwifery Implementation Initiative Committees. Midwives have been hired by all three sites, MRC Registrar has been hired, Council members appointed and work beginning.
• 2009 (March 18): Midwifery Act is proclaimed and comes into effect. Midwifery is a legal, publicly funded service, available initially at three model sites—the IWK in Halifax, Guysborough Antigonish Strait District Health Authority, and South Shore District Health Authority.  The MCNS applauds, but expresses our concern about a gap in midwifery services of several weeks between the date of proclamation and the date when the MRC is able to register midwives. We are also concerned that midwifery services are no longer available to women who live outside the three model site areas and urge the Department of Health and District Health Authorities to move quickly to make services available to all women in NS.
• 2009 (April): South Shore District Health Authority announces the availability of midwifery services.
• 2009 (April): Midwifery services offered at IWK.
  IWK Community Midwives Clinic holds formal opening ceremony in June.
• 2009 (June): IWK Community Midwives Clinic holds formal opening ceremony.
• 2009 (June): Midwifery Evolution in Nova Scotia Committee (MEINS) meets for first time. MCNS continues to question the “shared care” model being used by GASHA site. MRC Registrar sits on this committee.
• 2009 (August) Third midwifery model site opens at St. Martha’s Regional Hospital in Antigonish with one midwife.  As of May 2013, two midwives are employed in the program.
• 2009 (September):  MCNS reps meet with the new NDP Minister of Health to discuss our concerns with the progress of implementation and lack of commitment to the midwifery model of care.
• 2009 (October): MEINS Committee split into two components:  Operational and evolutionary to “avoid confusion” between the day–to-day operations at the model sites and the bigger policy issues involved in the evolution of midwifery in the province.
• 2009 (October) IWK finalizes policy and homebirths with midwives are begun.
• 2009 (December)  IWK fires first midwife (Karen Robb).  (She is later exonerated by the MRC.)

2010

• 2010 (November) Second midwife fired by IWK (Rachel Godwin.)
• 2010 (November) IWK informs midwifery clients that homebirths are suspended for the foreseeable future. (As of May 2013, homebirths have not been reinstated, although the IWK that they “expect to have homebirths up and running later in 2013.”)
• 2010 (November) “Implementation of Midwifery In Nova Scotia”, the evaluation of the midwifery implementation process commissioned by the MEINS Committee (Midwifery Evolution in Nova Scotia) is completed. “Uncomfortable Positions: Consumer Comments on Midwifery Implementation in Nova Scotia” prepared by MCNS is released as an accompanying document. In response, the Department of health commissions yet another evaluation, this time with external evaluators. This evaluation is “to provide an independent assessment of the key recommendations developed by the MEINS Committee based on the midwifery implementation evaluation.”
• 2010 (December) Third midwife resigns from IWK program, leaving only one midwife.

2011

• 2011 (January) The single remaining IWK midwife goes on stress leave and the program is suspended after being in operation for only 20 months.
• 2011 (January) MCNS participates in large and noisy demonstration in support of midwifery in front of NS Legislature.
• 2011 (June) IWK program returns with one midwife. Second part-time midwife returns shortly after. As of May 2013, there are 4 midwives working at IWK.
• 2011 (July) “Midwifery in Nova Scotia: Report of the external assessment team” is submitted. Makes many specific recommendations to each site and to the Department of Health and Wellness.
• 2011 (December) Minister of Health Maureen MacDonald announces funding for three midwifery initiatives: Hiring of a Midwifery Practice Specialist; starting a second attendant program; and funding two new midwifery positions at the IWK site.

2013

• 2013 (March) Midwifery Practice Specialist, promised in December 2011, hired. (Kerstin Martin); As of May 2013, still no result on second attendants or hiring two additional midwives at IWK.
• 2013 (September) Home birth services reinstated at IWK.

2014

• 2014 (January) Two new birth centres open in Ontario: one in Ottawa and one in Toronto. Both birth centres are available only to midwifery clients. The Toronto Birth Centre is leading the charge for a new kind of maternity care, one the recently dissolved Liberal government endorsed as part of its wider effort to shift as many health services as possible out of expensive hospitals.
• 2014 (February) On Feb. 3 at 10:05 p.m., Jacky Tuinstra Harrison became the first woman to have a baby at the Toronto Birth Centre.
• 2014 (May) Leo Glavine, Liberal Minister of Health, proclaims May 5 International Day of the Midwife and acknowledges their role in providing quality health and maternity care to Nova Scotians.

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