October 5, 2005 will mark the first NHL game played in over a year for either Alberta NHL franchise. The end of the NHL lockout has definitely perked up old Henry. Martha has noticed a certain spring in his step of late.

If you, or someone you love, are an NHL fan then you are likely anticipating October 5 with all the joy of an expectant mother. It seems the NHL lockout has had that same effect on an inordinate number of people. In fact, Prince George, B.C. hospital staff noticed a sudden surge in births about nine months after the lockout began. Normally, about 60 to 80 babies are born each month in the city but in the last few months that number has jumped to over 100 per month. The B.C. Statisticians wondered if it was all just a coincidence.

Maybe the sudden baby boom is coincidentally nine months after the lockout but it did get Martha wondering if the doulas, doctors, hospitals, birth centres and midwives were ready for the coincidental increase in demand for their assistance.

Now, Martha is no Spring chicken so looking for a qualified birth attendant has not been high on her list of to-do’s lately. So it took a little digging before Martha realized what a miserable job Alberta is doing of integrating midwifery care into the overall health care system.

Despite the fact that Alberta passed legislation to recognize midwives (and thus regulate and license them) in 1994, there has been little movement on the issue of funding midwives. In 1997, the Alberta government funded an evaluation project on the integration of midwifery services but that report has never been made public.

In May of this year Liberal MLA Laurie Blakeman asked the Health Minister Iris Evans when midwifery care would be provided under health care coverage, considering a home birth saves the system money. Here is their exchange:

    Ms Blakeman: Given that midwife-attended home births cost the system $2,800 compared to a $4,100 price tag for a hospital delivery, when will the government instigate reforms for a sustainable health care system and include midwifery services under health care coverage?

    Ms Evans: Well, Mr. Speaker, certainly it’s an important distinction the Hon. Member has made, but quality health care isn’t all about examining the bottom line. Quality health care is about engaging in those practices that deliver the health care, as it should be, to people who are in need of it. The Hon. Member has pointed out the cost-effectiveness of midwives. We’ve had some conversation between the other partners âe” the physicians, family practitioners, and others âe” and I know that midwives anxiously await the results of that. When we’re ready, we will provide further information to the House. (source — emphasis added).

Martha read that answer over and over and never did figure out what the Health Minister was talking about. Midwifery care isn’t for everyone, granted. I mean men and non-pregnant women really don’t need a midwife. Many expectant women prefer a family doctor or an obstetrician to a midwife. (These women are well served, as long as their doctor is willing to attend births and a dwindling number of family physicians are.)

But about 20 per cent of expectant mothers want a midwife. And in Alberta, if women want a midwife, then they need to shell out about $3000 to get one. As a result, Alberta midwives have gone from 150 strong to 19 in just ten years. (Alberta Midwives Association). Most midwives moved to Ontario, Quebec, B.C. or Manitoba where midwifery care is fully funded through their health care system. In fact, Alberta promised such funding in 1991. (If you were pregnant when that was first promised your little bundle of joy is entering the ninth grade and considering a new body piercing.)

More recently, Alberta asked University of Alberta nursing professor Bev O’Brien to determine whether midwives can safely and affordably deliver babies when there are no complications with the pregnancy. “From our study, it was clear the outcomes were as good, or better,” O’Brien said. “Economically, it makes sense, because through the course of care, births were less expensive.” (CBC report)

Alberta’s Health Minister says it isn’t all about examining the bottom line when it comes to health care but that is not what her boss says. In fact, Premier Klein has called his examination of the bottom line The Third Way. Albertans are told over and over that it is about the costs. So it mystifies Martha that the Alberta government has not grabbed onto midwifery care with all the passion of a Flames fan on the Red Mile. I mean if midwifery care is something that saves the system money then why not fully fund it and see who would prefer it?

About 40,000 babies are born in Alberta each year. (That was before the lockout and all those nights with no hockey). If just five per cent of them (or 2000 babies) were caught by a publicly funded midwife it would save the Alberta government over $2,000,000. Now is it just me or does that make sense: offer a real choice to expectant mothers and save money?

Now let’s forget birth and get back to hockey! (I wonder if the CBC lockout will cause the same sort of “coincidental” increase in the birthrate as the hockey lockout?)

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