When Sarah Piercy talks about her experiences using a midwife to deliver her children, she calls the experience “life-changing.”
The Oro-Medonte mom’s desire to use the same midwife to deliver her third child was thwarted when she was told Barrie Midwives wouldn’t be able to accept her as a patient this time around earlier this year.
Six midwives, who had been working for years at Barrie Midwives, were informed back in December 2019 that their contracts would not be renewed past July, after expressing an interest in starting their own practice.
Further, the six midwives say they were informed last week by the Barrie Community Health Centre that their request to the Ministry of Health to open their own practice in Barrie had been denied.
Since then, the group has started advocating for change at the provincial level for how midwives are dealt with by the province as health-care providers.
“I was heartbroken. When somebody walks you through such a vulnerable season of life, it’s natural to want to turn to them when you’re going through it again,” said Piercy. “You end up becoming close with the people who deliver your babies, because they see it all.”
“This is a huge loss. I don’t really understand the whole situation. I literally trust them with my life and my babies' lives,” said Piercy.
Andy Mills is one of the six midwives who saw her contract end in May, and has since been working with the group to start their own practice in Barrie. She had worked as a midwife with Barrie Midwives for nine years and delivered Piercy’s first two children.
“She really helped us and walked us through everything. With our second, we asked for Andy again because she was so wonderful with our first. Her care was life-changing in a lot of ways,” said Piercy. “With pregnancy, it’s the most vulnerable I’ve ever felt.
“There are six midwives who were with Barrie Midwives and I had half of them. They were absolutely incredible. I rave about them to everybody,” said Piercy.
Piercy said she put in her request for care for her third child through Barrie Midwives in December 2019, about 10 weeks after she found out she was pregnant.
“They called me back and said they couldn’t accept me as a patient, and that was it. They didn’t offer to put me on a wait list or anything,” said Piercy.
Piercy said she then applied to the Orillia Midwives and was accepted, delivering her baby at home in July. While she said she also received excellent care through that practice, she would have preferred to use the services of the midwives she already knew if given the choice.
The business of midwifery is client-based and relies mostly on word-of-mouth referrals over advertising.
Mills said she and her fellow midwives have received multiple requests for care since May, all of which she’s had to turn down.
“We’ve heard from women that they’ve applied but can’t get in,” said Mills.
On the group’s Facebook page, Advocates For Pregnancy Care Choice in Barrie-Innisfil, multiple women have shared stories about long wait lists locally for a midwife, and stories of specifically wanting one of the midwives who started the group to be the one to provide their care.
“Pregnancy and birth is a very unique scenario where there’s potential for fear and anxiety. There’s great research into the value of continuity of care; having somebody who knows you to care for you,” said Mills. “We want to go back to work. We love what we do. It’s frustrating to sit here and have previous clients send me messages saying ‘I’m pregnant. Can you be my midwife?’ and I have to say no.”
Prior to the six contracts not being renewed, Mills suspects there wasn’t likely an unfulfilled need in the community but now, the situation has changed.
“We were all working full-time in terms of caseloads. We were just taken out of the equation,” she said. “We now know of women in Barrie who are with the Newmarket Midwives because they wanted care but could not get it in Barrie.”
While Mills said she would be willing to go back to Barrie Midwives should a new contract be offered, that hasn’t yet happened.
“If I were a physician, I could set up a shop, put up my shingle, accept patients and bill the system. Midwifery is much more controlled. It’s an old system that is more than 25 years old,” said Mills.
“A midwifery practice has to be approved and that approval is based on demand in the area. Once that practice is approved, it has a contract to provide care. Then, it contracts with midwives to provide that care.”
Midwives contracted to a practice are called associates.
“Associates do not have a legal right to the work we do beyond that contract. I don’t own my work or my clients,” said Mills.
Ami Nunn, midwife and partner at Barrie Midwives, told BarrieToday this week that the community needs for midwives are being met, and takes issue with some of the messaging in the Facebook post by Advocates For Pregnancy Care Choice in Barrie-Innisfil.
“The post makes it sound like the community needs will not be met because they didn’t get approved. That isn’t the case,” said Nunn.
Nunn said that for a period of time since May, Barrie Midwives was unable to grow while their application was being considered by the Ministry of Health.
“The ministry wasn’t going to fund the growth of our practice if there might be two (practices). We were in a limbo waiting to see,” she said. “We have a high demand for midwifery care in this community, but we’ve always been able to meet that. We’ve had hit-or-miss months here or there.”
In July and August, Nunn said the centre has seen home births double over the previous year’s numbers. Nunn attributes the increase in interest to pandemic rules in hospitals.
“Some people want to have a doula present, or a birth photographer. At the hospital, you can only have one support person,” said Nunn.
Overall, Mills said she feels passionately that a change in the system is required.
“Ideally, I would be an independent health-care provider. There are advantages to being in a group, but I should own my work. If I’m a hairdresser and I rent a chair in a salon, if I leave that salon, most of the time, clients follow you. The allegiance is to their care provider,” said Mills.
“I understand there isn’t unlimited choice in a publicly funded health-care system. This isn’t a free market. But if we’re going to provide choice, and we do, why is it structured such that choice is restricted in this manner?” she said.
“I’m passionate about changing the system. There’s inequity here,” she added.
A request for comment to Barrie Community Health Centre for this story was not returned by publication time.