ON Chiropractic
to hospitals. In the 1990s, the Ministry
of Health altered regulations to provide
access to hospitals for midwives in advance
of legislative authorization through
amendments to the Public Hospitals Act.
Although those changes were eventually
made, even today midwives struggle to get
sufficient access to hospitals to treat the
number of Ontario women who request
midwifery care.
Data collection was a primary means
of making their case. As part of their
funding mechanisms, midwives were
required to submit a data collection form
in order to get paid for their services. The
result was a database of independently
analyzed results that clearly demonstrated
that patient outcomes and satisfaction levels
supported an expanded role for midwives.
This data is still collected as part of the Birth
Outcomes Research Network (BORN)
Registry. The registry allows for analysis
comparing midwife births inside and outside
of hospitals to physician births. This data
has been essential, too, in making the case
for Ontario’s forthcoming birth centres.
I
n addition to evidence and a strong
and consistent professional identity,
cost effectiveness was a core element in
the advocacy that led to the announcement
of two new midwifery-led birth centres
last year. “It’s expensive having births in
the hospital and childbirth is the number
one reason why women in Ontario are
hospitalized,” Weston reports. In accordance
with this evidence, the Association of
Ontario Midwives led the effort to secure
funding for the birth centres.
The campaign was fortunate to
coincide with an era in which the Ministry
of Health and Long-term Care is seeking
ways to provide higher quality care at lower
costs to taxpayers. A variety of economic
data points supported the case for birth
centres. The AOM demonstrated the
potential savings in a variety of ways.
First was the hig