Putting mom in charge
By Jennifer McFee

Reprinted from - Burnaby NewsLeader - May 2, 2008 edition

With photos of h er other recent births proudly posted on the wall of her Sapperton clinic, midwife Tracy Simpson visits with Zadin Bergmeier. MARIO BARTEL/NEWSLEADER

Midwives provide an opportunity for expectant mothers to play a greater role in the decision-making process

When she was seven centimetres dilated, Kirsti Bergmeier knew it was time to lower herself into the inflated pool set up on the living room floor of her New Westminster home.

With a garden hose hooked up to the kitchen sink, the pool took two full tanks of hot water to fill. Meanwhile, Bergmeier’s husband ran back and forth to top up the tub with water he boiled on the stove.

When she sank down in the warm water, Bergmeier began to relax as her labour pains subsided.

But midwife Tracy Simpson wouldn’t let the labouring woman rest for long. After a brief break, she coached the first-time mom to get out of the tub because her relaxation was slowing the process too much.

Reluctantly, Bergmeier stepped out of the water and paced around her home, climbing up and down the stairs. When she needed a rest, she sat back in the tub and reclined until the water reached her armpits.

When Simpson discovered the baby was stuck in a posterior position, she guided the labouring woman over to a secondary birthing area on the couch, which was already prepared with pillows and blankets.

Under their midwife’s direction, Bergmeier’s husband propped up his wife to use gravity’s pull in the delivery.

After a seven-hour active labour, baby Zadin was born March 28.

Always on call

Using a midwife doesn’t always mean giving birth in your living room, of course. Based out of a New Westminster clinic, Simpson acts as midwife to 40 women per year for births in both homes and hospitals. She is on call 24 hours a day, seven days a week.

Like doctors, midwives monitor pregnancies, deliver babies and provide medical care. The difference, Simpson said, is the education, emotional support and continuity of care offered.

“Women are in the driver’s seat. It’s a shared decision-making process throughout the pregnancy and during the birth. The woman, with her midwife, makes the best choice, so the woman feels like she’s in control and not like things are being done to her. It’s not just about the end result but about the process,” said Simpson, whose clients are primarily based out of Burnaby, New Westminster and the Tri-Cities.

She speaks from experience, having used a midwife when she had all four of her own children. The process was so positive it prompted her to change careers from arts management to baby birthing, which she studied through a midwifery program in Seattle. Like the other 101 practising midwives in British Columbia, her services are fully funded by the province’s Ministry of Health and covered by Medical Services Plan.

The midwives’ return

While the practice is experiencing a resurgence in popularity, with 6.6 per cent of B.C. babies delivered by midwives each year, the profession has had a tumultuous history in Canada.

In 1691, the government in what is now Quebec recognized midwifery as a branch of medicine, putting midwives on par with physicians and surgeons. Showing similar support, the British government paid the wages of midwives who immigrated from England to Nova Scotia in the mid-18th century.

Yet when the Medical Council of Canada formed in 1912, midwifery all but disappeared. Midwives could even be charged for practising medicine without a licence.

Only in the past decade has the practice returned to the forefront, with B.C. midwives registered for the first time on Jan. 1, 1998.

Now midwives use an informed-choice model to provide personalized options for every birth. Since the Canadian standard of care requires two qualified birth attendants, mothers can opt for two midwives at home births or may work with a midwife plus a nurse in a hospital.

“Women feel cared for. That’s been shown to improve outcomes and satisfaction,” said Simpson, adding that a midwifery program is offered at UBC.

“When you watch a normal birth, the majority of babies will just come out on their own. As midwives, our job is just to maintain the normalcy of the birth. We’re there to keep them safe and be the lifeguards. Besides that, the process unfolds on its own, especially if you leave it alone.”

But when a mother or baby needs help, midwives are trained to be there. Angie Oshika experienced this personal touch when Simpson delivered her first child, Aili, in a hospital birth five months ago.

The birth went well and everything was fine until Oshika noticed something strange.

“I think something’s wrong,” she told Simpson, who was tending to the newborn baby girl. “My blood pressure’s really low.”

When she heard the reading, Simpson immediately went to get help for the new mother, who had begun to hemorrhage.

Two weeks later while Oshika was at home feeding her baby, she hemorrhaged again and had to be rushed back to the hospital.

As soon as Simpson heard the news, she dropped everything and headed to the hospital where she sat by Oshika’s bedside all night.

“That was certainly above and beyond,” said the new mother. “I got more care than I expected to.”

Like Oshika, nine-months-pregnant Tiffany Paul has noticed a high level of personalized care since she opted to use a midwife for the birth of her second child.

She used a doctor for the birth of her first born in Yellowknife two and a half years ago. The doctor decided to induce her labour, and eventually performed a caesarian section on Paul, who believes she experienced unnecessary medical interventions.

“I wasn’t happy with how things went. You’re always rushed through like any doctor’s visit. You don’t talk about anything but the most pertinent medical things. With the midwife, you talk about how you want things to go,” said Paul, now a New West resident.

“I guess the way it went has bothered me more than I thought it would. I’d prefer to go as natural as possible. I think doctors aren’t necessarily looking at it the same way. I just think it’s a different attitude.”

This alternative attitude has benefited Bergmeier and her family. Five-week-old Zadin has not yet seen a hospital or doctor’s office because Simpson examines newborns in their homes for the first six weeks of their lives.

“I was amazed at how quickly I recuperated. He was nursing right away and really alert. I know I’m really lucky,” said the new mom as she rocked her baby against her shoulder.

To recognize International Midwives Day and the 10th anniversary of registered midwives practising in B.C., Simpson is hosting an open house Monday, May 5 from 6 to 8 p.m. at her clinic, Mama Love Midwifery at 434 East Columbia St.

jmcfee@burnabynewsleader.com



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