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Integrating Indigenous midwives into a comprehensive primary care setting.

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Canadian midwives are expanding their services in primary care, offering sexual health and perinatal support. A pilot project in British Columbia highlights benefits and challenges, especially for Indigenous midwives serving youth.

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Area of Science:

  • Public Health
  • Healthcare Policy
  • Indigenous Health

Background:

  • Midwifery practice in Canada has historically faced significant restrictions, limiting access to sexual health and perinatal care.
  • While Prince Edward Island lifted prohibitions in 2024, most Canadian jurisdictions still restrict the full scope of midwifery practice.
  • The Canadian Midwifery Regulators Council advocates for the expansion of midwives' scope of practice.

Purpose of the Study:

  • To evaluate the integration of full-scope midwifery into a primary healthcare clinic in Victoria, British Columbia.
  • To identify the benefits and persistent challenges of integrating midwifery services within a primary care setting.
  • To highlight the unique contributions of Indigenous registered midwives to primary care and youth health outcomes.

Main Methods:

  • Implementation of a midwifery pilot project in Victoria, BC, from 2023-2024, allowing full scope of practice.
  • Focus on interprofessional collaboration and cooperation within the primary healthcare team.
  • Analysis of the specialized cultural and clinical skillsets of Indigenous registered midwives.

Main Results:

  • Demonstrated benefits of integrating midwifery into primary healthcare settings.
  • Identified ongoing challenges in securing long-term, salaried employment for midwives and their teams.
  • Showcased the positive impact of Indigenous midwives' expertise on primary care for youth clients.

Conclusions:

  • Integrating full-scope midwifery into primary care offers significant advantages for patient care, particularly for youth.
  • Addressing systemic barriers to salaried employment is crucial for the sustainability of midwifery services.
  • The specialized skills of Indigenous registered midwives are vital for improving health outcomes in diverse populations.