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Alberta's midwives have reached a deal with the government on how they will be paid for their work under the public health-care system, now that parents no longer have to pay out of pocket. (April 2, 2009)
Average annual paycheque is $166,000, but practitioners pay for overhead expenses THE EDMONTON JOURNAL APRIL 2, 2009 "It's very good," said Jane Baker, president of the Alberta Association of Midwives. "We're being appreciated for the professionals that we are, by the region."
Under the agreement, midwives will be paid $4,150 for each pregnancy, up from the $3,500 they received from individual families before the service became part of the publicly funded health system.
If a midwife works full time and cares for 40 women, she'll make $166,000, but will take home about $66,400 after spending about 40 per cent on overhead costs such as birth supplies, clinical equipment to monitor the babies, office rent, insurance and provincial registration costs. "It will be competitive for midwives in Alberta in terms of bringing new midwives to the province," said Baker, who also hopes the three-year agreement will coax retired midwives to return to work.
Women who were receiving care before April 1 and are still getting help from a midwife will receive a portion of the fee back, based on a formula.
"It's fantastic. It's wonderful. We're really happy," Baker said.
"This means a lot to us, as a profession and for Alberta women. We've been looking for this for a while. It needed a political will in order to get this done and we have that now." In Ontario, where midwives have been covered under the provincial system since 1994, a full-time midwife's annual salary ranges from $74,000 to $96,000, based on experience. That involves serving as the primary midwife in 40 births and as a secondary midwife in another 40 births, the Association of Ontario Midwives says.
Since becoming publicly funded, Ontario has seen the number of midwives jump to 450 from the 60 it had in 1994, bolstered by three schools offering midwifery training programs.
Baker hopes Alberta's new system will also boost and strengthen midwife numbers here. There are 33 registered midwives in Alberta. About six or seven work in northern Alberta, including Edmonton and Red Deer, with most centred in Calgary. Baker said Edmonton and Calgary need another 40 midwives each if they are to offer their services to about 10 per cent of moms whose pregnancies are considered low-risk. In Calgary, midwives are delivering about three per cent of babies right now, Baker said.
There are no local training schools, although Mount Royal College in Calgary is working on a proposal for a four-year midwifery degree it hopes to get off the ground in 2010.
Even then, it will take time to boost midwife services, Baker said, since graduating midwives must work under experienced midwives before they can be certified. With only 33 experienced midwives now, finding placements will be difficult.
Parents will have to be patient, Baker said. Alberta Health and Wellness has committed $4 million to fund the midwifery program in its first year, with another $700,000 coming from Alberta Health Services to cover $23,600 for professional liability for each midwife the first year, said Don Stewart, spokesman for Alberta Health Services. Midwives will also have to pay $1,000 to cover part of that liability, which totals $235,000.
A working group of midwives, family doctors and obstetricians will also be set up to integrate midwifery services into maternity care. They will look at how to get midwives working in centres other than Edmonton and Calgary, and how to integrate midwives in primary-care networks, where pharmacists, doctors, dieticians and other health-care providers care for patients as a team.
"We're hopeful that, over time, midwives will become more available to women across the province," Stewart said.
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