About eight per cent of women within Alberta obtain the care of a midwife, and there are about 140 practicing midwives within the province, according to the Alberta Association of Midwives. Access to them is uneven.
“There’s an unmet demand for midwifery services in every area of the province,” says Chelsea Miklos, president of the Alberta Association of Midwives.
Most Alberta midwives practice in urban areas. See the map of midwifery practices here.
A midwife is a regulated health professional who provides the complete course of care to women and their babies during pregnancies that are considered low risk. This includes the labour, birth, and post-partum period. Patients may choose to deliver at home or in hospitals or birth centres.
Each midwife in Alberta is publicly funded through Alberta Health Services (AHS) meaning the service is free to women. However, there is a billing cap on each individual midwife which puts a limit on how much care each one can provide every year.
“For full time midwives, that’s generally considered about caring for 40 clients a year, which would be attending 40 primary births,” Miklos says. “Then there’s always two midwives that are attending roughly 40 secondary births.” This can mean waitlists.
Jaye-Lynn Stebner, who lives on an acreage in Parkland County, Alta., was fortunate when a local midwifery practice had room for clients when she applied.
For her first midwife in 2004 she applied through a program called Shared Care out of the WestView Health Centre, where you had to give birth in the hospital but were allowed a waterbirth.
For her second midwife in 2009 Stebner went through a program called Beginning Midwifery Care, where she was able to deliver her baby at home and paid for her care out of pocket until it became provincially funded later in the year.
One of Stebner’s favourite parts of receiving midwifery care was being able to deliver in the comfort of her own home, while also not needing to leave the house to receive her postpartum care.
Since Stebner has rhesus negative (rh-) blood and two of her children have rhesus positive (rh+) blood, she needed a RhoGAM shot to ensure that if her body developed antibodies from their blood, her body would not “attack” any subsequent pregnancies.
“I got to stay home and receive those shots in the comfort of my home after giving birth, I didn’t have to travel anywhere,” Stebner says. “They came to my house and did the first check with the baby within 24 hours, and second and third checks, but I literally just got to stay home and be in the comfort of my own house the whole time.”
When asked about her experience with using a midwife, Stebner gave insight into what could be expected during your pregnancy.
“They really take the time to make sure you are well informed to make choices. It was just the appointments were longer, it was less pressured. I felt like I had a relationship with them,” Stebner says. “A very mutually respectful relationship with them, as opposed to an appointment where a nurse takes my weight and doctor sat with me for minutes and then I was gone until the next one. I felt like I was just very well informed the whole time.”
Shauna Fankhauser was made aware of midwifery and water births when she became pregnant with her third child, learning more about the programs available and applying directly through the Low-Risk Maternity Clinic at the High River Hospital.
“They were just really compassionate and were really knowledgeable and informed about the risks and benefits,” Fankhauser says. “The water births were great.”
Fankhauser recommends using a midwife to others, depending on what they’re looking for when it comes to labour and delivery.
“I was looking for a natural birth, if that was possible, which was what led me down that path. I certainly had a great experience and appreciated the care they gave. I think it does depend on what you’re looking for,” Fankhauser says. “If you’re looking for a birth with pain control and things like medical pain control and stuff, then it’s maybe not as necessary.”
Rocky Mountain House midwife Nicole Matheson, R.N., says midwifery is not a job, “It’s a calling”.
“Rural midwifery is really wonderful because it allows us to live in our rural communities and work with the clientele who are rural people, a lot of them are farmers or live rurally. It also tests your skills quite a bit,” says Matheson. “We also do something called shared care a bit. There might be a client who needs to see an obstetrician for a part of their care–whether it be a complication or a risk factor–and we need to have some input. Sometimes what we can do is work with this specialist and share some of the care, so the client doesn’t have to travel into the city.”
However, most midwives practice in urban areas.
Camille Taliani used the same midwives to deliver her second and third children in Edmonton, having home births in October 2018 and January 2022.
Taliani’s labour and delivery for her first child, delivered at the South Campus Hospital in Calgary, was just under three hours leading to her decision to apply for a midwife and plan a home delivery in fear that she would not be able to make it to the hospital with her future children.
“Your next kids usually come quicker and so I was really scared to not make it to the hospital,” Taliani says. “I wanted to have the comfort of having a home birth because I did not want to have a road-side baby.”
Taliani’s second baby was born 30 minutes after she had the first signs of labour, and her third child was born only 15 minutes after the first signs of labour.
During her pregnancy, Taliani saw her midwife once a month when she hit 12 weeks, every two weeks when she hit her third trimester (27 weeks), and once every week when she hit 36 weeks. After delivery, her midwife came to her house to do follow-up appointments for herself as well as her baby.
“Anytime I needed to call or email they were there for that kind of support as well,” Taliani says.
Meg Martin sought midwife care by applying through the Alberta Association of Midwives to be paired with a midwife during her pregnancy. She knew that she did not want to deliver her baby at a hospital and would rather give birth at a birthing centre or at home, which helped drive her decision to apply for a midwife. Martin waited around one month before getting the news that she would be under midwife care.
Martin felt stressed during the wait time after applying, as she knew that having a midwife was something that she wanted and did not want to settle for an obstetrician (OB).
An OB is a physician or surgeon that focuses their study on pregnancy, childbirth, and the postpartum period.
“I was definitely very nervous and very stressed. It was difficult. I mean, being pregnant during COVID and I was pregnant before people were eligible for vaccines,” Martin says. “So having to wait to be able to see a medical practitioner for the pregnancy. And to consider having to go to an OB, when that’s really what I didn’t want to do was quite stressful.”
Isabelle Morin wrote about Calgary practices and client ratings “5 Health Centres with the Best Midwife in Calgary”.
With the steady expansion of midwifery within the province and approximately 10 new midwifery graduates from Calgary’s Mount Royal University every year, the Alberta Association of Midwives hopes for more funding and that midwives stay within the province to work.
Midwife Nicole Matheson advises: “For families who are interested in midwifery care, but don’t have a midwife in their community: write to the government, sign up on the waitlist, talk to AHS, talk to people in your community that have connections, the Rural Health Professions Program.
I think it’s going to be the voices of communities that actually help bring midwives to those communities.”