Clients outside Whitehorse excluded from midwifery rollout, critics say

The Yukon Government is rolling out its midwifery program for people who are below 20 weeks of pregnancy and live in Whitehorse, but critics say the program came too late and that it excludes people in other communities.

Driving to Whitehorse from another community to access midwifery is not even an option in the current program, said Dawson City resident Catherine Lalonde.

"The biggest issue is that, for reasons that are beyond my comprehension, this is only available to Whitehorse residents. So every single family in any community outside of Whitehorse will not be able to have a birth with a midwife."

Lalonde has had a midwife for both her pregnancies and said at least six people in her community are pregnant now and would like to access a midwife.

Travelling for 'home' births

For her first delivery in 2016, Lalonde travelled to B.C. in order to give birth at her sister's home. The Yukon Government paid the associated costs of having a midwife down south.

She had a midwife again in 2020, paying $2,500 for the midwife to be with her during delivery in Whitehorse.

"It was totally worth it. I would do it again in a heartbeat," she said.

In mid-April last year, the Yukon Government introduced midwifery regulations and Lalonde's midwife, who had advocated for regulation to make midwifery more accessible, was no longer able to practice.

"To be honest, I'm extremely disappointed with how the Yukon government has rolled out midwifery in the territory," Lalonde said.

"They had said that it would be a few months between regulation and implementation ... During that time birthing families in the Yukon had no access to midwifery whatsoever."

Four years behind

Yukon Party health critic Brad Cathers said the Yukon Government is four years behind their commitment to bring midwifery to the territory and that it was a mistake to regulate the profession without a structure to support ongoing private practice.

Cathers said the Yukon Government made its midwifery announcement over a year ago with "entirely political timing" for the call of an early election. 

Before the regulations, midwifery was available for people who could afford to pay out of pocket.

He said midwives should be compensated similar to how doctors are, using negotiated agreements with the Yukon government. 

'Empathize with that rage'

Sophia Ashley, co-chair for the Yukon Association for Birth Choices, said while the launch is "not perfect" and there have been gaps since the legislation came into place, the association is eager to see the new midwifery program succeed. 

She said the period where people could not use a midwife was "terrible" because only people with time and resources could access higher levels of care. She's understands why the current situation is equally upsetting. 

"I think a lot of people are really upset about it. We empathize with that rage," she said. 

In an email, a Yukon Government spokesperson wrote that the midwifery program would continue recruiting midwives to expand their services to other Yukon communities. Claire Robson wrote that midwives would join the team this fall and allow Yukoners outside Whitehorse to access the program. 

Meanwhile, Ashley said they'll continue to advocate for greater services.

"The limit on the number of weeks that a person is pregnant is really largely due to not wanting to overwhelm the system from day one and make sure that they can iron out the kinks," she said.

Ashley said the midwives will be able to troubleshoot before going "full spectrum" with the program and that her group would continue working with the Yukon Government to get midwifery services to residents in the communities.

Ashley had a midwife for her first birth, but not her second.

"I got caught in the in-between period," she said.

That meant she couldn't see a midwife, have a support person who was not a doctor order tests and diagnostics, or get the kind of postpartum care midwives offer.

She also says the new legislation essentially made private practice illegal for midwives, which she sees as a problem, especially because "not every midwife is going to be an ideal Yukon government staff member and candidate."

She said leaving room for private practice can diversify the number of midwives and add "more diverse voices in the field."