No end in sight for midwife shortage in Nova Scotia

Nova Scotia health officials say hiring about five more midwives would clear the long waiting list of people wanting midwifery care in Halifax, but how many are needed in the rest of the province is unclear.

Demand for midwives has been unmet in Nova Scotia for years, with an average of 136 pregnant people wanting, and not receiving, midwifery care from the team at the IWK Health Centre annually since 2016.

Midwives provide care to expectant parents throughout pregnancy, childbirth and part of the postpartum period as an alternative to the care of a physician. They work out of clinics, hospitals and patients' homes, with the option of home-birth if patients choose.

There are currently 16 midwives working at three sites in Nova Scotia — Halifax, Lunenburg and Antigonish.

A recent letter from the Department of Health and Wellness to a legislative committee said an additional 5.5 full-time equivalent positions would have cleared the IWK's wait-list in 2022. However, funding for the program has been stagnant for the past four provincial budgets at around $2.3 million.

A spokesperson for the department said the province "has been focused on stabilizing midwifery services within existing teams and locations," while exploring future expansion.

Even if the department were to fund those additional positions, midwife CJ Blennerhassett said it wouldn't be the absolute fix.

"It's not, unfortunately, quite that simple," said Blennerhassett, vice-president of the Association of Nova Scotia Midwives, and president of the Canadian Association of Midwives.

"When you increase the amount of midwives you need lots of other things. It's not like you can just increase the amount of midwives and solve this wait-list problem. You would need more administrative support, more support in terms of logistics, like locations."

She said recruitment and retention efforts would also be needed including signing bonuses, relocation support and a leader within the Health Department.

"But certainly," she added, "we know there are midwives who want to come and work in the province."

Additionally, Blennerhassett said she expects demand will keep growing. Interest in midwifery travels by word of mouth, and Blennerhassett said each new patient is likely to attract more patients.

There's also uncounted demand for midwifery services outside the three existing sites. Anyone who does not live in the catchment areas of St. Martha's Hospital in Antigonish, the IWK in Halifax, and Fishermen's Memorial and South Shore Regional hospitals in Lunenburg County would not be able to access midwifery care, or be on a waiting list. 

Nova Scotia signed on with the other three Atlantic provinces in 2022 to conduct a feasibility study for a regional midwifery school. That study is underway and expected to be completed by the end of this year.