'It's quite demoralizing': Midwives feeling overworked, undervalued in pandemic

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Midwives have been treated like an "afterthought" during the COVID-19 pandemic despite the important health-care services they provide, says the president of the Midwives Association of B.C.

"We have been just systematically left out of any pandemic pay and any pandemic supports," Lehe Spiegelman told The Current's Matt Galloway.

"It's quite demoralizing, nine months down the road, to be working to the extent that midwives are working without this important safety net."

According to a survey of 121 midwives conducted by researchers at the University of British Columbia, 81 per cent had to buy or make their own personal protective equipment (PPE) during the pandemic. Seventy-seven per cent said they experienced burnout due to increased demands and a lack of government support.

One in five midwives said they were struggling financially, and actively working to leave the profession. Meanwhile, more families called on midwives for their services during the pandemic, particularly for home births, the survey found.

In the spring, the B.C. government announced it would provide more than 250,000 front-line workers with a pandemic pay increase. Several other provinces did the same, including Ontario. However, midwives were excluded from the financial support. 

Both the B.C. and Ontario ministries of health provided statements to The Current, saying they value midwives' important health-care contributions. The B.C. government said it has created a midwifery advisory committee "to address priority issues raised by midwives," including "burnout, financial concerns, intentions to leave the profession, mental health issues, and workload changes."

The Ontario Ministry of Health said in a statement it has expanded its pandemic programming to provide workers such as midwives with free PPE, but added: "we are not able to expand the pandemic pay program beyond the over 375,000 employees already deemed eligible."

Midwives left 'scrambling' for PPE

Like doctors and nurses, midwives are working in hospitals to help mothers deliver their babies. And each of those health-care workers has an important role to play, said Spiegelman.

"Maternity care is based on teamwork ... and it's important that that team is supported in an equitable way," she said. 

"Walking into a birth knowing that any one of us could be exposed [to COVID-19], but I'm the only one that doesn't have any supportive network for that, is a hard pill to swallow."

Remi Ejiwunmi, a midwife with Midwives of Mississauga, in Ontario, echoed Spiegelman's concerns. 

She regularly jumps between the midwifery clinic, the hospital and patients' homes to do her job, depending on the type of care she is providing.

"And at each stage, it's imperative that, you know, we're protecting our patient population and also protecting ourselves from [COVID-19] exposure," she said.

Yet there hasn't been "a clear management line" to ensure midwives have PPE, she said. Instead, clients in some communities have been sewing protective gowns for midwives, so they can do their jobs safely. 

Walking into a birth knowing that any one of us could be exposed [to COVID-19], but I'm the only one that doesn't have any supportive network for that, is a hard pill to swallow.- Lehe Spiegelman

Midwives have also spent much of their personal time reorganizing clinic space to ensure it is safe for clients, without any dedicated funding to help them do so, said Ejiwunmi.

In B.C., midwives were left "scrambling" to purchase their own PPE out of pocket in the early days of the pandemic, because they were only afforded protection for home birth visits, said Spiegelman.

"It was really just about a month ago that the government started funding PPE for midwives," she said.

Lack of 'safety net' contributing to burnout

All of this pandemic pressure is taking a toll on midwives' well-being.

Spiegelman said they're putting in an extra 10 to 20 hours per week to manage COVID-19 in their personal and professional lives.

For Ejiwunmi, that means avoiding hugs with her four-year-old son when she gets home from work — a "real change" for the family, she said. Instead, she first heads to her separate laundry room, and her separate shower, so she doesn't risk making her family sick.

Many midwives who do get sick have no benefits to fall back on, said Spiegelman, nor does the job come with parental leave or retirement savings.

But she stressed that it's not the job of caring for mothers and their babies that is leaving midwives feeling burnt out. 

Rather, it's the general lack of a "safety net."

Ejiwunmi said midwives are exhausted from trying to cope through the pandemic. They're finding it harder to recover from overnight shifts, and some people are taking leave or deciding to leave the profession altogether.

"We are all deeply committed to the work that we do," said Ejiwunmi. 

"But I think when you are overworked and undervalued on top of that, it makes it that much harder to be able to stay on track."

Written by Kirsten Fenn. Produced by Lindsay Rempel and Rachel Levy-McLaughlin.