In the face of a PR nightmare following the death of a baby, Quebec midwives who have been fighting for years for acceptance and recognition again find themselves on the defensive.
However, they are hoping questions that arose after a newborn died at a Pointe Claire birthing centre are an opportunity to set the record straight.
“It’s terrible. My first thoughts last week were, ‘Oh dear, this is so ugly,’ ” said Claudia Faille, president of the Regroupement des sages-femmes du Québec, a non-profit group that speaks on behalf of the province’s midwives.
“We’ve been working so hard for the last 10 years to have midwifery accessible to the whole population and then this happens, and public opinion is affected.
“We just want the facts made public,” Faille said, referring to misleading information about the circumstances in the death of a newborn on June 21 at the West Island Health and Social Services Centre birthing centre.
Faced with an impending complication in the birth, the centre had placed a 911 call at 9:12 a.m. to transfer a woman with labour complications.
The baby, however, was born before the fire department’s first responder team arrived, and the centre barred them from entering.
Centre director Christiane Léonard told them that the baby was in cardiac distress and three midwives were attempting to revive and stabilize him while the facility awaited specialized neonatal transport from the Montreal Children’s Hospital.
Outraged, a fire department responder threatened to break down the door and then called the police, who arrived followed by Urgences Santé paramedics.
Her staff did nothing wrong professionally, Léonard said, and the standoff with the first responders should never have happened.
“That’s a strong image,” Faille said. “Even people who know me said: ‘You didn’t let them in?’ ”
But that’s only half the story, Faille said.
The police and firemen do not understand the role of midwives, she said.
The fact is, midwives are the first responders and they’re trained in advanced neonatal resuscitation while firemen and ambulance technicians are not, Faille said.
“It’s absolutely not their place. Access was rightfully denied – they’re not trained for that,” Faille said.
The centre has an agreement with 911 for transfers and the firemen should not have been deployed, Faille said. “It was a dispatch mistake.”
Birthing centres have all the necessary equipment and medication to intubate and resuscitate a newborn while waiting for the neonatal transfer team.
First responders would never threaten to break down a door of a hospital, Faille added.
Intervention from their team would not have saved the baby, she said.
“We’re going to have to work at getting the facts out. Babies die in a hospital every day and we never hear about it but because it’s a midwife, it’s a big thing,” Faille said.
The practice continues to suffer from lack of acceptance, she said.
“I don’t know why the reaction. But if you look at (the) neonatal mortality rate, we always say it’s similar to doctors in hospitals,” Faille said, which is 4.2 deaths per 1,000 births.
“It’s important to get the right information out so this never happens again,” Faille said.
The Quebec coroner, police and the provincial order of midwives have launched investigations into emergency protocol at the centre.
About 25 per cent of women surveyed last year said they would choose to give birth outside a hospital if they could.
Officially reintroduced in Canada in the 1990s, midwifery is answering a real need for perinatal care, Faille said.
But there are wait-lists, she added. Three out of four women who request midwife services are refused in the Montreal area because the services are not available.
