In lieu of accessible midwives, Jasper doulas offer expecting mothers care and support
Nicole Gaboury remembers when her doctor at Hinton Healthcare Centre told her to stop pushing her baby.
She had been in labour for four days, and all she wanted to do was push. Her dream of having a natural birth was so close to being realized. However, her unborn child was facing upwards, instead of down, and the stress of the situation caused her baby’s heart rate to drop. Doctors made the medical decision to perform an emergency caesarean section.
“The hardest part was I didn’t get any sympathy,” said Gaboury. “Being in that clinical setting, they try to regulate you. The doctors don’t tap into the emotional side of things.”
As a first-time mom, Gaboury didn’t know very much about giving birth or pregnancy, and found her biggest challenge to be the unexpected.
“It’s scary and you feel alone,” said Gaboury. She said she wishes she had been able to access midwifery care for her pregnancy and birth.
“There would have been more flexibility and understanding. More of an emotional forgiveness that I didn’t get in the hospital,” said Gaboury.
If she had worked with a midwife, Gaboury would have explored the option of having a water birth and labouring in a birthing centre.
Although she could have gone on the waitlist for a midwife in Edmonton, Gaboury didn’t feel like the stress of going back and forth from Jasper to Edmonton and being on the road for four hours at a time was worth it.
“I wanted to have a relaxed pregnancy and not drive white knuckled in the middle of winter to see my midwife,” said Gaboury.
Despite choosing not to access midwifery care, Gaboury still wanted support outside of traditional physician care. She heard about Jenna McGrath’s doula services through other women in Jasper who had worked with her and said they “loved the support.”
McGrath provides support to women and their partners preparing for the birth and carrying out their birth plan. She is also present during labour, providing emotional and physical support.
“You become another person in labour, almost like an animal. Jenna got all that, she gave me whatever I needed,” said Gaboury. “She was there with me until the bitter end.”
McGrath has been working as a doula since 2010 and said one of the main challenges for mothers in Jasper is “that they don’t know what their options are when it comes to resources.”
McGrath spends time with her clients talking about stages and phases of labour and recommended reading and videos. She focuses on supporting women and their partners to allow the transition to parenthood to be as supportive as possible. After the baby is born, McGrath can provide postnatal in-home support, including breastfeeding assistance, answering questions and light housework.
McGrath can’t replace a midwife or doctor because she doesn’t have the same in-depth medical training. However, she is trained as a doula through DONA Birth Doula training. Many doulas work alongside midwives to provide additional support.
McGrath explains she believes in “the importance of having the choice between a physician or a midwife.” She said many women from Jasper and Hinton who use her services may initially want a midwife.
“It can be difficult to access a midwife in Alberta so my clients often think a doula is the next best option,” said McGrath.
There are currently approximately 98 midwives who have midwifery staff appointments with Alberta Health Services (AHS). These midwives assist with 4.1 per cent of pregnancies and 3.5 per cent of deliveries in Alberta. This compares to midwives assisting with more than 16 per cent of pregnancies and births in British Columbia.
Danica Sharp is the director of Provincial Midwifery Services for AHS. She said the province is working to get midwifes into communities in rural Alberta but “it’s a long process.”
“It’s not easy to just take a midwife and put them into a community. They have to have hospital privileges, they have to be sustainable and they have to have funding,” said Sharp.
Midwives also have to work for one year in an established practice before they are fully certified. Currently Calgary and Edmonton have the most growth because they already have established practices taking on midwives.
Sharp explains that funding is also a challenge. In April, the Alberta government announced an increase of $11-million dollars in funding for midwifery services over the next three years. However, not all midwives in Alberta are working to full capacity which is 40 courses of care per year (every client a midwife works with is equivalent to one course of care). AHS has committed to funding up to 400 more courses of care in 2016-17 for a total of 3,174 midwife-supported births.
Despite the lack of midwifery care in Jasper, women can still access alternative care and resources. McGrath and four other women offer birth doula services in Jasper and Hinton. AHS offers prenatal classes three times a year where they cover topics such as when to go to Hinton, comfort measures and breastfeeding. Community Outreach Services in Jasper also provides support to pregnant women and new parents.
Although there is alternative support to midwifery care for new parents in Jasper, McGrath acknowledges that not all of the support is accessible for everyone. McGrath charges $900 for her doula services while midwifery care is publically funded by the government of Alberta.
McGrath and Gaboury said in the future they’d like to have a birthing centre established between Jasper and Hinton where midwives could practice. Both women agree every mother deserves to have the option.
“The dream would be to have access to the care of a midwife,” said Gaboury.
Disclosure: Nicole Gaboury is the art director of The Jasper Local and partner to publisher/editor Bob Covey