Debates of March 1, 2016 (day 8)

Date
March
1
2016
Session
18th Assembly, 2nd Session
Day
8
Members Present
Hon. Glen Abernethy, Mr. Beaulieu, Mr. Blake, Hon. Caroline Cochrane, Ms. Green, Hon. Jackson Lafferty, Hon. Bob McLeod, Hon. Robert McLeod, Mr. McNeely, Hon. Alfred Moses, Mr. Nadli, Mr. Nakimayak, Mr. O’Reilly, Hon. Wally Schumann, Hon. Louis Sebert, Mr. Simpson, Mr. Testart, Mr. Thompson, Mr. Vanthuyne
Topics
Statements

Question 84-18(2): Status of Territorial Midwifery Services

Thank you, Mr. Speaker. My question is for the Minister of Health and Social Services. As I mentioned in my Member’s statement earlier, the government has an initiative to move towards a territorial midwifery strategy. Two midwifery consultants have been working since last fall in program development and stakeholder consultation. Can the Minister update us on the current status of the NWT midwifery initiative, including the provision of midwifery services in Yellowknife? Thank you, Mr. Speaker.

Speaker: MR. SPEAKER

Masi, Minister of Health and Social Services.

Thank you, Mr. Speaker. Mr. Speaker, we moved forward with midwives and stabilized midwives in Fort Smith, so there are two positions there providing birthing services in the community. We also have two staffed midwife positions in Hay River that are providing birthing services, as well as other services in the community. We did move forward with a model in the Beaufort-Delta. Originally, we were planning to have a community-based midwifery program there, but our demographics and some of our information changed. As a result, we went with a more community-based, or more regional, model that is supported by physicians and the MOREOB program, as well as one nurse practitioner consultant who also happened to be a midwife in a previous career. Since then, we have been able to expedite the work that we are planning to do in the 2016-2017 fiscal year, and we were able to start that in the 2015-2016 fiscal year as a result of those changes in the Beaufort-Delta.

We have actually hired two consultants. It took a little longer to hire those consultants than we would have liked. It was difficult to find the appropriate staff. These consultants are working on basically three broad areas. First, strengthening and supporting the current midwifery practice in the Northwest Territories. This includes updating policies, reviewing and revising standards, and reintroducing the Midwifery Advisory Committee. They are also building on the 2012 report to continue community and territorial program design, so they put together, or rather they are putting together some terms of reference that will outline the work that they are going to be doing in that nature to move forward with the territorial program that includes midwifery services here in Yellowknife. Third, they are also doing monitoring and evaluation to ensure that the services are being provided appropriately and effectively. Thank you, Mr. Speaker.

Thank you to the Minister for his reply. Can the Minister advise the House: Are there plans to include a midwifery unit in the new Stanton Hospital project?

There is no designated midwifery unit in the hospital, as midwifery is primarily a community-based service versus an acute care service. If the territorial midwifery program is advanced to implementation, part of the development will be to include identifying an appropriate location that best fits the needs of the program. As a note, Mr. Speaker, the three birthing rooms in the new hospital are sized to include birthing tubs, which would allow for water birth. Those rooms actually, the physical layout and how those tubs will be utilized, the midwifery consultants actually had some opportunity to provide some input on how that would be done. The midwifery staff have been having conversations about how those rooms can be used in the future.

We are only four years from the last midwifery report. Can the Minister clarify what outcomes are expected in the current consultation efforts that will be different than the outcomes that came in the 2012 Midwifery Options Report?

The 2012 report was more of an aspirational report. It wasn't actually a prescribed plan. It proposed three models for conversation: a community-based model, which the consultants felt could work in communities like Hay River, Inuvik, Yellowknife, or Behchoko; a regional model, which the consultants felt could work in the Beaufort-Delta, the Sahtu, or the Tlicho regions; and a territorial model. We did move forward and stabilize the midwifery services in Fort Smith. We did expand and provide midwifery services in Hay River. The realities in the Beaufort-Delta changed when we were actually looking at a community-based model for Inuvik. We had locum physicians, we didn't have any permanent staff, so there was a lot of turnover and inconsistency in birthing services, and we also had a very high rate of births.

The birth rates in the Beaufort-Delta have come down, and we now have stable staff in the Beaufort-Delta. As a result, we went with more of a regional model in Inuvik. The difference is we are actually moving forward on a territorial design, which is more than an aspirational document. It's a structured document outlining how we will provide the services both in Yellowknife and at a territorial level. It's actually a plan to move forward with some of the suggestions that were provided in the 2012 report.

Speaker: MR. SPEAKER

Masi. Oral questions. Member for Yellowknife North.

Thank you, Mr. Speaker, and thank you to the Minister for his answer. Lastly, advocacy groups like NWT Citizens for Midwifery are made up of moms, women with knowledge and experience in this area. Can the Minister tell us what opportunities there will be for these groups to be involved in the important initiative going forward? Thank you, Mr. Speaker.

It's going to be really important to get feedback from as many interested parties as possible, and over the next year, the department will reach out to community members, Aboriginal organizations, healthcare practitioners, and others from across the Northwest Territories to help develop an understanding of the strengths and gaps in the priorities for the enhancement of midwifery services at a territorial and Yellowknife level. The timing and details of the consultation plan will be developed by March 2017, and we hope to have a completed proposal for development of the territorial midwifery program at that time. Thank you, Mr. Speaker.

Speaker: MR. SPEAKER

Masi. Oral questions. Member for Nunakput.