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Locum midwives provide relief to rural and remote colleagues

practice in rural, remote and northern communities across Ontario. Some of these midwives work in practices with midwifery colleagues, others are solo practitioners.

Committed to their clients, they work hard to provide excellent primary care to women outside of urban centres.

They willingly accept the challenges of working in smaller and sometimes isolated communities, and the workload and long hours that are part and parcel of the job. But the work can be tiring and, like all midwives, they need support to have appropriate time off-call.

In 2009, with support from the Ministry of Health and Long-Term Care, the (AOM) introduced a program to respond to the needs of rural and remote midwives. The AOM Rural and Remote Locum Program relieves midwives for holidays, sickness, emergencies, continuing education or parental leave. It enables midwives to turn off their pagers with the confidence that their clients are in the experienced hands of another registered midwife.

Last August, Collingwood midwife Natalie Kirby returned to her northern Ontario hometown to do a month-long locum.  While living with her parents in North Bay, Kirby gained new insight into the life of a solo midwife with a practice in Powassan (20 minutes south of North Bay). At her regular job at Midwives Nottawasaga, which is a shared-care practice, she works one week on and one week off. During her locum, she was on-call for 28 days in a row. She caught four babies during the second week, three in hospital and one at home.

Kirby was granted locum privileges at North Bay Regional Health Centre for the duration of her stay, and worked with the health-care team and the hospital. Even so, “being a remote solo midwife is an incredible responsibility,” says Kirby. “You don’t have midwifery colleagues to call for back-up. You are it.”
Providing relief for the local midwife and continuing the philosophy and quality of care she had begun with her clients was a rewarding experience for Kirby.

“Balance is essential in our career; being pager-free so you can sleep, travel and do whatever you need to do.” She was also happy that the women in the community were able to stay in midwifery care. “If a locum didn’t come, the women would have been transferred to obstetrical care and wouldn’t have had home visits,” says Kirby. Without midwives and locums, maternity-care providers in rural locations, such as obstetricians, can be overstretched to meet the community’s needs.

Kirby was thoroughly briefed on each of the clients before she arrived in the community, but says she made a point of revisiting some topics during her prenatal visits with clients. “It’s important to make sure that you’re on the same page with clients because every midwife practices a little bit differently. You want every woman to have the birth experience they want,” says Kirby.

The job wasn’t without its challenges – such as orienting herself to a new midwifery practice and familiarizing herself with the protocols at North Bay Regional Health Centre – but Kirby says the locum experience was an incredibly positive one.  “I think it’s such a benefit for health-care providers to have a chance to visit new communities, see how they do things and adopt good policies where they can,” she says.  In addition to learning how another midwife practices, Kirby enjoyed collaborating with the members of the hospital’s health care team. She says she found everyone to be helpful, supportive and appreciative of the fact that she had come back home to do a locum. “I loved my experience!” says Kirby.

Last year, AOM’s Rural and Remote Locum Program provided funding for 14 rural and remote midwives to have locums. In 2012, AOM hopes to be able to relieve even more midwives. If you are interested in finding out more about the program, please contact AOM at 416-425-9974 or 1-866-418-3773 x2257.


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