Alberta Health Services has released the allocation of 2,774 funded courses of care for 2016/17 to Alberta’s midwifery practices.
In 2015/16, the relaxation of a restriction on the opening of new practices resulted in a number of midwives moving between practices and some opened new practices in order to serve rural and underserved Albertans to meet the goals of the province’s Midwifery Workforce Plan.
The allocations of courses of care have resulted in some practices reporting they have not received enough courses of care to allow them to continue to provide the services they and their clients have anticipated. One midwife intending to serve a rural area has not received any courses of care at all. Some new practices have indicated they may have to close. Some practices already have more women enrolled in care than the number of courses of care received, which means some women may have to be released from midwifery care and midwives unable to receive compensation for care already given. Midwives are also exploring the acceptance of private payments from clients in order to continue to accommodate demand. This private-pay system was in place prior to public funding in 2009. Midwives are reluctant to participate in a two-tiered payment system and have expressed concerns about equity.
The Alberta Association of Midwives recognizes the tough financial time facing all Albertans, and we are continuing to work with Alberta Health Services and Alberta Health on a sustainable long-term funding model to grow midwifery care and to avoid a repeat of the difficult situation we are all in this year. The freeze on the number of courses of care at 2,774, which, with the continued increase in the number of births, represents a drop in the percentage of births attended by midwives.
A course of care provides funding for 48 hours of prenatal care and postnatal care for both mother and baby, as well as for the required attendance of two midwives at each birth, and a provision for between 39-55% for overhead, registration fees and insurance fees.
The amount allocated for a course of care has not increased since 2012. The increase in the number of courses of care by 17%-18% last year is not an increase in pay for midwives, it is an increase in the number of Albertans who can receive midwifery care. Even with this increase our midwives are not utilized to their full capacity.
We also continue to ask that the number of courses of care be immediately increased to allow midwives to work at their full capacity to accommodate as many of the 1,800 pregnant Albertans who are currently waiting for care as possible. Many of Alberta’s midwives are only working part-time, or even less, With the dozen students graduating this spring, our midwives can serve 3800 pregnant Albertans who are having babies and want access to midwifery care in this fiscal year.