Sunday, February 24, 2013
Saturday, February 23, 2013
Would you work without a contract?
Midwives do! Midwives have
been working without a contract since March 2011, and there seems to be no
negotiation in sight. Why is this happening? Who are midwives, anyway? And what
do they do? These are some of the questions many people asked when they were
exposed to the Association of Ontario Midwives campaign “Born without a
contract”. Hundreds of pictures of babies, who were born under the care of midwives
without a contract, circulated the World Wide Web.
Born without a contract campaign
Midwives are registered health care professionals who care for
low-risk pregnant women and their babies up to 6 weeks after the birth. The
principles of midwifery care are to give women a choice of birthplace, which
includes hospital, home or birth centre, informed choice regarding
decision-making, and continuity of care. Midwifery has shown to be very
effective in the care of normal, low-risk pregnancies. It has significantly
reduced the cost of care to the health care system. According to a report in
the Ottawa Citizen, a midwifery-attended birth in a hospital costs $1000 less
than a physician-attended birth. Home births, which midwives are trained to
attend, would save the Ministry even more. With the most recent addition of
birth centres, the Association of Ontario Midwives says that the province would
save $50 million a year. It is known that midwifery care results in better
outcomes for mothers and newborns, with fewer interventions. Women get excellent
individualized care and the province saves money; this seems like a win-win
situation. We want and need midwives. So, why are midwives working with an
expired contract?
The Ministry of Health and Long-Term Care pays midwives but their contract is negotiated through the Association of Ontario Midwives. This
contract decrees how much midwives are compensated, among other issues, and
expired at the end of March 2011. Negotiations were started and dropped, and as
of today, no agreement is settled. This has resulted in midwives working under the
conditions of an expired contract. One contributing factor to this situation is
the fact that midwifery is not unionized, and thus, does not have access to a
labor legislator. In spite of the many efforts by the Association of Ontario Midwives, including campaigns such as the "Back to the table campaign" and "Born without a contract campaign" where hundred of families sent the minister letters, tweets and baby photos, they have been unsuccessful in getting the government to sit down with the Association of Ontario Midwives to negotiate a contract.
Midwifery is growing very quickly and it is of great benefit to the health care system in both quality of care to pregnant women as well as saving the province money. However, for the last 7 years midwives have not received an increase in pay. An independent third party report funded by the Ministry of Health concluded there is a large pay equity gap for midwives among other care providers with similar responsibilities and education, setting midwives to a 20% lower pay. The Association of Ontario Midwives states, "A 20% pay equity gap is like working for free one year every five! Midwives love their jobs, but they cannot continue being discounted in this way." Another contributing factor to the problem is that midwives are independent contractors and thus are not covered by equity legislation. It is also argued that there is a gender-related discrimination in the midwifery profession. It is historically proven that the female-dominated professions lack pay equity. Midwifery suffers a double strike, as it is a profession almost exclusively comprised of women who serve women. Midwifery is thus a women's issue because to degrade midwifery services is to degrade the people it serves; women and families.
If our goal is to promote and provide women with high quality care while saving the government money, we need to provide incentive to the midwifery profession. What a better way to do that, than to compensate midwives for their endless hours of on-call time to serve women? One can say that an investment has been made when funding was provided for midwifery schools and birth centres, but we need to understand the difference in investing in the midwifery profession and investing in midwives. If the plan is to grow the midwifery profession in Ontraio at the expense of midwives, we may just get the opposite effect. Who is going to want to be in a profession that is devalued? We may start to see new registered midwives leaving the province and the country looking for better conditions of work elsewhere. We have seen this happen before with physicians and nurses. It's about time the government learns their lesson.
Midwifery is growing very quickly and it is of great benefit to the health care system in both quality of care to pregnant women as well as saving the province money. However, for the last 7 years midwives have not received an increase in pay. An independent third party report funded by the Ministry of Health concluded there is a large pay equity gap for midwives among other care providers with similar responsibilities and education, setting midwives to a 20% lower pay. The Association of Ontario Midwives states, "A 20% pay equity gap is like working for free one year every five! Midwives love their jobs, but they cannot continue being discounted in this way." Another contributing factor to the problem is that midwives are independent contractors and thus are not covered by equity legislation. It is also argued that there is a gender-related discrimination in the midwifery profession. It is historically proven that the female-dominated professions lack pay equity. Midwifery suffers a double strike, as it is a profession almost exclusively comprised of women who serve women. Midwifery is thus a women's issue because to degrade midwifery services is to degrade the people it serves; women and families.
If our goal is to promote and provide women with high quality care while saving the government money, we need to provide incentive to the midwifery profession. What a better way to do that, than to compensate midwives for their endless hours of on-call time to serve women? One can say that an investment has been made when funding was provided for midwifery schools and birth centres, but we need to understand the difference in investing in the midwifery profession and investing in midwives. If the plan is to grow the midwifery profession in Ontraio at the expense of midwives, we may just get the opposite effect. Who is going to want to be in a profession that is devalued? We may start to see new registered midwives leaving the province and the country looking for better conditions of work elsewhere. We have seen this happen before with physicians and nurses. It's about time the government learns their lesson.
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