by Kyle Wells For a mother-to-be there are many choices to be made on how and where to give birth, but in Powell River those decisions are limited by a lack of options.
A woman who is giving birth in Powell River currently has the option to either have a hospital birth carried out by doctors and nurses, or to have a home birth without medical professionals present. The only other option is to travel to the Comox Valley to give birth with a midwife present either in a hospital or at a home.
Currently there are no midwives practicing in Powell River. A registered midwife is a professionally educated primary maternity care provider who works with pregnant women throughout their pregnancy and beyond, ultimately helping to deliver the baby either in a hospital or a home setting.
Laya Bourguignon grew up in Powell River and is currently going to school at University of British Columbia to become a midwife, a four-year process. She is planning to return to Powell River after finishing her degree to provide midwifery care here locally.
Midwives must have another trained professional with them while assisting in a birth—another midwife, a doctor or a trained nurse. A midwife is trained specifically for natural child birth and to recognize the signs of possible complications. If any complications do arise then the midwife will know when to bring in the care of either a family doctor or an obstetrician, but only if necessary.
“When you’ve got someone who’s had four years of getting trained and dealing with birth without intervention, the chances of that professional needing intervention to get the baby out greatly decreases,” said Bourguignon. “Our training is very much in recognizing and being able to deal with normal birth but also to be able to recognize signs and symptoms of possible complications.”
Under a midwife’s care, expectant mothers are screened carefully for potential complications before undergoing a home birth. Should there be any circumstances that increase the possibility of complications then the midwife can recommend a hospital birth. Even with home births, though, the hospital and ambulance service are alerted that the home birth is taking place and are ready should any unforeseen complications arise.
A study published in the Canadian Medical Association Journal in 2009, using data from home and hospital births in BC, found that home births have very low prenatal death rates, similar to hospitals, and that the rate of medical interventions and “other adverse perinatal outcomes” are lower for home births than hospitals, when attended by a registered midwife.
Dr. Pierre Du Plessis, an obstetrician and gynecologist in Powell River, said from a medical point of view he believes that so long as a pregnant woman meets certain health criteria and has professional care he has no problem with home births. He believes midwives provide adequate care but hopes mothers-to-be realize the inherent potential for complications with pregnancy and weigh their options carefully.
“If you have a normal healthy patient, with a normal healthy, uncomplicated pregnancy and she’s got adequate care at home, she can have a normal, safe delivery at home,” said Du Plessis. “Unfortunately you must sit on the other side of the bed to realize that bad things happen as well. If a bad thing does happen we should be aware that it’s much easier to manage a bad thing in a hospital.”
Julie Briscoe is one of just a few doulas in Powell River and only works with hospital births. A doula provides physical and emotional support for pregnant women, through the pregnancy, birth and postpartum period, but is not the primary care provider and does not perform deliveries.
Briscoe sees her job as making the hospital birth experience easier and more empowering for women. She said that women can, for the most part, still have the birth they want at the hospital and have the right to make decisions with nurses and doctors during the labour, rather than just taking instructions.
“Sometimes the doctors or nurses make you feel like you have to do it their way,” said Briscoe, “...but it’s always a personal choice. It’s always your birth.”
Briscoe is herself expecting a child in April and is going over to Vancouver Island in order to have a home birth. Specifically she wants to have a water birth, which involves the mother giving birth in water, and that option isn’t available at Powell River General Hospital.
Like Bourguignon, Briscoe believes it is the family’s right to decide to have a home birth if they want, even without a trained professional there, but she hopes more people would choose to have assistance if it were available. With her first child, Briscoe had planned to have a home birth with a midwife on the island but ended up having to go to the hospital with complications. She and her daughter were fine but Briscoe said that had a midwife not been there she’s not sure what the outcome would have been.
“I think the majority of the people that are having unassisted home births would rather have a midwife there,” said Briscoe. “It’s just that it’s not an option right now.”
In August 2011 Jenna Fickes chose to have an unassisted birth outdoors at her home with only her husband and first child there with her. She gave birth to her second child, a daughter, Feather Galiya. She made the decision to have a home birth partly because of the limited options here and partly because she wanted to have a birth that puts faith in the natural birthing process and a woman’s innate ability to give birth.
It’s a touchy subject, said Fickes, and many people don’t understand or agree with her family’s decision to have a home birth.
“We didn’t tell other people that this is what we were going to do because people just think you’re nuts,” said Fickes. “We’ve been a little bit conditioned to think that the hospital is the only safe place to give birth.”
Her family understood the risk, which Fickes considers to be a natural part of the process of giving birth. Hospitals come with their own risks and she sees the trend toward medically-assisted births as troubling. She said that most likely she would not have had a midwife even if one had been available locally, but does believe that having that option in the community is important.
