A registered midwife looking to gain privileges at Terrace’s Mills Memorial Hospital was told Northern Health would not endorse her credentials to establish a clinical practice.
Katherine Puchala, the only midwife with a practice within a reasonable travelling distance between Terrace, Kitimat and Prince Rupert, has been providing prenatal and postpartum care for mothers in northwest B.C. for the last year.
“I expect that by the end of the year, I will have had more than 40 people in my care,” said Puchala.
According to the BC Midwives Association obtaining privileges are important considering nearly 70 per cent of births attended by midwives occur in hospitals – without the privileges, Puchala can’t deliver babies at home or at Mills.
She can only provide care within the first and second trimesters before consulting with the prenatal clinic for the third trimester.
When it comes time to give birth, the mother’s care is transferred to a doctor at Mills and then transferred back to Puchala once mother and child have been discharged from hospital.
In late January, Puchala says a senior Northern Health medical health official told her she would receive medical privileges within three days, but it wasn’t until April that she was called back for the final verdict.
“I was told there was an issue that came to light in my final reference check, and showed that I am not going to be a good fit here,” said Puchala, adding Northern Health wouldn’t provide her with a specific reason, citing confidentiality.
“I have since talked to all of my references – none of them had any clinical concerns about myself,” she said. “I was incredibly confused and disappointed.”
Currently, midwives hold privileges in a number of communities in the region, including Prince George, Smithers, Dawson Creek, Hazelton, Village of Queen Charlotte and Masset.
But there is a gap in service in the Skeena coast area of northern B.C., leaving expectant mothers who want the option of a midwife no choice but to travel for hours outside of their community to get it.
Prince Rupert Advocates for Midwifery wrote a letter to the Minister of Health in July to express their disappointment in Northern Health’s decision and to request an investigation into the matter.
“In a provincially regulated health care system it is a woman’s right to ask for and receive the highest quality maternity care, and we believe that midwives provide this in consultation with doctors and obstetricians when necessitated,” the letter reads.
“Here is a situation where a registered midwife is eager to work in a small town in Northern BC with a demand for midwifery care and a shortage of doctors who provide maternity care, and yet her hospital privileges were not approved.”
Northern Health spokesperson Eryn Collins said while health authority couldn’t comment on Puchala’s specific application, it did recognize how important it is for mothers in northwest B.C. to have access to midwifery care.
“We have midwives that hold privileges in communities across the region – we very much appreciate that they have an important role to play in making sure families have a choice in, and access to, prenatal, intrapartum and postpartum care,” said Collins.
The health authority is currently conducting a midwifery review involving a variety of stakeholders to look at demographics, demand, the need for midwives to practice collaboratively with care providers and practitioners, and recruitment. A final report is expected later this year.
Collins also says there is another midwife in Terrace going through the privileging application process with the hopes of starting a practice.
Despite the outcome of her application, Puchala says having physicians work collaboratively with midwives can help bridge maternity care gaps.
“Recruiting and retaining doctors in this part of the province can be challenging, and new physicians aren’t required to also provide maternity care. Midwifery can be a collaborative solution to ease the onus on family physicians,” said Puchala.
“Midwives are specialists – pregnancy and birth are what we specialize in. We know that our schedules are going to be erratic.
“We make provisions to try and have some balance in our own lives, but we know that we care for pregnant women only.”