Meet 3 London-area midwives working to drive positive change in Ontario’s health-care system

A group of midwives in southwestern Ontario came together for a week-long convention where they shared their professional experiences, discussed research and how their skills can meet the unique needs of expectant parents and their newborns.

Three of these midwives shared their work with CBC London to innovate the way midwives work within the healthcare system and improve collaboration with other healthcare providers.

Meagan Furnivall – Midwifery Burnout

Registered Midwife Meagan Furnivall is Head of Clinical Services at the London Health Sciences Center (LHSC). Her research focuses on burnout at work and how to minimize stressors to maintain a lasting workforce.

“Burnout is pretty common in the midwifery industry. We wanted to look at how COVID is affecting that,” she said.

The results surprised Furnivall, she said. Although midwives reported experiencing moderate levels of burnout even before the pandemic, Furnivall found that COVID was exacerbating underlying issues.

The biggest contributor to burnout is the on-call model of care, which requires midwives to work around the clock when a woman goes into labor, Furnivall said.

“Work-life balance issues are particularly difficult for those with care responsibilities, which are children or parents to look after,” she said.

“They said, ‘This cookie-cutter model is really difficult and it makes me have to leave the profession because I can’t work in that capacity,’ which is a tremendous one for both the community and the clinic economic loss is loss.”

Midwives would prefer shift work or working in diverse settings such as clinics that focus on newborns, contraception or reproductive issues, Furnivall said.

When her department at Furnivall received funding from the Children’s Health Foundation nearly three years ago, she was tasked with building capacity to conduct research on midwives that would ensure midwives are better equipped to do their jobs.

This research can help midwives keep up with clinical research and better serve their patients. Furnivall will conduct similar research into burnout at the provincial level.

Ellen Blais – Creating an Indigenous Focus

Getting midwives back into the communities is a priority for Ellen Blais of the Oneida Nation of the Thames and Director of Indigenous Midwives for the Association of Ontario Midwives.

“For generations we’ve had midwives in our community and not doctors, but with the medicalization of childbirth and the withdrawal from the community, the system was imposed on us,” she said.

Blais heard from many pregnant people living in their communities, especially those in northern Ontario, who have to fly south just to access a hospital for the birth.

“We don’t see that in the well-resourced communities where people go to hospitals and bring their babies home. That’s not the case with indigenous peoples,” she said.

Blais, who was adopted into a non-Indigenous family as a result of the 1960s scoop, believes that community and culture directly influence one’s identity and that it is important to make systemic changes to make birth a joyful experience and doesn’t feel like an anxious experience, she said.

“We know that many tribal peoples experience racism in the healthcare system,” she said. “Indigenous midwives have the ability to be with the woman, to advocate for her needs and to navigate the system for her.”

Blais is working with the Department of Health to change policy to support Indigenous midwifery work and improve education for Indigenous peoples considering the profession.

Lauren Columbus – Teamwork in maternity wards

For LHSC midwife Lauren Columbus, it is important to improve communication between teams in maternity wards. She believes this can lead to a healthier work environment and better patient outcomes.

Columbus research analyzes how accessible people are at the top of the care team hierarchy [usually physicians] really are and how to create an environment where other professionals such as nurses, midwives or medical students can feel comfortable voicing opinions or pointing out errors, with patient safety as a priority.

“The way people are treated and spoken to by their peers really plays a big part in burnout and their eventual reasons for leaving a job or career altogether,” she said.

“Of course, when you feel like you’re a valued team member at work, you have that psychological security that if you make a mistake or a suggestion, you won’t be blamed.”

A simulated study by the Columbus team found that doctors were not challenged by other team members when making certain decisions or making mistakes. It made them think about how they could promote a safer environment.

“The building blocks include time and presence,” Columbus said, “being more accessible for people to ask questions, be vulnerable, and be able to admit mistakes models that for other team members.”

In the decade she’s been practicing, she’s noticed a subtle culture shift where delivery teams are becoming more collaborative, Columbus said. She hopes that the hierarchical approach to childbirth can finally be broken down and relationship building emphasized.