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Association of Ontario Midwives 2017 Annual Report

Message from the President and Executive Director

The Annual Report gives us a moment to stop and reflect on the past year as an association. We are truly amazed by the advancement of the midwifery profession year after year, and this past year was no different: the knowledge, creativity and power put forth by our members, staff and allies is unmistakably brilliant and we are so excited to share with you our accomplishments of 2017.

2017 began with the release of a new, three year strategic plan developed by the highly dedicated Board of Directors. One notable initiative, in step with our strategic commitment, was the creation of the Indigenous Midwifery department, which embarked on the important work of continuing to support the renewal and restoration of Indigenous midwifery

Since 2013, we have been fighting for pay equity, including through our legal challenge before the Human Rights Tribunal of Ontario. In June of 2017, the AOM submitted its final document and closing arguments. We are so proud of this precedent-setting legal struggle and the many contributions from midwives, staff and our legal team. We await a decision from the Tribunal.

This year we took a break from hosting the AOM Annual Conference as we welcomed the International Confederation of Midwives (ICM) Triennial Congress to Toronto. A record breaking 4200 midwives from 112 countries came to our province, where we were able to share what the AOM does and learn from midwives everywhere. AOM staff shared the Emergency Skills program and welcomed 20 Spanish-speaking Indigenous midwives to our office for a unique knowledge exchange.

We also had the opportunity to experiment with hosting an online AGM. This was a new venture for the AOM, through which we were able to engage with midwives from all over Ontario. In fact, 150 members were able to vote from the comfort of their home or practice – no less participation than in previous years. We did miss seeing our members and are excited for the in-person AGM at OMC 2018, and for the possibility of a hybrid AGM in the future.

The AOM has also been busy promoting midwifery research and clinical expertise. We are proud that the AOM, drawing upon the expertise of researchers as part of a peer-reviewed process, was able to award funding for midwifery-led research projects, and host the first AOM midwifery research symposium. Midwives were recognized by paramedics as the experts in out-of-hospital birth, and provided a "train-the-trainer" program that eventually reached over 9000 paramedics in Ontario!

While our message points out highlights from 2017, you’ll find more details throughout this annual report about our accomplishments, none of which would have been possible without the dedication of our staff and members. A sincere and heartfelt thank you to all of our members for your commitment to midwifery and the clients that you care for each and every day (and night). Thank you to the committee members who volunteer their time to guide the work of the AOM. Thank you to our Board of Directors, working midwives who give of their time to provide leadership and oversight for our work. And thank you to our staff - the hard work and devotion they bring to furthering the project of midwifery in Ontario is greatly appreciated.

Sincerely,

Elizabeth Brandeis, RM, MSc, President and Kelly Stadelbauer, RN, BScN, MBA, Executive Director
Ellen Blais, Director of Indigenous Midwifery and Dorothy Green, AM

Strategic Plan: 2017 - 2020

Vision:

Midwives leading reproductive, pregnancy, birth, and newborn care across Ontario

Mission:

Advancing the clinical and professional practice of Indigenous/Aboriginal and Registered Midwives

Strategic Goals

  1. The restoration and renewal of indigenous/aboriginal midwifery
  2. Flexibility to provide sustainable care and innovation to meet the diverse needs of communities and midwives
  3. A strong, equitable, integrated and valued midwifery profession
  4. Advancement of client-centred midwifery clinical excellence

Midwifery by the Numbers 2017

By the end of 2017, our membership reached a whopping 873 midwives. This number includes 72 new midwife members and 90 new student members. We have also added one new practice group and three new satellites to our roster, making a grand total of 89 practice groups and 23 satellites. This year, the AOM received funding for 29 rural, remote, and far north locums. To add to the excitement, six indigenous midwifery practices were newly funded this year. See the section on Indigenous Midwifery for more details!

*Practice Group and Satellite data not available prior to 2003

Welcome to all of our new members! We are excited to share our services and resources with you!

Cynthia Rebong, RM, Esther Willms, RM, Lily Martin, RM, Andrea Levy, RM

Quality and Risk Management

Through AOM On Call, our Quality and Risk Management team provided 24/7 support to approximately 240 different members in over 1000 phone calls. Top trending topics in 2017 included questions about infection prevention and control (IPAC), becoming a practice partner, disability and accommodation, drug shortages, privacy obligations, surrogacy, and supporting client choice.

Last year, our practice was dealing with a serious, stressful situation. We were scared and overwhelmed. I called AOM On Call and spoke with Cara. She gave us a step by step plan; after, she often called or emailed to check in, answer questions, and give advice. This issue is resolved now, but I don't think it would be if it were not for the wise advice, experience and support we got through AOM On Call." - Experienced Midwife

We continued to develop and share resources for midwives on infection prevention and control, including the Guide to Midwifery Reprocessing, pulse oximeter cleaning and considerations for water birth. A survey of midwifery practices, completed in summer 2017, showed that the AOM's resources and supports on IPAC and reprocessing have been useful and well-received: nearly all respondent practices reported implementing best reprocessing practices or adopting an alternative (e.g., disposables or out-sourcing).

In response to questions from midwives, we also developed or updated a number of new resources:

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Excellent Continuing Education Tailored to Midwives

Throughout the year, midwives relied on educational offerings to support and enhance their professional development, including webinars and live events on a wide array of topics. For the first time ever, 100% of Professional Development Funding was claimed in 2017-18.

Pelvic Floor Workshop

This ever-popular workshop was offered in Toronto and Kingston in 2017, reaching capacity for both sessions. The interactive, all-day event covers pelvic floor anatomy, suturing techniques with a variety of needles, understanding high vs. low pelvic tone and more!

Business Practice and Healthy Practice Culture

Barrie saw the refined Business Practice 201 event, while Markham welcomed the highly demanded Healthy Practice Culture.

Business Practice 201 covers a range of topics including MPG management, working with the TPA, human resources and managing practice finances. The day includes presentations by midwife experts, as well as an HR consultant and accountant. Practice Culture teaches participants how to create a healthy work environment by working through examples in communication, onboarding practices, conflict, and decision-making.

Induction of Labour

Both Hamilton and Toronto saw midwives learning more about the induction and augmentation of labour. This workshop is an engaging, all-day session that provides greater understanding and valuable insight into induction and augmentation. The day includes presentations from experts such as Bruce Wainman, Associate Professor, Pathology and Molecular Medicine, and is packed with hands-on instruction and practice of Foley catheter insertion.

Breech Birth Workshop

UK midwife Shawn Walker, RM, PhD, hosted a two-day workshop in Toronto for Ontario midwives.Over 40 members were able to practice and refine their breech birth skills through videos, presentations and hands-on practice.

Webinars

2017 also had an increase in webinars, with 514 attendees across 20 webinars! These webinars covered many different topics including:

Emergency Skills Workshops

Paramedic Emergency Skills Program

The Paramedic Emergency Skills Program (PESP) was developed by the AOM for paramedics in Ontario. This program incorporates the 2017 ALS standards of emergency childbirth management into evidence-based curriculum and hands-on training for skills development. In its inaugural year, a team of 39 midwife instructors trained 244 paramedics across the eight Base Hospitals to become paramedic trainers in our train-the-trainer program. The paramedic instructors were then able to provide training to an additional 9062 paramedics using the AOM-recognized curriculum!

Regional Member Meetings

Our regional meetings are always a time to hear from midwives from across the province and opportunities to discuss hot topics. At our spring regional meetings, 169 midwives were in attendance (21% of voting members), representing 69 practice groups (73% of all practices). In the fall regional meetings, 195 midwives were in attendance (22% of voting members), representing 66 practice groups (71% of all practices).

Indigenous Midwifery

In the summer of 2017, a new Indigenous Midwifery department was established in response to the strategic plan. Two new staff, a Policy Analyst and a Community Engagement and Outreach Specialist, were hired that fall. The AOM has also established the Indigenous Midwifery Advisory Circle to advise the Indigenous Midwifery team on their ongoing work.

Ellen Blais, Director of Indigenous Midwifery Department with former Honourable Minister of Health, Eric Hoskin

Outreach and Community Engagement

  • The Indigenous midwifery team met with the Chiefs of Ontario Health Coordination Unit, where they presented an update on the Indigenous midwifery funding to increase the awareness of Indigenous midwifery across the province.
  • The Indigenous Midwifery staff continue to provide concrete support and guidance to communities who currently have Indigenous Midwifery Program funding, community development grants and are working towards starting new practices in their communities.
  • The Indigenous Midwifery team attended the First Nations Health Managers Conference in September 2017, where the AOM had an exhibit table staffed by both AOM and NACM representatives.
  • The AOM supported the work of NACM following a federal funding announcement at the International Congress of Midwives in June.

Website and Digital Transformation

We are so excited to share with you the new AOM Website, OntarioMidwives.ca! All the same, great information is still available, but on a navigation-friendly platform! What's inside? Well, you may have to explore to find out...

  • New, long-awaited search function!
  • A list of clinical topics and all of our resources for each!
  • Clinic resources (you just may have to be a member to access this content)!
  • Brand new events page - search by type of event, clinical topics, or city you're in!
  • An amazing, easy-to-use Find a Midwife directory!
  • Recent issues of the Midwifery Memo right on the website!

We really hope you enjoy using this new, powerful resource. Keep checking back as we continue to add content daily!

Facebook: 7525 followers (10% growth from last year)! 7870 likes on our Facebook page (8.5% growth)!

Instagram: Reached 1000 followers in December! Our followers are most active on Thursday evenings!

Twitter: 5460 Twitter followers! 296 link clicks in 2017! 338 retweets! 318 likes!

Highlighted Midwifery News Stories of 2017

We love seeing the work of midwives being showcased in the news and media! 2017 had a wealth of stories that provided delightful insight to midwifery. Here are some highlights that were picked up by the media in 2017:

Supporting Midwives to Promote their Clinics

We developed and shared materials that help midwives promote their work in their local communities. Over 7000 English language About Midwifery brochures and Choice of Birthplace brochures were sent to midwifery clinics and healthcare organizations.

Rebecca Carson presenting 2017 Annual Midwifery Awards to Diane Parkin, RM, Judy Rogers, RM, Angela Reitsma, RM and Sharla Brookfield, respectively

Association of Ontario Midwives Annual Midwifery Awards

Lifetime Achievement Award

The Lifetime Achievement Award recognizes a midwife or midwives who have made demonstrated extraordinary contributions over their career to the profession of midwifery in Ontario. This year, the Lifetime Achievement Award was presented to Diane Parkin, RM. Attending births since the 1980s, Diane was involved with the AOM prior to regulation. As one of the first registered midwives in Ontario, some of Diane's contributions include opening the first midwifery clinic in Ottawa, acting as Eastern Regional representative in 1991, doing significant work for the CMO, furthering clinical research and serving as preceptor for the MEP from 1996 to 2016.

I thank all the midwives I've worked with, and learned from, and loved, along with all the students who have come through the practice, and our caring, receptive staff - I love you all. And so, friends and colleagues, I invite you to feel the love, and to give it. Without love, we are nothing." - Diane Parkin

Elsie Cressman Award

The Elsie Cressman Award recognizes a midwife or group of midwives who have successfully initiated an innovative and client-centred midwifery project. This year, Judy Rogers received the Elsie Cressman Award for bringing midwifery care to a small northern community and its surrounding area, including seven First Nations communities, and being part of obstetrical coverage, serving as part of the on-call rota for one week out of every six.

Excellence in Midwifery Research Award

The inaugural Excellence in Midwifery Research Award recognizes research that advances excellence in midwifery care. The 2017 recipients were Eileen Hutton and Angela Reitsma for the paper titled "Outcomes associated with planned place of birth among women with low risk pregnancies".

Hospital Integration Award

The Hospital Integration Award recognizes a hospital that has demonstrated excellence in successfully integrating midwives. Award recipient Temiskaming Hospital does not have restrictions on midwives. Midwives work to their full scope of practice and have full support from hospital administration, physicians, and obstetrical nurses.

Media Award

The Media Award recognizes a journalist who has demonstrated excellence in raising public awareness of midwifery. The Media Award was presented to Dr. Brian Goldman on behalf of his work with Dawna Dingwall and Jeff Goodes on "White Coat Black Art". This piece profiles Ottawa midwife Betty-Anne Daviss and highlights her expertise in vaginal breech births.

Dr. Brian Goldman, recipient of the 2017 Media Award

Resources that Centre Midwifery

The AOM produces evidence-based clinical practice guidelines (CPGs) and resources consistent with the midwifery philosophy of care, including informed choice, client as the primary decision-maker, choice of birthplace, and appropriate use of technology. CPGs summarize research and are a key way to facilitate evidence-based practice, especially when making decisions about health care. The Clinical Practice Guidelines team specifically develops resources tailored to member needs. In fact, the Choice of Birthplace Chart was created after receiving ideas and feedback from members. Many resources developed in 2017. Check them out below!

English

This is a VERY helpful app. I use it ALL THE TIME!"
We love the home birth pictograms and are so grateful to use them for our homebirth night!!!"

Multilingual Resources

Expanding Capacity for Midwifery Research

Midwifery research is critical in supporting the vision of midwives leading reproductive, pregnancy, birth & newborn care. To that end, we disbursed grants to three teams supporting midwifery-led research through the inaugural 2017 AOM Midwifery Research Grants Program. We held the first Midwifery Research Symposium with a focus on midwifery-led research and research capacity-building

[T]hank you to Sara, Liz, Eileen, Lisa and Vicki for putting together such an interesting discussion today. Also thanks to the AOM support crew. It was a really great event!" - Event attendee

International Confederation of Midwives: The World's Midwives in Toronto

The 31st Triennial Congress of the International Confederation of Midwives (ICM) took place in Toronto, Canada from June 18-22. 4200 midwives, partners, stakeholders in midwifery, and civil society organizations attended the congress, which was a lightning rod for education, information-sharing, networking and strategizing of the future role of midwives in the sexual, reproductive, perinatal and newborn health space. The congress is the leading international forum for midwifery with the aim of achieving progress in the care of pregnant women and people, mothers and parents, newborns and their families. A rich selection of experts in the field of midwifery and global health presented during the congress. They included His Excellency Jakaya Kikwete, former President of Tanzania, Her Excellency Toyin Saraki, ICM Goodwill Ambassador and founder of Wellbeing Foundation Africa, the Honourable, Jane Philpott, Minister of Health for Canada, Dr Natalia Kanem, Deputy Executive Director of the United Nations Population Fund (UNFPA), representatives from governments worldwide and many midwifery experts. The AOM is proud to have acted as a driving force to bring the ICM to Canada and for providing significant organizational support for this important event.

This year the ICM presented the Triennial Report for 2014-2017. The report details the key achievements and strategic partnerships made by ICM in this triennium. It is available in English, Francais and Espagnol.

March for More Midwives

The March for More Midwives was a curtain-raiser for the ICM's 31st Triennial Congress. Thousands of midwives representing 113 countries took over the streets of downtown Toronto in a spectacular parade through the city. The march drew attention to the role of midwives in reducing maternal and infant morbidity and mortality.

ICM Opening Ceremonies (left) and March for More Midwives in downtown Toronto (right)

Policy and Advocacy Highlights

Hospital Integration

The AOM provided support to midwifery practice groups working to optimize their scope of practice in hospitals and address barriers to midwifery expansion imposed by limited access to hospital privileges. For example, the AOM maintained a listserv for head midwives which facilitates a dynamic and timely forum for information sharing and support. We supported local advocacy efforts by maintaining resources and putting them to work by strategizing with head midwives. Provincially, we worked with the Ontario Hospital Association on a full-day conference “Maternal and Newborn Health: Current Developments and Future Directions".

Midwives Stand Up Against the Gender Pay Gap and Fight for Pay Equity

Elizabeth Brandeis, RM, President Association of Ontario Midwives at the 2017 Equal Pay Day Rally

On June 6, 2017, the AOM submitted our final reply submission for our legal action against the Ontario Ministry of Health and Long Term Care (MOHLTC) to the Human Rights Tribunal of Ontario (HRTO). This submission marked the end of three and a half years of dedicated work by AOM staff, members and legal counsel to fight for equitable treatment and compensation for Ontario midwives. This incredible journey included:

  • 1,225 days from filing to last day of closing arguments
  • 20 witnesses called by AOM
  • 14 witnesses called by government
  • 4 expert witnesses called by AOM
  • 6 expert witnesses called by government
  • 5 midwives provided testimony on injury to dignity
  • 290 exhibits filed at the Tribunal
  • 14,681 documents reviewed
  • 160-page application submitted to the Tribunal
  • 725 pages of affidavits submitted to the Tribunal
  • 357-page Final Submission - Review of the Evidence (plus appendices)
  • 103-page Final Submission - Legal and Remedial Relief (plus appendices)

During the first half of 2017, the HRTO heard illuminating testimony from many witnesses, including Paul Durber, Hugh Mackenzie, Margaret Anne McHugh, Jodey Porter, Anne Premi, Jackie Whitehead, Nicole Roach, Daya Lye and Rebecca Carson (Injury to Dignity witnesses) Dr. Pat Armstrong, Dr. Ivy Bourgeault, Dr. Lisa Graves, Dr. Candace Johnson, Martha Forestell, Dr. John Kervin, Bob Bass, Dr. Richard Chaykowski and Dr. David Price. As midwives eagerly await a decision from the HRTO, we optimistically envision a future in which midwifery is fully valued and supported in Ontario’s health care system.

The AOM joined with other members of the Equal Pay Coalition (EPC) to mark Equal Pay Day on April 11, 2017. The EPC called for the government to introduce pay transparency legislation that would require annual mandatory reporting by private and public sector employers to the Ministry of Labour on the state of the gender pay gap in their workplaces, by individual classification and job status. AOM President Elizabeth Brandeis energized the crowd at a rally held south of Queen’s Park.

Reproductive Justice

Elizabeth Brandeis, RM, President, Association of Ontario Midwives (centre) with Indira Naidoo-Harris, MPP, former Minister for the Status of Women (left) and Yasir Naqvi, Attorney General (right) at the announcement of the new Access to Safe Abortions Act

Together with reproductive rights activists and care providers, we advocated for and supported the right to access to safe abortion care without fear of intimidation or violence through a new piece of legislation - the Access to Safe Abortions Act (2017). We successfully bargained for new funding mechanisms that will enable expansions of midwifery roles into early pregnancy and abortion care. We engaged in discussions with stakeholders about increasing access to reproductive choice by considering the implementation of early first trimester use of Mifegymiso for termination. Midwives who choose to provide abortion services and care improve access, choice and defend bodily autonomy for more people across the province.

Governance: Leading for an Outstanding Association

The AOM Board of Directors (made up of 12 working midwives) provides strategic guidance, financial oversight and contributions to the vision of midwives leading reproductive, pregnancy, birth and newborn care across Ontario. This year, the AOM drafted and approved a new 3-year strategic plan with input from membership. The Board of Directors held six meetings, and a two-day meeting intensive. In addition, members passed eight constitutional amendments at the 2017 Annual General Meeting that will enable changes to the Board, including the ability to appoint three Board members. In total, 81 midwives and 11 students participated in the following groups: audit committee, awards task force, board recruitment task force, clinical practice guidelines committee, gender diversity task force, Indigenous/Aboriginal Midwifery Advisory Circle, leadership development committee, board and president evaluation task force, quality insurance and risk management committee, Conference 2018 task force, hyperbilirubinemia work group, IPAC work group, midwifery research work group, and timing of postpartum visits work group.

Times are changing. Our membership is changing. And now our Board of Directors is changing, too. For the first time in over 15 years, the Board recommended, and membership ratified, significant changes to the composition of the Board. These changes will help to make the Board more responsive, will better reflect the diversity of our members, and will more closely match member skills and knowledge to achieve our strategic plan. As our governance structures move away from geographic representation with the elimination of regional representatives, we replaced six regional coordinators with six additional member-at-large positions, three of which will be Board-appointed. These new positions enable our Board members to appoint members based on skill, knowledge, experience, or a demographic representation.

Three Board members completed their terms in 2017. We thank Tracy Franklin, Esther Willms, and Nicole Roach for their dedication, commitment and service to the profession of midwifery and our association.

AOM Board Members 2017-18

  • President: Elizabeth Brandeis, RM, BHSc, MScCH
  • Vice President: Rebecca Carson, RM, BHSc
  • Secretary: Genia Stephen, RM, BHSc
  • Treasurer: Jasmin Tecson, RM, BHSc
  • Member at Large: Carol Couchie, RM, BHSc
  • Member at Large: Sarilyn Zimmerman, RM, BHSc
  • East Regional Coordinator: Liz Fraser, RM, HBA, BHSc
  • North Regional Coordinator: Kelly Graff, RM, HBA
  • South Central Regional Coordinator: Simone Rosenberg, RM, BHSc
  • South East Regional Coordinator: Disha Alam, RM, BA, BHSc
  • South West Regional Coordinator: Anne Wilson, RM, BHSc
  • West Regional Coordinator: Andrea Cassidy, RM, BA, BHSc, IBCLC

In Memoriam: Basak Ardalani, RM

Beloved midwife Basak Ardalani unexpectedly passed away earlier this year. Basak worked for 15 years with Guelph Midwives, welcoming hundreds of babies to the world. We are thankful for the devotion, contributions and love of midwifery that Basak brought to Ontario Midwives, including her extensive work with the emergency skills workshops. Basak was not only a gifted Senior Instructor, but a knowledgeable and contributing member of the emergency skill workshop work group. She will be remembered for her passion, intelligence and dedication to midwifery.

Credits:

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