The profession of midwife risks being distorted by Bill 15 and the creation of the Santé Québec agency, denounce many feminist associations and leading figures of the movement.
“Being able to choose to give birth at home, will this still be possible after the adoption of Bill 15? » they ask in an open letter published on Wednesday.
“What is being decided is essentially the end of the midwifery profession as it has been claimed to date. »
The signatures argue that under the Agency it will be more difficult, for example, to allow a woman to experience a vaginal birth if she has previously had a cesarean section.
Many feminist organizations, including the Fédération des femmes du Québec (FFQ), as well as leading figures of the movement like Françoise David co-signed the letter.
In Quebec, three types of professionals have the right to perform deliveries: gynecologists (and obstetricians), certain family doctors and midwives.
However, midwives are independent workers who have enjoyed particular professional autonomy since the legalization of their practice in 1999. It is this autonomy that is jeopardized by Bill 15, explains Josyane Giroux, the president of the Association of midwives of Quebec.
“We did everything. We tried to participate in the parliamentary committee and we were not invited [NDLR : leur ordre professionnel a été invité, mais pas leur syndicat]. We also tried to contact the minister’s office. And finally, all the amendments to the bill related to the professional status of midwives were rejected. »
“Totally inflexible”
For example, midwives wanted that in the event of a complaint, members of their profession would evaluate them, whereas the bill gives this role to the Council of Physicians, Dentists, Pharmacists and Midwives. (CMDPSF), a body on which they will be represented, but in a minority.
Suggestions for amendments on this subject were rejected, deplores Liberal MP André Fortin. “It is difficult to explain because these were not big requests,” he points out. “The government could have simply found a way through this issue. »
According to the Quebec solidaire MP Vincent Marissal, who presented several amendments on their behalf, the deputy minister who defends the bill (Dr Stéphane Bergeron) showed himself to be “totally inflexible” in parliamentary committee. “He locks himself into the logic that it’s better for them. »
Under the bill, women who manage birthing centers will report to a medical director, a new position created in the agency’s new organizational chart. Until now, they did not report to a doctor, but to a manager (the CEO of the CIUSSS or CISSS).
In addition, birth center coordinators will see their status change and will become “heads of a midwifery clinical department”. In each region, one of them may also sit on the CMDPSF.
Recognition or control?
In a parliamentary committee, Deputy Minister and doctor Stéphane Bergeron said that the Agency recognized the importance of midwives by giving them an official place in its hierarchy.
In addition, the new law gives them the right to give birth in hospitals in addition to the birth center, he repeated.
However, midwives claim that they are being placed in a hierarchical structure which goes against their philosophy, in addition to placing them under the supervision of doctors, who are the majority in the CMDPSF.
Midwives say they view childbirth as “a normal biological process which belongs to the pregnant person, carrying a deep meaning for the woman and her family”.
They consider that hospital birth is more focused on “risks” and a “pathological approach” to pregnancy.