Amid bid for better pay, Hamilton midwife explains her job

Six hundred and eighty-one Ontario midwifes are arguing forequal pay, after nearly 20years of minimal salary increases from the province.

Hamilton midwife Christine Sandor, 29, is one of them.

Last Wednesday, Ontario's midwives took legal action against the Ministry of Health and Long-term Care over pay equity and filed a complaint with the province's Human Rights Tribunal.

It calls on the province to double their pay, to almost $200,000 per year, close to what a family doctor makes.In 1994, the province set a midwifes pay in between a community-health physician and a nurse practitioner, saidSandor. She is a member of the Community Midwives of Hamilton.

Since then, midwives have only seen a 33-per-cent salary increase, whereasphysicians and nurse practitioners have received a 74-per-cent increase, despite the fact that midwivesscope and responsibilities have expanded during the near-20 year period.

• Related: Midwife-led care best for babies and moms, researchers say

The Ontario Association of Midwivesalso argues that gender has played a role in the lack of pay compensation midwifery is largely dominated by women.

Each midwifehelp delivery up to 80 babies a year. Theyre on-call 24 hours a day.

Sandor spoke to CBC Hamilton about what her job is like, the personal sacrifices she makes for her work,and why this human rights case is important.

What is a typical day in midwifery like?

Each day is completely different,but in a typical week, we would have one or two days where wed have clinic, so doing pre-natal appointments for clients. We do all the prenatal care someone would need when they are pregnant. Wed do all their routine blood work and physicals, screening test and ultrasounds. We also do postpartum visits for moms and babies for up to six weeks.

Another typical day, wewould be called to a birth and bewith someone in labour and delivering their baby during the day or during the night, whenever we are called.

Sometimes we also do home visits,so we're driving around to peoples houses to do visits usually for the first 10 days to two weeks that theyre home with their new baby.

Were on-call 24 hours a day. In general, were on-call for the better part of the week, so sometimes were in clinic and have to run out to a birth and sometimes it's quiet.

Your work is entirely unpredictable. How has that affected your personal life?

I always tell midwifery students that if you think its going to be a job where you go to school, become a midwife and that becomes the job you come home from, its not going to be like that. It does affect your friends and family.

Learning to live on-call for most of the time that youre working is something that takes practice, because you need to get used to cancelling plans and your friends and family have to get used to you being not as reliable as you used to be.

I dont have kids right now, but midwives with kids have to have 24-hour, on-call child care organized if they have a partner who is working also. Thats another aspect of our job thats different from other health care providers.

What would a clinical appointment with a midwife look like compare to that with a doctor?

Usually the first and second appointments with our client are an hour long, so we go through the model of midwifery care, how our practice is set up, health history, a physical, blood work and then after that our appointments are half an hour long.

Those appointments, wed do the regular clinical things youd do at your family doctor and then there is time for discussion about whats happening during pregnancy,so moms and families understand this is, for example, the blood test Im recommending and these are the risks.

I want to make sure they have an understanding of what is happening during their care. It would be pretty unusual for me to say, hey, go for this blood work and you dont understand why youre going.

One thing that midwifes and the people we work with really appreciate is the relationship were able to build throughout their pregnancy.So by the time they'reready to have the baby, we know what the expectations are for the birth and what our recommendations are.

Do you feel youve been underestimated on the job?

In Hamilton, there is a really excellent relationship between the physicians, nurses and health care providers we interact with. In that sense, I dont feel like my skills are looked down upon.

In talking to people who arent as exposed to midwives or in communities with an established midwifery presence, it can be much more challenging. I think a lot of that stems from not understanding what our scope is, not knowing what our education is, whats involved in the care we provide.There is a lot of misunderstanding still, even within the health care field.

Do you agree with the argument that the Association is making aboutpay inequity,that it's because midwifery is a female-dominated profession?

Thats part of it. Now there are a greater proportion of females in the medical profession as physicians, but midwifery is the most female-dominated profession in Ontario.

We provide care only to women, who are healthy, so thats another part of the gender piece. Its a very unique career, Its basically all women providing care to primarily women.

The main point thats important to make is that were not seeking to double our salaries just for the sake of it. We want to be paid equitably in the way the government determinedwe should be paid 20 years ago.