Many people are confused about why Canadian birth attendants are prosecuted for the most minor actions. . . . calling herself a “midwife”, doing a vaginal examination at a woman’s request or with permission, advising a woman about how to eat for her unborn baby, etc.

Let me tell you how we got into the mess we’re in. Yes, it is a mess. Hundreds of thousands of dollars spent on legal actions, clients left upset and confused, hospital workers unclear about the legalities in their area, each province of Canada having a different wording in their Act, midwives mistrusting doulas and each other. It’s a climate of fear and turmoil that isn’t getting better after more than 20 years of legislating midwifery. (Ontario regulated in 1993, B.C. followed in 1998)

The first problem is that legislators tried to make laws to cover a life event that is natural and one that a woman can do all by herself, if she chooses. Birth is a normal life process. We don’t usually legislate who can be with an adult when they are in their own home. What can you make illegal about a woman having a baby and choosing someone to be with her? Well, you can make it illegal for that someone to charge money for being there. That doesn’t really fit with a concern for the well-being of the woman/baby. If a birth attendant is really wealthy can they go to help birthing women with no fear of the law? If the pregnant woman wants to donate money to her helper’s children, is that illegal? You can see it gets very tangled. The laws have been twisted and turned to try to make them less ridiculous as time goes by but no province has succeeded in coming up with wording that makes common sense.

Then, the law makers thought, “okay let’s make it illegal to do clinical acts like vaginal exams, injections, blood tests, etc.” Trouble with that is a) it is almost impossible to police these activities when they happen in a private home and, b) women allow their partners to perform vaginal exams all the time. Many massage therapists do pelvic therapy with vaginal exams, naturopaths, nurses, etc. so how does it help to say that one particular group cannot do vaginal exams? So, by saying that only a member of a midwifery disciplinary body may do a pelvic exam, things get almost laughable. Since any 16 year old boy can figure out how to do it, it’s hardly an act that needs 4 years of training. Many lay people have to give injections to their children/loved ones, learning how to draw blood takes about 2 hours, all these things are done by a myriad of workers in the community. It is grasping at straws to make these minor clinical acts a basis for a prosecution.

The original intention of seeking licensure started with midwives wanting to be paid under the National Medical insurance plan and to be protected from prosecution/persecution from the giant medical monopoly. That intent backfired right away due to the medical profession. Instead of embracing the midwives as colleagues, they began advising the clients of registered midwives to sue their midwife. There have been lawsuits against registered midwives here in B.C. where millions of dollars have been paid out to families. If a child has any type of neurological damage, the family physician advises the parents that “ the money won’t come out of your midwife’s pocket. That’s why they carry insurance. The insurance is there and you don’t know if your child will need special care that’s not covered by the National Medical insurance plan when he/she gets older. You’d better sue now.” Of course, they would never say that if the care provider was a physician. You can guess what happened then. The insurance rates for midwives right across the country went through the roof. Different provinces have different schemes for covering the midwives but the bottom line is that the government really doesn’t want more midwives because each midwife has to be subsidized for about $30,000 per year in order to provide insurance for her practice. If the midwives had to pay it all, they would be out of business immediately. The government also doesn’t want to give them a raise which leads to a great deal of bitterness on the part of the registered midwives.

Registered midwives are between a rock and a hard spot. They want to follow their dream and have happy, contented clients BUT they rely on the physicians to give them hospital privileges and, if they don’t toe the line of what the doctors wish them to do, they can lose those privileges or even lose their registration.

So, when you’re wondering what’s going on with registered-midwife-generated court cases to pound unregistered birth attendants out of business in Canada, this is some of the background. Because the numbers of registered midwives is low AND the midwives are so limited by the medical profession, there exists an alternative birth attendant market. There are a number of women throughout the country who still go out to help at home births without a blessing from the medical profession/government. They simply don’t want to work in that space between the rock and the hard spot.


Lisa Kusch Case in Saskatchewan, Canada

When a birth worker is charged with an offense in Canada, she receives legal advice not to discuss the case and not to speak with the clients involved. This makes things very difficult because she must raise funds to cover expensive legal bills and she can’t campaign on her own because of these restrictions.
I have asked for facts from different sources and submit the following information for those who are helping with the funding and care about my friend, Lisa Kusch.

Lisa in 2015

Lisa in 2015

In October 2016 Lisa was charged, as follows:
“It is alleged that between the 29th day of October 2014 and the 29th day of November, 2014 in Saskatoon Saskatchewan, Lisa Kusch “ DID ENGAGE IN THE BUSINESS OR PRACTICE OF MIDWIFERY, WHILE UNAUTHORIZED TO DO SO, CONTARY TO SECTION 23(2) OF THE MIDWIFERY ACT” (see below for the wording of that section of the Act).
That’s it. There are no specific details of what Lisa did or did not do. It seems to me that this is an overly broad and vague accusation. The document with the allegation was accompanied by emailed complaints filed by the birthing woman and the attendant at the birth (a doula/friend of the woman who accompanied her when she transported to the hospital).

Some of the information I have gathered which is to the best of my knowledge:
1. Lisa was not present when the baby was born.
2. Lisa is not a Registered Midwife and doesn’t represent herself as a Registered Midwife. That has been agreed upon by all parties and she is not accused or charged for this.
3. The woman was having her first baby and transferred to hospital for pain management. I am told that the baby was delivered by non-emergency c-section, at the mother’s request. The medical reason given was failure to progress.
4. Mother and baby were discharged from hospital on a normal schedule.
5. Lisa is accused in the complaints of causing poor outcomes and delayed recovery, due to excess blood loss during the surgery.

If Lisa is found guilty of a summary offense the result will be a fine of up to $4000. This is not a criminal case and it is not a civil case. The burden of proof is on the Crown to prove that the defendant practiced unauthorized practices according to the Midwifery Act of Saskatchewan. If one reads the applicable section of the act quoted in the charge above, it is vague in its definitions.
This case will set a precedent as it is the first in Saskatchewan and will have national implications.
The trial date is now set for October 24, 2017.

Start of Section 23 (2) No person shall engage in the business or practice of performing any of the authorizedpractices described in subsection (1) with respect to another individual unless:
(a) the person is a member who is authorized by his or her license to perform
that practice;
(b) the person is authorized pursuant to another Act to perform that practice;
(c) the activity is one of daily living and is performed by the individual or by
a person on the individual’s behalf. (end of section)

I submit the above to help people see the bones of this complaint and action against Lisa Kusch. Thanks for reading. I will update/edit as more info comes to light. Gloria Lemay, July 12, 2017

Some people have asked if they can send money for Lisa’s fund by bank transfer so I’ve set up a separate email and bank account for that purpose. The email address is lisakuschfund@gmail.com I’ll post periodic messages on the GoFundMe page about the total that comes in via bank transfer.
Lisa Kusch

The GoFundMe page to donate to the legal fund is at https://www.gofundme.com/lisakusch

Midwifery History Canada

I’m posting this article from 1991 to make the history of midwifery struggles in Canada available online. Thanks to Andre Picard, writer for the Globe and Mail (Canada) for granting permission. Gloria

Midwives no longer shrugging off attacks
ANDRÉ PICARD, The Globe and Mail (Canada)
Friday, November 29, 1991

THE death of a baby last week in Montreal has reignited the debate over one of the most emotional social policy issues in the province – midwifery.
Isabelle Brabant, a self-trained midwife who has delivered more than 400 babies, arrived at a hospital less than 10 minutes after the baby stopped breathing during a home birth and her resuscitation efforts failed. Doctors were also unsuccessful in reviving the infant.
Dr. Augustin Roy, president of the Quebec Corporation of Physicians, wasted no time condemning the tragic events, saying “home birth is a quasi-criminal act for a woman who has had a cesarean in the past.”
In the past, proponents of midwifery have shrugged off such attacks, saying doctors are more interested in maintaining the status quo (including revenues from hospital births) than in improving the quality of treatment.
Yesterday, however, they decided to draw a line in the sand.
“We’ve tolerated this witch hunt for long enough,” said Marie-Claude Desjardins, president of Naissance-Renaissance. “We demand that obstetrical violence end. . . . We demand that respect of women begin.”
Michele Champagne, president of the Quebec Alliance of Practicing Midwives, said: “Midwives are not endangering the lives of women and children any more than doctors are, and to suggest otherwise is a lie.”
Statistics compiled by the Office of the Coroner show there are about 350 deaths a year of children in their first week of life. One a day.
In the past five years, six of those deaths have been after midwife- assisted births. One a year.
There were about 97,000 births in Quebec last year, slightly more than 1,000 of them midwife-assisted.
Yet, midwifery remains in a strange sort of legal limbo. Last year, the government announced, as part of its massive health-reform package, plans for pilot projects that would lead to the licensing of midwives and their practicing in hospitals alongside doctors.
But the plan is stalled by the insistence of doctors’ groups that “self-trained” midwives be ruled inadmissible.
Because midwifery is not formally recognized in the law, there are no standards, but the Association of Practicing Midwives insists on all its members having a minimum of three years of training, and that at least two qualified midwives assist in home births. But, as the law stands, midwives are banned from doing their work in hospitals.
Polls in the province show 80 per cent of voters in favour of legalized midwifery, and legalization of the practice in Ontario has turned up the heat to the point where Quebec Health Minister Marc-Yvan Cote warned doctors that if they continue with their obstructionist tactics, he will skip pilot projects and go directly to legalization.
Three years ago, Ms. Brabant was attending another birth where the baby died. The subsequent coroner’s inquest, which many feared would be the death knell of the movement, exonerated her, and support for the cause has grown tremendously.
This time the Office of the Coroner has decided an inquest is not even warranted. That fact, coupled with the reaction of Dr. Roy, has convinced midwifery proponents that victory is near.
Micheline St-Onge, a parent whose child died during birth at a hospital, drove the point home, by bringing the debate back to its roots.
“We have to do everything to ensure the comfort of women and the safety of their children, so ultimately they must be allowed to make the choice between having their baby delivered by a doctor or a midwife,” she said yesterday.
“Very few people know just how painful it can be to lose a child,” Mrs. St-Onge said. “Why have things degenerated to the point where we have lost sight of that, where the death of our children is used merely to score” debate points.
“No child’s life should be cheapened to that point.”

© Copyright 2016 The Globe and Mail Inc. All Rights Reserved. Permission to share obtained.

Newborn Girl born at home

Newborn Girl born at home