Winnipeg birthing centre numbers still 50% below target levels set when it opened in 2011
Shortage of funding, midwives puts that goal out of reach: Ode'imin executive director
It's been open for more than a decade, but Winnipeg's $3.5-million birthing centre has not been able to reach close to its intended target number of newborns each year.
Ode'imin, previously known as the Birth Centre, opened in 2011 with a goal of handling 500 births annually, but it has yet to hit even 50 per cent of that capacity.
"We'd love to be doing 500 births," executive director Kemlin Nembhard said. "The way the resources are right now, I would say no, we can't safely actually support more [than we are currently]."
Nembhard says the target is simply not attainable with current staffing and funding levels.
"In a lot of ways, we need more midwives trained in the province — more funding for midwives and more supports for the birth centre assistants," she said.
There are four birthing rooms at the centre, which caters to women with low-risk pregnancies.
In 2012, the centre's first full year of operation, 120 babies were born at the facility. That number has slowly increased each year, peaking in 2019 and 2020 when 237 babies were born in each of those years. The number of admissions has also climbed.
Approximately 12 per cent of admissions result in transport to hospital for labour, according to the Winnipeg Regional Health Authority (WRHA).
The centre's requirements are also limiting admissions.
A woman's pregnancy must be deemed low risk and she also must be in the care of a WRHA midwife and live within Winnipeg or Churchill (which falls under WRHA territory).
"We get lots of people who would love to give birth here, but who are in the Southern Health region or in the Interlake," Nembhard said. "If you're outside of [the WRHA] jurisdiction, then you have to look for a midwife in your own health region, and so that's a limitation."
There is no lack of interest within the region. There is currently a roughly four-week wait just to get a call back for the intake list.
"When you're looking at such a time-sensitive situation, that's a long time to wait," Nembhard said. "Not knowing, 'Am I going to have to find an obstetrician? Am I going to have to be looking at birthing at home or in a hospital?'"
It's a problem that has plagued the facility since its opening, Nembhard says, and it's not just about funding — the lack of midwives makes matters worse.
Continuing shortage of midwives
Nembhard says in a time when the health-care system and hospitals are overwhelmed, it makes sense to invest in services that can alleviate the pressure and funnel more people away from hospitals.
"While obstetricians and doctors have a really important role to play, I think we also want to look at other resources to support people who are pregnant, [and giving birth] doesn't necessarily have to be in a hospital," she said.
According to the WRHA, more than a quarter of requests for midwifery services are unsuccessful. As of mid-December, there had been 1,098 requests for midwifery services within the WRHA, with 801 accepted.
"Between 2021 and 2023, Ode'imin has had an average of 23 midwives available for on-call services, with some vacancies to be filled," Nembhard said. "Recruitment is ongoing for those positions."
However, the College of Midwives of Manitoba says only 16 midwives currently work at the facility. The college also noted there are only three people expected to graduate from the midwifery program this spring.
Expanded services at centre
Since it opened, the centre has also been able to expand the services it offers.
Total clinic visits have more than doubled since Ode'imin opened, jumping to more than 8,000 in 2022 from roughly 3,500 in 2012.
Ode'imin is also home to a breast milk bank where donors make deposits for use by new mothers. It also operates a universal infant hearing screening program.
Care continues for at least six months after the baby is born, Nembhard said.
"We have a lot of family programming. We do stuff around birth weight … we support all of the home births," she said. "We also have a lot of family programming for new parents who want to do things in a community way."
One of its newest programs is the Dragonfly Support Program for those whose pregnancy resulted "in a birth in Spirit world instead of in the human world."
Nembhard said there are a lot of services that can be offered outside of a hospital setting that can better help the entire system and support moms and families, but they also require funding support.
Provincial response
Manitoba's health minister says it's important to focus less on the target set out by previous governments.
Instead, Uzoma Asagwara says, the focus should be more on making sure that women and families have the opportunity to give birth where they want.
"We are looking at many ways to strengthen birthing services across the province. Ode'imin provides a really good template, a shining example of the quality holistic wraparound care that women and families, pregnant people deserve in Manitoba," Asagwara said.
Asagwara says the government has been in communication with the Women's Health Clinic to better understand its needs and develop a strategy for the future, and is committed to ensuring women across the province have access to the care they need to plan their families.
Asagwara also pointed to cuts made by the previous government for exacerbating the dearth of midwives.
"The previous government attacked midwives, they attacked women's health care quite frankly, right from day one," Asagwara said. "Our government is going to listen to midwives."
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