Jeen Kirwen, retiring Quebec midwife, says profession still 'not understood'
Retiring Eastern Townships midwife says regulation has taken 'soul' out of profession
A pioneering Quebec midwife who worked in the Eastern Townships for 45 years says she's worried the provincial healthcare system is transforming the historical role of the profession.
Jeen Kirwen, who began working as a midwife 25 years before the practice was legalized, said legalization has "taken a lot of the soul out of midwifery, because now we have to prove how safe we are."
Kirwen said midwives now have to prove their worth in a medical context, not in a "midwifery world."
They now perform a host of medical testing, diabetes screening and other monitoring.
"I find all this progress, it's all good, but we're losing something," Kirwen said.
Midwives have always performed an observational and supportive role during a process women's bodies are biologically designed to do, she said. Now in the legalization process, we have to start doubting that.
There are still significant misconceptions, and some fear, associated with the profession in the general public and even in some medical environments, she said. Twenty years after legalization, it's disappointing to see, she said.
Kirwen was at the forefront of the provincial battle to gain legal status for the profession. She said the politics around that battle were draining and the ongoing issues are in part what motivated her retirement.
Perception of the midwife
When Kirwen started out, there was no midwife training in post-secondary schools.
Her education came through books and from speaking to midwife organizations in Scotland about how they operated.
Because of the negative perception of the practice that preceded legalization, she advised her patients to keep a low profile about their decision to use a midwife.
"I said that family members and friends who really didn't believe in what they were doing, it would be better to tell them after," she said.
Kirwen said she didn't fully realize the importance of being more secretive until two cases were brought against midwives in the province.
In the wake of those cases, Kirwen had a lawyer draw out a consent form that parents of the unborn child could sign. While it likely wouldn't have legally protected her, Kirwen said it clarified the mother's intent and consent.
Even before legislation was passed, the midwife organization, le Regroupement Les Sages-femmes du Québec, set out clear protocols for the professionals in preparation.
"We had our mission statement, our philosophy. It gave us a more serious look," said Kirwen.
"We weren't just hippy girls playing doctors. We wanted to be serious professionals."
A love for people
Kirwen became a midwife after giving birth to her first child and she felt the "power" in her contractions.
Above all, she said she'll miss holding newborns and the interaction she had with parents.
"I love babies so much," said Kirwen.
Kirwen said she stopped counting how many babies she delivered after she got to 2,000.
Some facts and figures about midwifery in the province:
- As early as last year, 20 per cent of midwives in Quebec were unemployed despite there being a great demand for them in the province.
- A report earlier this year showed that only 3 per cent of pregnancies were overseen by midwives.
- Most recently, the Quebec government passed Bill-10, increasing the overall responsibility of midwives in the healthcare system.