Work Life Balance

Birth doesn’t happen on schedule. When you’re working in a client-centred profession like midwifery, unpredictable working hours come with the territory. This can create a challenge for midwives seeking a robust work life balance, particularly for those midwives who have families with dependents, or where they are the primary or sole income earner for their household. Some resources midwives use to work through these challenges:

  • Lifeworks. All AOM members can access 24/7support from Lifeworks. They can provide support for everything from finding a plumber in your area to securing a referral to a psychotherapist.
  • AOM On-Call. If the real source of your stress is a conflict within your practice, for example, you can get free support advice 24/7 from the AOM On-Call team.
  • Changing the nature of their work. For some midwives, the solution has been to change the nature of their work to suit both their needs and those of their communities. From the Spring 2015 issue of Ontario Midwife:

Although Stephanie Crouch is not providing midwifery services, she’s still bringing the principles and benefits of midwifery to a whole new group of women in her community. Currently working for an OB/GYN, Crouch provides some postpartum and well-woman care, while also running a pessary clinic for senior patients. Pessaries are used to treat incontinence and uterine prolapse for women in their childbearing years and beyond.

Though quite different from midwifery, Crouch finds her work at the clinic infinitely gratifying. Running appointments that allow time for discussion, getting to understand the patients’ concerns and forming relationships all benefit the women who come under Crouch’s care. Being fitted for a pessary can be physically uncomfortable, not to mention embarrassing for some patients, Crouch says. But getting to know her patients and taking a midwifery approach helps.

“[Women] feel comfortable coming to see me even if the procedure itself isn’t the most pleasant thing. I feel really good about that part of what I’m doing,” says Crouch.

Crouch works under a college- approved alternate practice arrangement (APA), outside of the traditional model and scope of midwifery. APAs require approval from the College of Midwives of Ontario and must serve the needs of the community. For example, Toronto midwife Jay MacGillivray has a CMO-approved APA that exempts her from providing home birth services because her HIV- positive clients give birth only in hospital.

Crouch began looking for new ways to practice several years ago when her partner fell ill and the demands of on-call work, paired with caring for her partner and small children, became too difficult to manage. She heard a local doctor was seeking help with the pessary clinic, and things quickly fell into place. Obstetrician Kim Rogers thought Crouch’s hands-on midwifery skills made her an ideal candidate for the position, while Crouch was looking for work that would allow her to continue to use her midwifery skills and training. “So it was fortuitous that Dr. Rogers was looking and I was looking,” Crouch says.

Crouch’s arrangement required the coordination of a few key pieces, including insurance coverage. “The AOM looked at what Stephanie wanted to do in the community, and we saw the gap that this work would fill. We were happy to work with HIROC to facilitate the right kind of insurance that would meet her needs,” says Bobbi Soderstrom, insurance and claims advisor at the AOM.

While the arrangement has helped Crouch’s personal situation, it also meets an important need in the community, she says. Wait-list times to see Dr. Rogers were sitting at two years before Crouch took over running much of the pessary clinic. With Crouch now dedicated to seeing those patients, women are receiving care faster from both the physician – whose time is freed up to address those on the wait list – and by Crouch, who can more easily fit in last-minute appointments.

Crouch acknowledges that only being able to perform delegated acts under Dr. Rogers’s authority has been a challenging element of her new work arrangement. But the independence she’s gained in running the pessary clinic has provided a lot of satisfaction. Crouch says she misses delivering babies and does see a time when she can come back to providing full midwifery care, if the right arrangement became available and if she could continue to work with the pessary clinic.