In Canada....

Midwifery is still a "new" profession and there is currently only three provinces that have schools for midwifery (Ontario, British Columbia and Quebec).

In Ontario, there are three universities which offer the 4 year midwifery program. Individuals are able to apply out of high school, however the majority of individuals who become accepted into the program have previous degrees.

Year 1 consists purely of in school academic work including courses in anatomy & physiology, women's studies, social work. The basics of midwifey are studied and there is alot of emphasis on the ethics of midwifery. Each student also spends one or two shifts on the labor floor to observe births. Then you get a summer off....

The first half of Year 2 continues to be in school academic work, with focus on pharmacology, reproductive physiology and an introduction to midwifery clinical skills.
Our first clinical placement begins the second semester of year 2 (and that is what I'm doing now!). With this placement, we spend 3 1/2 months at a midwifery clinic and essentially follow one or two midwives. Emphasis is put on giving informed choice discussions, laboring monitoring, labor support and most students end up doing quite a few four handed catches with a few being allowed to catch on their own depending on who their preceptor is. During the placement, students attend an online midwifery class once a week for three hours. Then you get a summer off....

Year 3 begins with another clinical placement. Similar to the previous placement, but the student is expected to know more and is given a little more independence. During the second semester of year 3 we do our community placements. This consists of one month following an OB (some even get to assist in c-sections), one month with the nurses on the labor floor and one month elective (Which could be with lactation consultants, at NICUs, with naturapathic doctors, or where ever else you feel would be beneficial to your midwifery education). No summer off!

Year 4 is a year long clinical placement and there is a focus on emergency situations that can arise during pregnancy and birth.

Also, before each clinical placement all students from each of the three universities gather together for an "intensive" course regarding the new skills they are suppose to master in the upcoming placement. This intensive usually lasts one week.


The midwifery education program in British Columbia was modeled after Ontario program and therefore it is quite similar and I am unsure of the structure of the midwifery program in Quebec as that is a purely french program.


Overall, there are ample job prospects for midwifery here in Canada (atleast in some provinces). In Ontario approximately 40% of women who seek a midwife are unable to get one. The waiting lists are huge and some communities do not have midwives at all! With that said, many Canadians are still very uneducated about midwifery and its existence in our country. The word is spreading though and as more and more women are telling others about their positive experiences the demand for midwives grows even larger!

British Columbia also appears to be in desperate need for midwives!

In the other provinces in which midwifery is not funded by the government (ie Alberta, Nova Scotia), the demand is not as large as many women are not willing to pay for the service out of their pockets, but still many midwives are able to maintain employment there.

Thanks Midwifey for that! Very informative.

Canada seems a really beautiful place, as a kid I really wanted to be a mountie! (still do sometimes)

Welcome to the forum.

It is so interesting to hear how your course is structured, very differently to here.

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I'm in Virginia, USA. My state started licensing "certified professional midwives" in December 2005. (This is a credential administered by the "North American Registry of Midwives." One can become a "CPM" through a MEAC-approved school (I don't know much about that avenue since I didn't chooses it - couldn't afford to take on debt when I have 3 children who'll be needing to go to university before too long). The other way to become a "CPM" is to do an apprenticeship with someone who is already a CPM or otherwise a documented experienced midwife. I chose the apprenticeship route, again, partly as a financial choice, but also because to me it seemed a very valid model, given how hands-on midwifery is in real life (as opposed to theoretical). I apprenticed with two different senior midwives (it is not required to work with more than one, although it is recommended because it's so good to see the variety of styles of homebirth midwifery. The apprenticeship training must be a minimum of one year in length, but unless the candidate has a great deal of preparation in advance, most often it is closer to three years in length. Among the requirements are a list of specified midwifery skills (e.g., counseling, prenatal care, care in labor, postpartum care, newborn care, lactation), each skill which must be demonstrated to the senior midwife's satisfaction. This list is 45 pages long and contains 750 separate skills. Additionally, the Apprentice must document to NARM, that she has attended at least 20 births as an "active participant," 75 prenatal exams (20 of which must be the initial exam), 20 newborn exams, 40 postpartum exams, and 20 births as the "primary midwife under supervision." When all of this is done, and completely documented, the application is submitted to NARM. After NARM reviews and audits the application (NARM randomly requests copies of client charts to confirm the accuracy of submissions), then the candidate is permitted to take a "Skills Assessment," with a "Qualified Evaluator," a midwife who has been trained to administer this test for NARM. In the Skills Assessment, the candidate might be asked to perform a routine prenatal examination (with a "live" expectant mum), a full physical exam, and or a newborn examination. Once this test is passed, the final hurdle is a comprehensive written examination which NARM offers 3 times per year. The cost is currently about $1500 in direct payment to NARM, and of course, the candidate incurs her own costs in securing an apprenticeship and getting the experience necessary to complete the requirements. For me, working with two different senior midwives, it was fairly expensive as one lived an hour and a half from me, and the other one half hour drive from me, and then in turn, each of these midwives served clients within a one and one half hour drive from their homes...so, suffice to say, I put A LOT of miles on my car during my apprenticeship... and spent tons on gas, which had just soared to all time historic high prices just in time to start my apprenticeship! I believe it's a great way to train a homebirth midwife, as I feel confident that I have the skills to serve women safely on my own now. (I've passed the Skills Assessment and am just waiting to sit the final written exam).
The other option that exists in Virginia, as in Kansas, is to be a CNM, or Certified Nurse Midwife. The schooling for that option has already been outlined, but I will add that in my state, the CNM's can only work if they have physician backup, and the physicians effectively get to mandate the CNM's protocols - i.e., who they can serve, and under what conditions. At this moment in time, this is more restrictive than how the CPMs may practice. Legislation is currently being proposed in our state to restrict the scope of practice of CPMs, so the future is uncertain here right now.
Last but not least, there are still (of course?!) traditional midwives - those who may or may not hold the CPM certification, who have chosen to remain in an "illegal" status, so that they can practice as truly independent midwives. They do so, unfortunately, at risk of being jailed if they are turned in for the "unlicensed practice of medicine." It is a grave error, IMHO, that midwifery has been categorized being r under the jursidiction of the board of medicine in our state. I believe midwifery is a separate and distinct discipline, and if it is to be regulated, it should be under a "board of midwifery," as the Midwifery Model of Care is so dramatically different then obstetric medicine as it is practiced in Virginia in 2008 (cesarean rates well over 30 percent, VBAC rates under 3 percent, induction rates hovering around 90 percents, etc.).
More than you were looking for, I'm sure, but I happen to be stuck in bed with a bad head cold (which was seriously exacerbated by staying awake for 49 straight hours at a birth on day 2 of this cold!).
Cheers to all my fellow international student midwives! Keep the faith.

Aotearoa New Zealand..

Direct Entry - 3 years full time, the RN - RM route is two years full time, but this is under review and will shortly be extended. Emphasis is very much on the Independent Model, or Lead Maternity Carer (LMC), which is enshrined in our legislation. So, the 'push' is for Midwives to get out there post qualification. The reality is somewhat different tho', as Independent Midwifery can take such a heavy toll on family life (relentless on call) - so many MW's will do 2 years in Indie practice then return to Core (hospital-based) for a break.
Partnership and the Treaty of Waitangi (our treaty with our Indigenous peoples) underpin Midwifery in NZ, together with the philosophy of Cultural Safety. In the 90's, NZ had a strongly feminist discourse running socially and politically, to some extent this has been sacrificed to the great god of consumerism - you may be aware of NZ's commitment to a nuclear free pacific and to Greenpeace in the '70's, too.

NZ's cultural influences beyond Maori and Pakeha (white) are Polynesia and Asia, so it's an excitingly diverse ethno-scape..more South Pacific than Australia.

I'm a rural Kiwi, so train via a peripheral hospital linked to a larger city university.

Job opportunities are great, but it's a user-pays system with no public funding, so St MW's can start out with a loan to pay back of $20,000 - $50,000. The loan is interest free (until they scan your passport as you leave for a better paid position in the UK/Australia.....then the interest goes on!) and can be paid off over many years...but it definately contributes to lower uptake of training and fall-out rates...

Great to read other folks' challenges!

xx

called2serve pretty much summed it up, i'll be doing the PEP program through NARM which basically checks off all skills learned by your supervising midwife. I am lucky and get to sort of float between the local midwives here. Apprenticeship is what drives me, I'm in process of enrolling in a traditional midwifery program called AAMI right now just to make sure i've covered all the info I need to pass that NARM exam. I'm not interested in birth in a hospital, though I know they can be wonderful, homebirth is where my heart is. I live in Boston, MA inthe USofA where homebirth midwifery is flourishing and for that I am very greatful.