In Canada there are over 1500 registered midwives, with approximately 150 new midwives graduating from post-secondary institutions each year. Midwives are licensed to provide care to low-risk pregnancies up to and during labour, as well as provide six weeks of post-natal care. But to many administrators of provincial, national, and international midwifery associations who believe in abortion-on-demand, midwifery is an ideal profession to increase the number of people in the health profession who are willing to commit abortions.

In Ontario, where more than 800 of Canada’s midwives work, the Association of Ontario Midwives has a page on their website answering questions about “midwives and abortion care” in which they state that though provincial regulations do not allow midwives to currently provide abortions anywhere in Canada, they are open to the idea of allowing midwives to receive funding for providing abortions and developing a midwifery model of abortion care. To those midwives who refuse a client’s request to abort their pre-born child, midwives must refer their patient to someone who will abort the child.

Katrina Kilroy, head of the Canadian Association of Midwives (CAM), claims that there is a growing interest among midwives nation-wide to provide abortions, saying that “this is not a contentious issue in the midwifery community.” On October 17, CAM will be holding a symposium in Quebec on global health, with one panel on “Abortion Care and Post-Abortion Care.”

The International Confederation of Midwives states that, as part of its basic midwifery practice, a midwife must be able to “prescribe, dispense, furnish or administer drugs (however authorized to do so in the jurisdiction of practice) in dosages appropriate to induce medical abortion” and “perform manual vacuum aspiration of the uterus up to 12 completed weeks of pregnancy.” Some countries, like Sweden, already expect their midwives to do abortions. To refuse, as pro-life midwife Ellinor Grimmark did in 2015, may subject the midwife to harsh penalties including denial of employment.

Despite claims from midwife organizations throughout Canada that there is a consensus that it is appropriate for midwives to become abortionists, there is evidence that a significant number of Canadian midwives would be uncomfortable actually taking part in the procedure. A 2011 survey of Ontario midwives in the Canadian Journal of Midwifery Research and Practice showed that 32 per cent disagreed that abortion should be included in the scope of practice of Ontario midwives (with most explicitly stating a strong disagreement), whereas 37 per cent agreed with abortion being added to the scope of midwife practice. The remaining 31 per cent were unsure, indicating a strong split in opinion on the matter. Additionally, the survey found that 24 per cent of Ontario midwives had moral objections to providing abortion services and 51 per cent would find it emotionally difficult to provide abortion services to clients.

In 2017, Canadian Midwives for Life (CML), a national organization of midwives who recognize that in a pregnancy there are two humans in their care and that they have a medical responsibility towards both the mother and the pre-born child, was founded to support pro-life midwives. CML believes that to target and end the life of a pre-born human for any reason is a violation of that child’s human rights and that it goes against a midwife’s responsibility for the health of their client.

CML provides a network for midwives who feel marginalized due to their pro-life values, and provides support for midwives who find themselves in morally compromising situations involving abortion. “There are many pro-life midwives who will feel their conscience rights are threatened if abortion is added to their scope of practice,” CML said in a statement provided to The Interim. “The difference of ideologies among midwives will likely never reach consensus, but for true respect and safety it needs to be acknowledged. The only conceivable reason that abortion was not considered a contentious issue in midwifery is because those who have an objection have felt silenced.”

But what ought to be the role of the midwife in response to mothers who are considering abortion? CML says midwives are in an ideal position to respond to this: “As midwives, we have the time, relationship and resources to respond to a woman considering abortion with questions, compassion, and real support,” CML stated. “If there’s something that would make a difference between her choosing life or death for her child, mustn’t we try to offer it? We will be seriously failing these women and their children if we don’t consider a request for abortion as a concern, but simply a health service for well women and well babies.”