Winter 2015 - Ontario Midwives
Transcription
Winter 2015 - Ontario Midwives
M IDWIFE ontario Winter 2015 Pictured: client Jennifer Song and her daughter Emilie at a prenatal appointment with midwife Sepideh Hashemitari. IN THIS ISSUE Advocating change to eye prophylaxis................4 Provincial wage gap consultations.......................6 Spotlight on rural midwifery................................7 Midwives partner with PCMCH..........................8 The secret lives of midwives................................ 10 Ontario Midwife Winter 2015 Welcome new practices and members Midwifery is growing! Two new midwifery practice groups were approved this year – Midwives of Middlesex & Area and Norfolk Roots Midwives. A total of 78 new midwives joined the profession between October 1, 2014 and November 19, 2015. This means the profession has grown by nearly 10% in the past year. Farhana Alam, New Life Midwives Kim Alderdice, Midwifery Care of Peel and Halton Hills Catherine Alstrup, Community Care Midwives Sarah Anderson, Access Midwives Melanie Beauchamp-Grandmaitre, East Ottawa Midwives Alison Bekendam, Community Midwives of Hamilton Ashley Bennett, Madawaska Valley Midwives Lara Bernstein, Burlington and Area Midwives Nicole Boudreault, Midwives of Sudbury Jesse Brown, Community Care Midwives Caty Bush, Community Midwives of Hamilton Amy Callahan, Midwifery Services of Lambton-Kent Liz Cates, Midwifery Care-North Don River Valley Megan Cook, Niagara Midwives Amanda Cordocedo, Midwives Collective of Toronto Jessica Core, Midwives Grey Bruce Leah Crawford, Seventh Generation Midwives Toronto Debra Crumb, Community Midwives of Halton Katie Darling, East Mississauga Midwives Vanessa Dixon, The Midwives’ Clinic of East York-Don Mills Jenna Falk, Midwives of Headwater Hills Harriet Ann Ferrant, Ottawa Valley Midwives Anne-Christine Foisy, Neepeeshowan Midwives Jacqueline Gaudette, Talbot Creek Midwives Emily Gaudreau, The Hamilton Midwives Christine Geiger, Midwifery Care of Peel & Halton Hills (Brampton) Karen George, Family Midwifery Care Hava Glick, Community Midwives of Toronto Helen Guenther, Ottawa South Midwives Shannon Halvorsen, Community Midwives of Thunder Bay Ayeshah Haque, Midwives of Chatham-Kent Tiffany Holdsworth-Taylor, Midwifery Services of Haliburton-Bancroft Sarah Hook, Community Midwives of Hamilton Bounmy Inthavong, Blue Heron Midwives Sanaz Kama, Diversity Midwives Fatemeh Keivan-Far, Midwives of East Erie Jewell Kirkopoulos, Access Midwives Karolina Kullerstrand, Midwifery Care of Peel and Halton Hills Andrea Lindenbach, Midwives of Algoma Catherine Lombardo, Midwifery Group of Ottawa 2 Association of Ontario Midwives Kathy Macerollo, Riverdale Community Midwives Arlaine MacLennan, Access Midwives Kate Mansbridge, Kensington Midwives Tylee Maracle, Midwifery Collective of Ottawa Brigid Matheson, Genesis Midwives Keren Menashe, Midwife Alliance Lisa Middleton, Midwifery Collective of Ottawa Emma Miles, Gentle Beginnings Midwifery Rebecca Moore, Midwives Grey Bruce Kathryn Nelder, Womancare Midwives Amy Nelson, Barrie Midwives Pamela O’Farrell, Community Midwives of Brantford Ashley Park, East Mississauga Midwives Kelsey Peppler, Midwives of Sudbury Mimi Pothaar, Midwives Nottawasaga Claire Ramlogan-Salanga, Guelph Midwives Emily Roth, Countryside Midwifery Services (Palmerston) Megan Seargeant, Maternity Care Midwives Thunder Bay Maggie Seegmiller, St. Jacobs Midwives Amanda Sgrignoli, Midwives Collective of Toronto Angela Silcock, Midwifery Care-North Don River Valley Alexia Singh, Uxbridge Stouffville Midwives Kinshasa Steele, Huron Community Midwifery Services Karlee Stevens, Access Midwives Leslie Stevens, Niagara Midwives Rebecca Thompson, Thames Valley Midwives Kimberley Tigani, Community Midwives of Kingston Amanda Tomkins, Midwives of Windsor Anna Trippel, Uxbridge Stouffville Midwives Angela Umoh, The Hamilton Midwives Krista Weatherston, Maternity Care Midwives Thunder Bay Leah White, Community Midwives of Kingston Lisa Wiley, Thames Valley Midwives Justine Wilson, Stratford Midwives Jenna Wilson, Burlington and Area Midwives Christina Winger, Community Midwives of Halton Corine Witteveen, Cambridge Midwives Laura Wood, Midwifery Care of Peel and Halton Hills Ontario Midwife Winter 2015 The working (and secret) lives of midwives by Lisa M. Weston, President This issue of Ontario Midwife reveals both the working and the secret lives of midwives. For example, we talked to two solo midwives about the collaborative dynamics necessary to support rural midwifery care (see page 7). We got to delve into the impact midwives are making at a provincial level in our story on the Provincial Council for Maternal and Child Health (page 8). And we especially enjoyed being able to take a peek into their lives when they’re not on call (hint: it involves astronomy, art and axe throwing. Yes, you read that correctly—check out page 10 for more). Ontario Midwife is published three times a year by the Association of Ontario Midwives and is available online at OntarioMidwives.ca or you may request a printed copy. But I’ll be honest—pulling together a newsletter on the working lives of midwives while also fighting for the appropriate valuation of that work has sometimes been challenging. As we go to press, our leadership is in the thick of working with government on a variety of matters that impact how midwives work and how they get compensated for it. Making the right decisions for and on behalf of midwives—a profession deeply committed to pay equity— demands the greatest of judgment calls. Even for our most skilled leaders and advocates, this work can be tremendously challenging. In a way, though, that’s the reality of life in the midwifery sector. Midwives must make quick decisions while thinking on our feet, consulting with other experts in the moment. Using a combination of education, experience, input from trusted colleagues and, sometimes, gut instinct, all result in a series of decisions that support the best outcomes. It’s what midwives do every day and what your professional association is always trying to do too. Sincerely, Lisa Executive Director: Kelly Stadelbauer Midwife Advisor: Jasmin Tecson Editor: Juana Berinstein, Director of Policy and Communications Managing Editor: Sabina Hikel Contributors: Tahlee Afzal Jill-Marie Burke, Amber LepageMonette. Design and layout: Laurie Barnett We welcome your feedback. Please contact [email protected] Follow @OntarioMidwives for daily news and updates. AOM staff announcement Join us in welcoming Cheryllee Bourgeois as the new Director, Clinical and Professional Development at the AOM. Cheryllee has extensive experience as a registered midwife, an educator, and a leader in the midwifery community. She is a founding member of Seventh Generation Midwives Toronto and currently serves as the president of the board of directors at the Toronto Birth Centre. Cheryllee is also an instructor and Aboriginal coordinator at the Ryerson midwifery program, and is completing a Masters of Education at York University in the Urban Aboriginal Education Cohort. Association of Ontario Midwives 3 Ontario Midwife Winter 2015 Bit.ly/Amalie-dealing-with-eye-drops by Lars Ploughmann is licensed under CC BY 2.0 (creativecommons.org/licenses/by-sa/2.0/) Advocating change to eye prophylaxis Belleville midwife Liza van de Hoef didn’t have a history of public advocacy or activism. But she felt so strongly that the Ontario government should end the mandatory administration of erythromycin ointment into eyes of all newborns that she launched a grassroots campaign that has garnered the support of midwives and other health-care providers, midwifery clients, doula groups and politicians. The campaign reached a major milestone on November 30 when MPP Todd Smith (Prince EdwardHastings) presented van de Hoef ’s petition with over 1400 signatures in the Legislative Assembly of Both the AOM and the CPS are calling on the government to change the outdated eye prophylaxis law. More details about the scholarly research can be found in their position statements. To read the CanadianPaediatric Society statement on eye prophylaxis visit bit.ly/CPSstatement The AOM statement can be read at bit.ly/AOMeyeprophylaxis 4 Association of Ontario Midwives Ontario. The petition also had the support of NDP Health and LongTerm Care critic France Gélinas and Sophie Kiwala, Liberal MPP for Kingston and the Islands. Prior to the presentation of the petition, van de Hoef, midwifery researcher Liz Darling, PhD and midwifery consumer Laura Hardy spoke at a press conference at Queen’s Park. Van de Hoef is optimistic that the groundswell of support for the campaign will lead to a change in law. While Ontario’s Health Care Consent Act recognizes parents as the most appropriate substitute decision-makers for their child, the prevention and treatment of communicable diseases in newborns’ eyes are exempted from this Act. Research evidence has shown that erythromycin is limited in its effectiveness against chlamydia or gonorrhea, the two most common causes of neonatal eye infections that could cause blindness. Despite this, the Ontario Health Protection and Promotion Act requires midwives and physicians to administer erythromycin ointment within one hour after a baby is born. If parents refuse to have the ointment administered, the Children’s Aid Society may be called and the baby could be removed until ointment is administered. Both the Association of Ontario Midwives (AOM) and the Canadian Paediatric Society (CPS) have issued similar position statements against this outdated public health policy, which is no longer supported by clinical research evidence. “CPS believes that physicians caring for newborns should advocate for the rescinding of these mandatory neonatal ocular prophylaxis laws,” says Dr. Dorothy Moore, one of the principal authors of the CPS position statement. “It would be more effective to screen all pregnant women for gonorrhea and chlamydia infection and treat and follow-up those found to be infected.” In addition to screening all pregnant women, with treatment for those affected, neonatal eye prophylaxis could be offered to parents following an informed choice discussion. Parents could choose or decline the intervention based on their personal risk factors and the evidence for the intervention. Ontario Midwife Winter 2015 “It would be more effective to screen all pregnant women for gonorrhea and chlamydia infection and treat and followup those found to be infected.” Dr. Dorothy Moore For van de Hoef and her colleagues, the law creates a major challenge to client-centred care. They know the ointment is ineffective, but they can’t break the law or risk being fined thousands of dollars for not administering it. “I’m committed to family-centred care and informed choice,” says van de Hoef, “so I have to tell families about the evidence, then I say ‘but you don’t get a choice on this.’ It’s frustrating to say ‘the evidence says this doesn’t work, but we’re going to do it because it’s the law.’”. The work van de Hoef has undertaken, however, may just change that law. Health Minister Eric Hoskins recently referred the issue of mandatory eye prophylaxis of the newborn to the Provincial Infectious Disease Advisory Council (PIDAC) to consider the evidence and make recommendations to the Ministry of Health and LongTerm Care. Midwives applaud this important step. At the Queen’s Park media conference: (bottom row, left to right) midwifery researcher Liz Darling, Belleville midwife Liza van de Hoef, midwifery client Laura Hardy; (back row, left to right) NDP Health and Long-Term Care critic France Gélinas, Conservative MPP Todd Smith (Prince Edward-Hastings) and Sophie Kiwala, Liberal MPP (Kingston and the Islands.) BACKGROUND • • • • Mandatory ocular prophylaxis laws were introduced in the 1800s before routine antenatal public health screening for STIs and the discovery of antibiotics. The original formulation used silver nitrate eye drops, a very effective but highly irritating solution. Adopted as a public health policy, the practice greatly reduced the incidence of blindness caused by certain infectious diseases transmitted to the baby at birth. Today, we use an antibacterial ointment called erythromycin, which is limited in its effectiveness against either chlamydia or gonorrhea–the two most common causes of ophthalmia neonatorum. LEGISLATION • • • • Ontario’s Health Care Consent Act protects the decision-making authority of patients. In the case of minors, parents and legal guardians are recognized as the most appropriate substitute decisionmakers for their children’s care. Mandatory eye prophylaxis is enshrined in Ontario’s Health Protection and Promotion Act. It is also exempt from the Health Care Consent Act, which means parents CANNOT refuse this practice for their babies. CONSEQUENCES • • • • Lack of a clear legal process for opting out of neonatal eye prophylaxis affects both midwifery clients and midwives. Parents who refuse treatment are subject to investigation by public health and child protection agencies. Health-care providers who refuse to administer the treatment are subject to hefty fines. Mandatory eye prophylaxis undermines the authority of parents to make decisions in the best interests of their children. Association of Ontario Midwives 5 Ontario Midwife Winter 2015 The “caring dilemma” is one midwives struggle with day-to-day: balancing caring for clients, newborns and their own families while trying to address the pay gap. Midwives share personal experiences at provincial wage gap consultations Rebecca Hautala, a registered midwife and a mother of three young children, thought twice before attending the government’s wage gap strategy consultation in Thunder Bay. That week, she had a hectic on-call schedule and had already missed several dinners and bedtimes with her children. Attending the town hall in the evening would mean missing more time with her kids. This “caring dilemma” is one midwives struggle with day-to-day: balancing caring for clients, newborns and their own families while trying to address the pay gap. As part of Premier Wynne’s directive to the Ministry of Labour, the government’s Gender Wage Gap Steering Committee launched public consultations in Ontario on October 26, 2015. The committee has scheduled town hall meetings across the province to hear firsthand the impact the gender wage gap has on individuals and communities. Once the consultations are complete in February 2016 the committee will make recommendations to the government on ways to close the gap. The gender wage gap in Ontario is 31.5%. This means that the average woman earns approximately 68 cents to every dollar that a man earns. According to a pay equity expert Paul Durber, midwives only get paid 52% of what their work is worth, experiencing a significant gender penalty on their pay (see the full Durber Report at ontariomidwives.ca/support/ equity/resources). Generations of midwives have been providing care despite the gap; newer midwives spoke at the consultations about the impact of having to pay off student loans, and late-career midwives have articulated concerns about retirement. Midwives have also discussed feeling undervalued working in a female-dominated profession that focuses on women’s health-care needs. Ultimately, midwives across the province have reported feeling that the wage gap consultations have been useful. “I went in feeling the meeting was likely futile, but came away feeling empowered and heard,” Hautala says. Midwives have spoken to the impact of the gap at consultations in Cornwall, Ottawa, Toronto and Scarborough. In Burlington, a record-breaking 21 midwives were in attendance. As midwives and consumers continue to participate in consultations across the province they will be watching the panel’s progress to ensure that the recommendations are translated into concreate action by Ontario’s government. The committee has invited individuals and organizations to further participate by sending in submissions in response to the Consultation Reports by January 15, 2016. The Wage Gap Strategy Consultations will be held till February 2016. For further details and a full schedule visit labour.gov.on.ca/english/about/ gwg/consultation.php 6 Association of Ontario Midwives From left to right: Maureen Silverman, RM; Carolyn Scott, RM; Amanda Sorbara, RM; lawyers Jen Quito and Mary Cornish; Amy Belair, midwifery student. Ontario Midwife Winter 2015 Spotlight on rural midwifery Necessity is the mother of invention ... and just one of the dynamics that drives collaborative, forward-thinking models of practice in rural settings. When you’re providing care in a small community with a level 1 hospital and no obstetrical or pediatric staff, good working relationships, flexibility and a cando attitude are a necessity. “You have to establish good relationships,” says midwife Melanie Guerin who practices in her hometown of Hearst, population of just over 5,000. In addition to having her clinic located in the same building as the family health centre, Guerin has an excellent relationship with Dr. Richard Claveau, one of the local family physicians who was her support person when she established her practice and now covers her clients when she’s offcall or away. “I leave my clients in his hands,” she says. “He knows the way I work.” For her part, Guerin has been brought into the on-call schedule at the hospital. “By working this closely together, our clients and patients are supported and able to stay in the community. Because of our team model, clients don’t have to leave Hearst to get the care they need,” Guerin says. Midwife Judy Rogers (far left) and RN Karen Beck-Sanderson admire baby Grace, being held by mom An Le. Delivering the best care possible and keeping care close to home is also at the heart of Judy Rogers’ model. Rogers opened her new Parry Sound practice in 2013, and she too is on the hospital rota on-call schedule and covers for physicians. It’s one of the main reasons why she received instruction and training in performing vacuumassisted deliveries. “If a midwife was the person oncall for the week and a woman had abnormal fetal heart tones and could have had a vacuum delivery with a doctor, it wasn’t appropriate to have a C-section just because a midwife was on-call,” she says. Rogers also hopes to be able to order oxytocin for augmentation of labour through medical directives. The next step for Guerin is to be a surgical assist to the family physician who performs C-sections in their community. In addition to being a practicing midwife, Rogers also serves as an associate professor at Ryerson University and has extensively researched maternity care in rural and remote communities. “I’ve always felt midwives could make a contribution to sustainability in maternity care in rural communities,” she says. As her and Guerin’s work shows, she’s right. The AOM report Rural and Remote Maternity Care in Ontario (bit.ly/AOMrural-remote) provides analysis of the challenges facing rural maternity care providers as well as recommendations to ensure care that is accessible, culturally appropriate and close to home. Earlier this month, a newly released joint paper marked a major moment for rural medicine in Canada. A collaboration between the College of Family Physicians of Canada, the Society of Obstetricians and Gynaecologists of Canada, the Canadian Association of General Surgeons and the Society of Rural Physicians of Canada, the statement recommends family doctors with enhanced surgical skill provide services such as C-section and the development of networks of surgical and maternity care that include obstetricians, general surgeons and family doctors able to perform surgery. The paper can be viewed at bit.ly/srpc-jointpaper Association of Ontario Midwives 7 Ontario Midwife Winter 2015 “I think this opportunity is somewhat unique because we are focusing on the care of healthy pregnant women, which is central to the work midwives do.” Liz Darling, RM Midwives partner with the PCMCH to support maternal newborn care strategy Midwives have embraced the opportunity to share their expertise with the Provincial Council for Maternal and Child Health (PCMCH) as it advances the maternal-newborn agenda in Ontario, in close collaboration with patients, families and healthcare professionals. The PCMCH is an arms-length advisory body for government with the mission of improving the delivery of maternal child health- Midwives Remi Ejiwunmi (pictured) and Liz Darling are on the leadership team of the PCMCH’s Low Risk Maternal Newborn Strategy Expert Panel. care services by building provincial consensus regarding standards of care, and leading practices and priorities for system improvement. A number of midwives have been appointed to the PCMCH. Vicki Van Wagner is the first midwife to be a member of the Council itself. From 2009 to 2015, she was a member of the Maternal Newborn Advisory Committee (M-NAC), and recently, midwives Beth Murray-Davis and Carla Sorbara became members of M-NAC. Five midwives are participating in the Low Risk Maternal Newborn Strategy Expert Panel; Liz Darling and Remi Ejiwunmi are on the leadership team and Judy Rogers, Carla Sorbara and Sara Wolfe are panel members. Finally, Tracy Pearce-Kelly and Carla Sorbara are on the Low Risk Birth Quality Based Procedure Expert Panel. AOM President Lisa M. Weston says she’s pleased that the PCMCH has invited midwives to collaborate with other maternity care experts to shape the future of maternal-newborn care in Ontario. “Eighty per cent of births in Ontario can be considered normal and, as experts in lowrisk birth, midwives will be able to provincially champion the practices they use with individual clients every day,” says Weston. Remi Ejiwunmi says that by proactively recruiting midwife participants, the PCMCH has acknowledged the importance of having a midwife voice and is consciously engaging midwives as equal partners at the table. “They recognize that we have a significant role to play in everything to do with maternal and newborn care,” says Ejiwunmi. Ejiwunmi and Darling (who job-share one position) sit on the Low Risk Maternal Newborn Strategy Expert Panel’s leadership “They (PCMCH) recognize that we (midwives) have a significant role to play in everything to do with maternal and newborn care.” Remi Ejiwunmi, RM 8 Association of Ontario Midwives Ontario Midwife Winter 2015 Midwife Liz Darling (right) says the time is right for midwives to be involved in the work of the PCMCH. team with an obstetrician, a family physician and a registered nurse. It makes sense that this interdisciplinary group is tasked with identifying barriers to better collaboration within the healthcare system. “Our aim is to flip the system on its head to create a patient or client-centred strategy for low-risk maternal newborn care, rather than a provider-driven one, because there’s good evidence that this approach is best practice. This will make it possible for us to highlight to the Ministry (of Health and Long-Term Care) the necessary changes to the system that need to happen in order to create the solution and enablers to making those changes a reality,” says Ejiwunmi. Liz Darling says that in the past much of the PCMCH’s work was related to high risk pregnancies, which midwives aren’t involved with in their day-to-day clinical work. Now that the PCMCH is shining a spotlight on low risk birth, the time is right for midwives to be involved. “I think this opportunity is somewhat unique because we are focusing on the care of healthy pregnant women, which is central to the work midwives do. This is an issue where our voices are really valuable,” says Darling. Darling is also enthusiastic about working with her new colleagues to explore innovative solutions. “It’s an opportunity for maternal care in general and for women and families in this province to potentially envision something that’s different than what we’re already doing and that goes even further to meet the needs of women and families - to make care as satisfying as possible for them, while at the same time making sure that we’re providing good quality care and maybe using our health-care resources more efficiently,” says Darling. Low Risk Maternal Newborn Strategy Expert Panel member Judy Rogers says her values and goals are aligned with those of the panel, which has chosen the vision statement “The Best Possible Beginnings for Lifelong Health.” The panel, says Rogers, has a strong commitment to woman and family-centred care that is culturally respectful and as close to home as possible. “There’s a real desire to hear from clients because there aren’t many organizations in Ontario that represent the people receiving the care,” says Rogers. Judy Rogers and the other midwives who have partnered with the PCMCH look forward to collaborating with patients, families and other health-care professionals in the months ahead to support the PCMCH’s vision of the best possible beginnings for lifelong health. Association of Ontario Midwives 9 Ontario Midwife Winter 2015 Secret lives of (off-call) midwives Remi Ejiwunmi Midwifery Care of Peel and Halton Hills AXE THROWER Every Monday night, for the last two years (when I haven’t been at a birth) you’ll find me throwing a hatchet at a target and hanging out with a great group of people. I first learned about axe throwing in December 2013 when I attended a private axe throwing event with friends. The Backyard Axe Throwing League has multiple locations and runs both axe throwing leagues (like darts, but with axes) and private events. After our three-hour session (with lessons and mini tournament) my friends and I were hooked. Several of us joined the league and have been attending since. It’s a great stress reliever and a lot of fun! Beth Murray-Davis Community Midwives of Hamilton SPORTS FAN & ASPIRING BAKER Here is what weekends off call in October looked like: first up, a glass of wine! But half -ay through my first glass, reality sets in; I’m too sleepy! So off to bed I go. I wake and go for a run with my running club, pager free! I have big plans to bake all day but realize it will take more time and effort than I can afford so instead I just watch a Great British Bake Off marathon while texting with fellow midwives who are fans of the show. Then I prepare for my big responsibility of being a Jays fan. Games to watch, tweets to write, stats to catch up on. All the while checking in with my family and planning to babysit my lovely 16-month-old nephew the next day. Life is good! Sandra Gervais Ottawa South Midwives EXECUTIVE MBA STUDENT, MARTIAL ARTS PRACTITIONER & STAR GAZER Since September 2015, I’ve been enrolled in the executive MBA program at Ottawa University. Thanks to this demanding program, I have little time for anything else other than studying and working as a midwife part-time. Prior to returning to student life, I regularly trained in martial arts and gazed at the stars as part of the Ottawa Centre of the Royal Astronomical Society of Canada. Can’t wait to get back to star gazing soon! Stargazing (bit.ly/1IQucqV) by davejdoe is licensed under CC BY 2.0 (creativecommons.org/licenses/by-sa/2.0/) 10 Association of Ontario Midwives Ontario Midwife Winter 2015 Jasmin Tecson Sages-Femmes Rouge Valley Midwives ARTIST I make Art Trading Cards (ATCs). They started in Switzerland as a way for artists to try out new techniques, mediums, or styles. The only consistent thing is that the cards must be the size of a baseball card. Most are made to be given away or traded. Artists will get together to make cards, with time at the end to show off their creations and exchange them. Sometimes distance exchanges are organized by artists through the mail. That way there’s the fun of receiving a package, as well as discovering what other artists came up with. I heard about ATCs a few years ago when I dropped into a workshop at a local artists’ workspace. I’ve since continued to make them on my own, but my favourite is making them alongside others so we can swap them after. Natalie Wright Orillia Midwives TRIATHLETE & PHILANTHROPIST Outside of my midwifery life, I compete in the 5 Peaks trial running series. Our team, Still Thrive(ing) is the defending champions for two years in a row now. I also compete in the Subaru Triathlon Series, Sprint Duathlon events, and came first in my age group this year. I also enjoy paddle boarding, mountain biking, snowshoe running and cross-country skiing. I am a volunteer medic at Hardwood Ski and Bike for mountain biking and cross-country skiing. I recently qualified to compete for Canada at the World Duathlon Championships in Spain, June 2016. I do these events because not only do I enjoy the adrenaline rush from competing, but it helps me keep balance in my day-to-day life. Midwifery is all about caring for someone else. While training for these events is hard work, it is dedicated time for me. I run because it is MY time. A morning run helps me start the day fresh. An evening bike ride helps me process the day. A tough race helps me process unsettled thoughts and relieves any stressors that I have been carrying around with me. I’ve recently decided to combine my love of sport and am using the World championships as an opportunity to fundraise for Wakunga (www.wakunga.ca - my NGO) and give back to the women of Kenya as I train my way to Spain. Why do I love making them? I love the small format. It’s contained and I can finish a piece in a couple of hours. It fits in well with the on/off-call cycle: small art for small windows of creative time. I can express myself creatively and re-balance, and have the satisfaction of completing something pleasing too. I’m a really tactile person and enjoy textures, so I try to represent that with mixed media, different papers, layers, and collage. Every card has an element of serendipity to it so most are very different, even ones like my “Clinical Spanish for Superheroes” series. Association of Ontario Midwives 11 Con O _ l N ua Ontario Midwife Winter 2015 aom .on R R tion/An E T ca I S g_Edu G E uin ont C / .ca W! n f e re ce/ n in Midwives supporting a shift to low-risk care May 16-18 Niagara-on-the-lake 12 Association of Ontario Midwives White Oaks Resort and Spa