The BC College of Midwives is conducting an investigation into a Quadra Island woman, Moreka Jolar, who it claims is illegally doing the work of a midwife while claiming to be a traditional birth attendant.
College Registrar Jane Kilthei tells the Mirror that Jolar has been on the College’s radar since 1998 and became an issue again this summer after the BC Ambulance Service flagged her role in the August birth of Morgan Stewart-Webb.
Morgan’s life was saved by his dad Noah Webb, 25, a volunteer fire fighter whose training kicked into high gear after Morgan’s mom, Amanda, 28, went into labour three days early and gave birth in the couple’s backyard wading pool. Often babies take a few seconds to breath, but baby Morgan did not and the 911 call was made.
Noah said later: “I’ve done quite a bit of training to do CPR, but I never thought I’d have to use it.”
He inserted an airway and continued to work on the infant until paramedics arrived.
Kilthei says she was contacted by “someone very senior in the BC Ambulance Service.” Apparently, paramedics at the Quadra birth were troubled by what they encountered.
The College alleges Jolar “provided midwifery care to a woman and her newborn in Quathiaski Cove on Quadra Island on Aug. 15 including managing this woman’s labour and delivery on her own responsibility.”
“Jolar delivered a newborn male with a heart rate of less than 60 beats per minute and no respiratory effort who required full CPR including eight to 10 minutes of cardiac compressions.”
The College also alleges that Jolar represented herself “as qualified to act as primary care provider at this woman’s birth.”
“We sent Moreka Jolar a warning letter in September 1998 in which we outlined the penalties for breaching the Health Professions Act,” Kilthei says.
The act defines restricted activities and amongst them are managing labour and delivering a newborn. Only physicians, nurses in hospitals and registered widwives are permitted to perform these procedures. The College claims that Jolar is leaving herself open to a $2,000 fine and/or six months in jail.
“She has never applied to be registered as a midwife and does not call herself one. But, if she thinks that she is avoiding the requirements of the Act by calling herself a traditional birth attendant she is mistaken,” Kilthei says. “The College has a duty to protect the public as well as regulate its members and we are very concerned that Jolar is misrepresenting herself as a primary care giver. It is really important that the public gets the message that these illegal practitioners are putting families at risk.
“She is an illegal practitioner and we have grave concerns about her continuing to practise and put mothers and babies at risk.”
One of the options open to the College is to seek an injunction under Section 52 of the Health Professions Act that would restrain Jolar’s birthing activities.
The allegations have not been proved in any court nor before any tribunal and the the Campbell River Mirror has been unable to reach Jolar for comment. Jolar’s Quadra phone is disconnected. Her Facebook page identifies her as a “Traditional Birth Attendant.” Her website, www.morekajolar.com, is inactive.
BC Association of Midwives Executive Director Ganga Jolicoeur says the association has alerted area hospitals about Jolar’s lack of status and the authorities are all aware of the problem. Midwives must hold hospital privileges before they can practice.
“When we see something like this it creates concern. We have a responsibility to get the word out to the public.”
Jolicoeur says using a registered midwife is a wonderful option within the bounds of the medical system. Using a supposed birth attendant when there are safe options in the publicly funded health care system is not an option, she adds.
Midwives in B.C. spend four years earning a Bachelor of Science degree at the School of Midwifery at UBC and augment their academic work with clinical study placements. Upon graduation they are required to spend six months in an established clinic before venturing on their own.
This case arises just as B.C.’s midwives have received a welcome endorsement from Health Minister Margaret MacDiarmid who is encouraging women with low-risk pregnancies to plan their deliveries at home if that’s what they prefer. The former president of the B.C. Medical Association cites research published in the Canadian Medical Association Journal in 2009 as the safety standard.
As long as mothers were screened to be low-risk and assisted by a registered midwife, “there wasn’t any difference between the outcomes for moms and babies whether they were at home or in a hospital,” MacDiarmid says.
Last year, 983 B.C. babies – two per cent of the total – were delivered by midwives at home. Of 783 midwife-assisted births, 140 were home births, says Luba Lyons Richardson at the Department of Midwifery for Vancouver Island Health Authority. Richardson welcomes the ministry’s decision to earmark $500,000 this year to fund a second professional – another midwife, nurse or paramedic – required by law to attend home births. The money will pay for about 1,400 planned home births in B.C.