Sylvia Fedyk chokes up as she thinks back to all the transfigured faces of women seeing their newborn babies for the first time.
The trail-blazing registered midwife has attended to more than 1,000 births over the course of her career and still attends around 60 a year through her Maple Ridge practice, Transitions Midwifery.
This year midwifery is celebrating 20 years in British Columbia since first being recognized in January 1998.
“My registration number is 27,” said Fedyk, adding that in 1998 there were less than 100 midwives province-wide.
Now there are more than 288 midwives practicing.
The term midwife comes from Old English, meaning “with-woman,” or the person who is with the woman or mother at childbirth.
Midwives are primary caregivers for healthy women during their pregnancy, labour and delivery and eight to 12 weeks postpartum, as well as caregivers for the normal newborn.
“You can read that online anywhere. What we really do, we’re involved in what for most women is the biggest event of their lives,” Fedyk said.
“Particularly, the first pregnancy and the first baby is life-changing. So we’re there at that ultimate moment over and over again.”
The basic tenets midwifery was founded on, said Fedyk, are an informed choice, acknowledging the woman as the best decision-maker for herself and the baby, and is the final authority on what happens to her.
Patients won’t necessarily see the same midwife every visit, but they will see someone who is familiar to you, who knows what you want and who knows enough about you and you know enough about the midwife that everybody feels comfortable and that your needs are met.
Fedyk has six children and two stepchildren.
Her first two babies were born by C-section, then she had two vaginal deliveries in hospital. Her fifth child was born at home and her sixth, again, by C-section.
During the late 1980s and early ‘90s, it was tough for Fedyk to be approved for a vaginal birth after two C-sections, but her midwife, prior to registration, was instrumental in that and went with her to the hospital even though she had no privileges there.
She could help with labour, but none of the medical procedures. It was after the birth of her fifth child that she decided to go into midwifery.
“I had a home birth, then and I remember looking at her and holding my baby shortly after he was born and thinking what a great job she has,” Fedyk said of the midwife.
She started upgrading her sciences, but ultimately had to go to Seattle to finish her schooling and graduated in the summer of 1997.
Fedyk opened up a midwifery clinic in Maple Ridge the year the practice became recognized, with Jean Cooper, a midwife from Britain, where midwifery had already been integrated into the medical system for decades.
Cooper was on the initial board of the College of Midwives when it first formed, prior to registration to decide what midwifery was going to look like in the province.
Fedyk learned a lot from Cooper’s experience, including the wide variety of what is considered normal for each individual pregnancy, how to use humour judiciously, and most important, how to work well within the system.
“Acknowledging that everybody has their area of expertise and we all need each other, I can’t function without obstetricians, pediatricians, registered nurses, family doctors, childbirth educators. We are all part of it. And nobody can be all things to everybody,” explained Fedyk.
Registration gave meaning to the title of midwife.
“So when you go to someone who is presenting themselves as a midwife, you know that they are trained, you know that their training is up to date, you know that they consistently upgrade their education, that they are safe and knowledgeable practitioners and that they’re integrated into the medical system,” explained Fedyk.
Fedyk says the first six years of her practice were challenging because she found herself always explaining to nurses and doctors who didn’t quite understand what midwives were permitted to do, or what privileges there were allowed. Over the years the scope of the profession has gradually expanded too.
“For instance, I assist at cesarean sections now after taking a special course for that. There are midwives who do consulting and prescribing around birth control. The treatment of sexually transmitted illnesses, all those can be done under specialized practice now,” Fedyk added.
Even prescribing capabilities have expanded.
“We used to have to wake up some poor obstetrician in the middle of the night just to get some painkilling medication for a woman in early labour and now we can do that ourselves.”
Now a majority of deliveries by midwives are done in the hospital. Midwives are able to directly admit patients to the hospital. They are with them throughout their active labour, they catch the baby, stay with them for an hour or so after the birth and come back the next day to discharge them.
“I would say we do a good 80 per cent of our births in the hospital,” said Fedyk, making more personalized midwifery care accessible to a much broader population.
The most challenging aspect of Fedyk’s career has been trying to get enough sleep. When she first started attending births with Cooper, they were traveling from Burnaby to Hope.
“We were spread so thin because there was no one else,” said Fedyk.
She has missed birthdays, Christmas and a lot of important events, but can’t imagine another career.
“If you want a quiet life don’t be a groundbreaker in anything because it’s always going to be an uphill road,” laughed Fedyk.
Fedyk currently works in a practise group of four midwives and credits young women who lobbied hard for their practise care, like Krista Hamblin, a first-year midwife in the group, as instrumental as to why Fedyk remains a practising professional in the industry.
Hamblin wanted to become a midwife after watching the movie The Business of Being Born, about obstetrics in the United States. She was most taken aback after learning that the most common position for women to give birth is lying on their back because it easier for the person delivering the baby.
“That was like a seed that got planted and I couldn’t get over it. I just kept thinking about it and wrote about 15 papers on it and I wrote an honours paper on the over-medicalization of birth,” said Hamblin, who has a degree in sociology and was planning on getting her Ph.D.
“But something stopped me. And I sort of like working with my hands and I don’t like sitting around a lot. So I chose the right job,” said Hamblin.
“For me, it’s this great mixture of art and science,” said Hamblin, who entered the midwifery program at the University of British Columbia and did her fourth-year placement at the centre with Fedyk.
And Fedyk couldn’t be happier with the new generation of midwives who will be taking over when she retires.
“The new generation that is coming out is so over qualified,” said Fedyk during whose time, she joked, it was seen more as a very expensive hobby.
Fedyk is looking forward to the future of the industry, that she says, we can see happening now.
“We are seeing mixed practices begin where midwives are working in a complete share-care model with family practitioners who have an interest in maternity care and a whole woman model,” she said.
She also sees midwives being a part of hospital staff or expanding into “well-woman care”, or more generalized clinical work for a woman who is not necessarily pregnant including pap-tests.
Even the future growth of inclusivity of trans-men, who can give birth and the LGBTQ plus their families.
Fedyk is happy to have seen the growth of midwifery to a fully integrated, valued part of the medical system.
“This and having my own children are probably the things that make me feel that my life has been of value.”