Unique project brings midwives to county

April 15, 2025

Midwife Mianh Lamson, who arrived in the county two years ago from Ontario, had no intention of working in her field here when she made the move with her five children. While living in Ontario, she had travelled throughout that province and parts of Quebec as well, providing midwifery care on a short-term basis, and planned to continue to travel for work.

But a casual conversation at a local veterinary office planted the seed for a service that is breaking new ground in the province.

“I was at the vet with my cat, and the vet tech asked me what I did,” Lamson recalls. “I explained I was a midwife, and that I only worked when I went away. She said, ‘that actually sounds like something we could use in our community. You should call my mom’s doctor. She would be interested in hearing about this.’”

So, she took that advice and started looking into how she may be able to practise closer to home. As luck would have it, two things were happening at the same time that paved the way for her wish to do just that.

In 2022, the Midwifery Regulatory Council of Nova Scotia made it possible for midwives to work outside of the province’s three midwifery clinics which operate in Halifax, Antigonish and Lunenburg. These alternative practice arrangements would allow midwives to work in their field, provided they could look after the funding for those services.

And just last year, Doctors Nova Scotia finalized a deal with the province that would allow doctors to engage other healthcare professionals. The pilot project will see professionals like midwives be able to bill doctors for their services, and the doctors can then bill the province. The aim of the project was to expand healthcare services, but to also relieve strain on doctors at the same time.

“I didn’t think it would work, because Doctors Nova Scotia, in launching their pilot project, didn’t realize that midwives could work outside the hospital employment model, so they hadn’t included midwives on the list of healthcare providers who could be included in this program,” Lamson says. “But they did have some fine print at the bottom that said if you wish to engage with a healthcare provider who is not on this list, send in your proposal and we may consider it.”

“I took that as someone giving me an inch, and I would see if I could get the mile,” she adds. “I submitted the application anyway and it worked, so here we are.”

So, with the funding piece in place, the plan was pitched to the regulatory council and its approval paved the way for Lamson and another midwife to begin offering service to all of Cape Breton.

Working one day a week out of the Community Health Centre in Inverness, and travelling to homes, when necessary, their plan is to eventually provide services outside of the island. Lamson says a number of community groups have already come forward offering clinic space, and that the Family Place Resource Centre has also stepped up to propose locations where they can offer services.

“One thing we know that’s going well is that there’s already been some really good engagement from the communities,” Lamson notes.

“We’ve already had people self-referring, saying ‘I don’t have a family doctor, and I’m pregnant, so can I have care with you?’ So that’s nice just to see that it’s already been getting out there and that we’re not just having referrals from other healthcare providers.”

Jenny Wright, executive director of the Midwifery Regulatory Council of Nova Scotia, says she’s looking forward to seeing how the service rolls out in Cape Breton.

“In the case of Cape Breton, there is currently no midwifery available for them, so this was a really unique proposal that came forward by the two midwives and it certainly fit our criteria for alternative practice arrangement,” Wright says.

“They were able to come up with what we thought was a very sustainable and very interesting funding model, and an incredibly collaborative one. So that was very unique.”

The Doctor’s Nova Scotia project expires in 2027, and Wright says the province plans to have new regulations in place by 2026 that will allow for the expansion of midwifery care in Nova Scotia.

“The council would certainly love to see more collaborative and inter-professional programs like this,” she notes.

“We have a lot of really bright, creative midwives. Now that they have seen an alternative practice arrangement come to be, I do foresee more proposals coming forward.”

As for Lamson, who is currently living in Skye Glen, near Whycocomagh, she and her family have settled into their new home nicely.

“It just seemed to fit,” she says. “We have a beautiful community, and my children are super happy. The schools are great. I just can’t believe that my teenagers are spending their Saturday nights at a square dance where they hang out with 80-year- olds, and they have the time of the lives. Where else can you get that?”

“It seemed like finding a hidden secret, a little magic. We’re very happy and we’re very settled.”