“We’re Trying Really Hard, but I Don’t Think We’re Getting it Right”: Understanding the Role of the Midwives’ Association and Midwifery in the Province of Alberta, Canada: A Single-Case Study

Main Article Content

Kirsty Bourret
McMaster Midwifery Research Centre, Department of Obstetrics and Gynaecology, McMaster University, 1280 Main St. West, HSC-4H26, Hamilton, ON L8S 4K1 Canada, Dish with One Spoon Wampum agreement.
https://orcid.org/0000-0003-4319-5728
Ashlyn Wiens
School of Nursing and Midwifery, Faculty of Health, Community, and Education, Mount Royal University, 4825 Mount Royal Gate SW, Calgary, Alberta T3E 6K6 Canada, Treaty 7, Métis Nation of Alberta Districts 5 and 6

Luca Surkan
UBC Faculty of Medicine | Midwifery

Alyssa Wiens
Edmonton Community Midwives

Deepali Upadhyaya
School of Nursing and Midwifery, Mount Royal University
https://orcid.org/0000-0003-4891-8286

Keywords

Midwifery, Midwifery Leadership, midwives' associations, Indigenous Midwives, anti-racism, racism, Capacity building, intersectional research

Abstract

Problem: There is a critical shortage of midwives in Canada. Midwives’ associations are a possible solution to sustain the profession. However, many provincial and territorial organizations are smaller, with minimal funding. Our study aimed to understand the role of the Alberta Association of Midwives (AAM), a smaller association, and the status of midwifery in the province of Alberta.


Methods: We used a single case study design grounded in feminist intersectionality and transformative theories. A theoretical framework for strengthening midwives’ associations informed the data collection and analysis.


Findings: We reviewed nine documents related to AAM and midwifery in Alberta, eight podcasts released by AAM, and conducted 17 interviews with midwives and health system collaborators in Alberta. Findings showed that while increased membership strengthened the AAM governance and advocacy capacity, leaders lacked support to develop expertise. The profession was not enabling for racialized midwives, or Indigenous midwives. Participants identified AAM’s role as dismantling systemic racism, advancing Indigenous midwifery, and addressing sustainability challenges in rural and remote practice.


Conclusion: The study highlights both organizational growth and persistent inequities, calling for anti-racist practices, transparent governance, leadership development, and urgent recognition of racialized midwives and Indigenous midwifery within Canada’s truth and reconciliation efforts.


RÉSUMÉ
Problème : Il existe une pénurie critique de sages-femmes au Canada. Les associations de sages-femmes constituent une solution possible pour pérenniser la profession. Cependant, de nombreuses organisations provinciales et territoriales sont de petite taille et disposent d’un financement minimal. Notre étude visait à comprendre le rôle de l’Alberta Association of Midwives (AAM), une association de petite taille, et la situation de la profession de sage-femme dans la province de l’Alberta.


Méthodes : Nous avons utilisé un modèle d’étude de cas unique fondé sur l’intersectionnalité féministe et les théories transformatrices. Un cadre théorique visant à renforcer les associations de sages-femmes a guidé la collecte et l’analyse des données.


Résultats : Nous avons examiné neuf documents liés à l’AAM et à la profession de sage-femme en Alberta, huit podcasts publiés par l’AAM, et mené 17 entretiens avec des sages-femmes et des collaborateurs du système de santé en Alberta. Les résultats ont montré que, si l’augmentation du nombre de membres a renforcé la gouvernance et la capacité de défense des intérêts de l’AAM, les dirigeants manquaient de soutien pour développer leur expertise. La profession n’était pas favorable aux sages-femmes racialisées ou autochtones. Les participants ont identifié le rôle de l’AAM comme étant de démanteler le racisme systémique, de faire progresser la profession de sage-femme autochtone et de relever les défis de la durabilité dans les zones rurales et isolées.



Conclusion : L’étude met en évidence à la fois la croissance organisationnelle et les inégalités persistantes, appelant à des pratiques antiracistes, à une gouvernance transparente, au développement du leadership et à la reconnaissance urgente des sages-femmes racialisées et de la profession de sage-femme autochtone dans le cadre des efforts de vérité et de réconciliation du Canada.

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Published
Feb 13, 2026
DOI https://doi.org/10.22374/cjmrp.v25i1.209

Article Details

Issue
Vol. 25 No. 1 (2026): CJRMP
Section
Original Article
Author Biographies

Kirsty Bourret, McMaster Midwifery Research Centre, Department of Obstetrics and Gynaecology, McMaster University, 1280 Main St. West, HSC-4H26, Hamilton, ON L8S 4K1 Canada, Dish with One Spoon Wampum agreement.

Dr Kirsty Bourret (elle/she/her) 

Kirsty was born in Kapuskasing and raised on the traditional lands of the Fort William First Nation, in a city now known as Thunder Bay, a Francophone settler, midwife, academic researcher and mother, passionate about the prioritization and access to sexual and reproductive health and rights. She has lived and contributed to the work on this human rights issue in Northern Ontario, Nunavut, Haiti, Democratic Republic of Congo and Sweden. Health policy and health systems trained; her research is grounded in intersectional feminism. Her expertise in integrated knowledge exchange and mixed methods research is innovative and incorporates equity principles in the research process. 

Kirsty held an academic position as a Laurentian University faculty member, and postdoctoral fellowships with the Karolinska Institutet in Sweden, Department of Women and Children’s Health-Reproductive Health Research, as well as the McMaster Midwifery Research Centre, Department of Obstetrics and Gynecology, McMaster University. She has partnered with global NGOs, such as the International Confederation of Midwives, IPAS International, Global Affairs Canada and the Canadian Association of Midwives.

She is currently adjunct faculty at Lakehead University and continues to build her research program to increase access to SRHR and midwifery care in health systems. She is also working with Dr Brianne Wood and in partnership between NOSM University, the Thunder Bay Regional Health Sciences Centre, and the Thunder Bay Regional Health Research Institute. The research team works on the development, implementation, and evaluation of learning health systems research in Northern Ontario. 

 

Ashlyn Wiens, School of Nursing and Midwifery, Faculty of Health, Community, and Education, Mount Royal University, 4825 Mount Royal Gate SW, Calgary, Alberta T3E 6K6 Canada, Treaty 7, Métis Nation of Alberta Districts 5 and 6

Ashlyn Wiens BMid (she/her) is a Registered Midwife. She has previously practiced in Fort McMurray, Alberta, and currently lives and works in Calgary, Alberta. She brings experience from both urban and rural practice contexts and is interested in strengthening midwifery through attention to how care is shaped by differing practice environments. Ashlyn graduated from Mount Royal University’s School of Midwifery in 2022.

 

Luca Surkan, UBC Faculty of Medicine | Midwifery

Luca Surkan (she/her)

UBC Faculty of Medicine | Midwifery

Student Midwife, Year Four

Luca (pronounced “Lootsa”) is honoured to be part of your care during this meaningful and transformational time. As a student midwife, Luca deeply values the unique wisdom that each client and family brings to the clinical experience. She looks forward to building a relationship founded on trust, mutual respect, and open communication throughout your time together.

Originally from Vancouver Island, Luca grew up in a large family and was first introduced to birth through the home births of younger siblings under midwifery care. She holds a degree in Philosophy from the University of Victoria and, prior to entering the UBC Midwifery program, worked as a birth doula and in student support administration within the post-secondary education sector. The support Luca received from midwives during the birth of her own child further inspired her commitment to this profession.

During her midwifery training, Luca has had the privilege of working with clients across the perinatal spectrum in Nanaimo, BC, gaining experience in pregnancy, birth, and postpartum care. She is passionate about midwifery because of its potential to provide continuous, holistic, client-centered, culturally safe, and evidence-informed care that positively impacts individuals and families.

Outside of clinical work, Luca enjoys trail running with her partner, engaging in midwifery-specific research, cooking for friends, and exploring the outdoors with her son.

 

Alyssa Wiens, Edmonton Community Midwives

My journey to midwifery has been a long, winding road, with each stop lending itself perfectly towards this beautiful destination. I started my career as a primary care paramedic in 2006, working for both the city of Edmonton and then Calgary. Around 2010, I spent time in Turkey where I accidentally discovered a love for photography. This discovery led to the transition of careers in 2014 from paramedicine to full-time family, newborn and wedding photography. After photographing hundreds of newborn photo sessions and hearing so many birth stories, it became clear to me that there was a stark difference in (positive) birth satisfaction and outcomes when pregnant people received care from a midwife. My own births were highly medicalized and entirely impersonal, and I realized that, though I can’t change my own birth stories, by providing midwifery care I could change the stories of other pregnant people for the better. As a Métis woman, I long to change the narrative around birth for Indigenous people of Treaty 6 and am passionately committed to fighting racism in the health care system. I truly believe that better births make lives better, and that this is especially for the equity deserving in our city and our province.

Deepali Upadhyaya, School of Nursing and Midwifery, Mount Royal University

Dr. Deepali Upadhyaya is a Professor of Midwifery at Mount Royal University and a practicing Registered Midwife. She holds a PhD in Community Health Sciences (Medical Education) from the University of Calgary, an MS in Nurse-Midwifery from Oregon Health Sciences University, a BSN from Metropolitan State University, and a BA in Political Science and Philosophy from St. Olaf College. Her professional experience spans perinatal and child health practice and the education of health-care providers in diverse global settings. Her teaching focuses on perinatal and neonatal care, complications and consultations, and cultures and communities.