A Documentary Film Currently in Development

By

Connie Littlefield  

Midwives have been an integral part of the birth process for millennia, and today, in the east end of Toronto, the tradition continues. 30 babies a month are born in homes, hospitals and at the Toronto Birthing Centre with the skilled assistance of Riverdale Community Midwives.

googlemapsrmclinic                                                     48 River Street, Toronto

Riverdale Midwives was formed in 1994 when midwifery was first regulated in Ontario. Today, while midwives participate in nearly 20% of Toronto childbirths, their work remains largely unrecognized. This feature-length documentary will follow a group of families over the course of a year, providing a unique, intimate portrayal of one of the most culturally diverse midwifery communities in Canada. This participatory film project will offer the on camera subjects a hand in the storytelling, giving audiences unprecedented access to the drama, humour and unpredictability of the world of midwifery.

INTRODUCTION

This feature length documentary will be a fly on the wall immersion in this vibrant, urban midwifery practice during one cycle of care for a cohort of families from their intake appointment to their final post-natal visit.

Nine midwives, three student midwives, and two admin staff comprise the Riverdale Midwives team. From a cosy three-story Victorian townhouse on River Street in Toronto, this band of dedicated women serves families from all parts of society. People from many ethnicities, all income levels, ages, and all points along the gender and political spectrums live in the Riverdale community.

The dynamic, culturally diverse group of women face a variety of dramatic situations every day. They work in the ‘primary care’ model, which means clients are assigned a primary midwife and a back-up midwife, allowing plenty of time to establish a relationship of trust with both their care providers.

Midwives are on call much of their lives: a full-time income requires that they attend 80 births per annum. To compensate, they get one weekend per month and two full months per year off call.

The clinic’s weekly meetings are fun, occasionally heated, boisterous events, and it’s no wonder: there is a ton of human drama in every aspect of the birth process. Birth is a powerful event in people’s lives. Having babies changes everything: it turns us into parents, into families, and – sometimes – into adults.

Midwives are privy to intense emotional situations, and our camera will likewise bear witness to these moments of rare, raw power.

I’ve been listening to midwife Tia Sarkar’s birth stories for years, and they always lead to interesting conversations. This email came in early January:

Yesterday we hid the last box of Christmas chocolates from the swiftly incoming prenatal class. It was stashed away in a cupboard, but midwives could not keep themselves from filching candies throughout the day. Melida brought in a bunch of clothes from her daughter and insisted the newly hired petite midwife try on the cinching black skirt. In the weekly meeting it was discovered that there would not be enough of us on for the month of August. An elaborate back tracking forensic chart is being created to prove that some midwives have had too many coveted August months off in the past year – this requires 7 years worth of forensics -a job for Wendy to fulfill by next week. A new low risk birth unit is being proposed within St. Mikes by an OB who wants to lure women away from the MW birth centre and bolster the OB numbers. We have been told by the OB department that our cap on hospital births cannot be exceeded. It has. Linda to go duke it out next week with the chief of OB…..

I recall one time Tia peddled furiously to the waterfront in the middle of the night, flung her bicycle in the back of a water taxi, sped over to Toronto Island, hopped on her bike again, peddled even more furiously, and got there in time to catch the placenta. (Fortunately, another midwife had arrived in time.)

The Riverdale midwives live and roam all over the GTA, and most travel by car. Several, like Tia, ride their bikes most of the year, as midwives have done ever since the bicycle was invented. It makes a lot of sense: they’re able to avoid most traffic jams, and bicycles are much easier to park than cars.

Some scenes recur:

  • Midwives attend obstetric rounds in the hospital weekly.
  • They constantly upgrade their skills at Ryerson University, Toronto’s midwifery school.
  • It seems like somebody drops off food and/or flowers for the midwives… Every. Single. Day.
  • Sabina teaches childbirth classes in the clinic, once a week.
  • One of the student midwives teaches “Water Babies” classes at a nearby pool.
  • Parking tickets are an ongoing hassle.
  • In hot summer weather, the midwives have been known to inflate the birthing pool for a quick chill on the back deck.
  • The Annual Riverdale Midwives’ Winter Solstice Pot Luck is famed throughout the ‘hood, as is their Summer Solstice Picnic in Riverdale Park.
  • The midwives and their staff gossip like fan-girls over the latest episode of BBC’s period dramatic series, “Call the Midwife;” a collective favourite.
  • “Cluster Births” occur with stunning regularity: in other words, babies tend to be born in batches, testing the resilience and logistical skills of the team.
  • The weekly practice meetings pull everything into focus – briefly – on Wednesday mornings.

PRIMARY LOCATION

The clinic building itself – the midwives’ home base – reflects the Riverdale community in all its diversity: it is bright, colourful, old yet modern, well used, and a little messy. It’s a welcoming place for the women who work here and for the families who come through the door, bringing with them beauty, humour, fear, frustration, struggle, and the strength of their experience. We have been invited to tell some of these stories, with the Riverdale clinic at the centre of the action. In the process, we’ll generate a dialogue about the midwifery experience in childbirth.

SECONDARY LOCATIONS

Many people confuse midwifery with home birth. Having a midwife doesn’t necessarily mean that you’ve chosen to have your baby at home. Midwives are qualified to attend births in homes, hospitals, or anywhere the parents choose. Occasionally, someone has a baby at the Riverdale Midwives clinic, but that doesn’t happen very often since the Toronto Birth Centre opened just around the corner. (Mothers who want all the comforts of home, but with the security of a hospital, often find that a birth centre offers the best of both worlds.)

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Midwives have hospital privileges at hospitals in their catchment area, which in this case is St. Michael’s. The midwives are required to attend obstetrical rounds, among other obligations. We will follow our characters to St. Mike’s, to the birth centre, and into private homes; but the action will stay rooted on River Street.

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PROCESS

My methodology will be to encourage, engage, and invite. The canvas of the project is wide and embracing.

I plan to engage prospective parents in the idea of documenting their journey through the midwifery model of care. I will ensconce myself in one corner of the clinic’s waiting room with a computer, a camera and a small interview backdrop. I’m also going to have an old-fashioned photo booth built with digital photo and video capability. The results of this engagement – the pictures they take, the stories they tell – will form scenes in our documentary. A child’s drawing may become an animated bumper, and an old-time photo booth sequence might make a good nameplate device for introducing new subjects.

I will be at the clinic with my camera and mini-studio two days a week, for 10 months. I will start by creating a space where clients can pose for photos and videos, take their own photos or videos, look at other people’s pictures, post to social media, learn about filmmaking, or just talk to me about what’s going on in their lives while I work on this project.

After a period of “casting,” selected midwives and families will become the focus of deeper exploration. Relationships will be developed with these collaborators over the longer term – just like in the primary care model that the midwives use.  By the time this cohort is in mid-term, I will be fully embedded.

Clients and staff of the clinic will be encouraged to document their baby bumps and babies in front of our backdrop, or wherever they like. I will encourage them to tell their own stories for our camera. The primary purpose of this image-making apparatus, however, is to give me a way to connect with the people who will become the subjects of our film. While sharing the filmmaking process, and in showing them how to document and share their own images and impressions, I will develop relationships with the clients and midwives. The stories will unfold, organically, from my residency in the clinic space.

I will work collaboratively, and include everyone at the clinic in the filmmaking process, to the extent that they want to be included. As I gain the trust of my subjects, I will follow them out of the clinic with a camera crew. I will spend as much time with them as possible, especially in the weeks surrounding the births. We’ll interview our characters in the clinic and at home. Verité footage of midwives on the job – and racing to get there – will provide riveting action sequences.

When it comes time to follow the families through the final stages of the birth process, I’ll do this with a small crew of female technicians, sometimes filming the births ourselves, other times simply activating a GoPro camera in the birthing room. Other families will allow us to use their own footage, so that we can tell a comprehensive version of all their stories in the film.

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Tiffany Fung, RM
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Tia Sarkar, RM
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Andrea Luciuk, RM; clients; Melida Jiminez, RM; student

I have been amazed at the explosion in the imagery of birth that has occurred over the past twenty years, largely driven by social media. I plan to engage the families on that level: through image making, and in dialogue about the value of image making in the birth process. The products of these photo and video productions can be given to the families either digitally or as more tangible forms of portraiture.

From another one of Tia’s emails:

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Sabina Fella, RM

Sabina on her way to wash a speculum stops for a chat about the holiday party…..an OB has written to ask permission to observe a home birth, Sabina says we have to take risks, that’s what life’s about, also the film maker, Connie, that’s a risk too, and that’s a good thing. Yes, says Tia, she’s a good thing, and I want to re-vamp our speculum wash station and here’s my idea, it starts with a metal bucket…

CURRENT SOCIAL/POLITICAL CONTEXT

The social/political climate in which midwifery occurs is complex, as befits a profession that is ancient and venerated, yet indisputably gendered.

Globally speaking, it is clear that the demand for midwifery services far exceeds the supply. A report from the WHO in 2011, ‘The State Of The World’s Midwifery,’ said that “Increasing women’s access to quality midwifery services has become a focus of global efforts to realize the right of every woman to the best possible health care during pregnancy and childbirth.”

Currently, midwives attend only about 4% of births in Canada; that number goes up to 20% in Toronto.

BC, Quebec and Ontario have more established systems; other provinces are still struggling to get legislation in place. In Ontario, Midwifery has been regulated and covered by OHIP for 23 years, yet few women who want a midwife can secure one. Every clinic has long waiting lists, and Riverdale is no exception.

This brings up several questions:  What do midwives offer that doctors don’t? If midwifery is cost effective AND increasingly popular, why aren’t there more midwives on the job? What are the impediments to growth?

Part of the problem is that the medical establishment keeps tight control over who gets hospital privileges. This forces midwives to work within a system that was not designed with them in mind.

The CAM, or Canadian Association of Midwives and The AOM, The Association of Ontario Midwives, represent the Riverdale midwives in the legal and political arena. Currently there’s a courtroom in Toronto where our midwives can occasionally be seen lurking in the gallery. The AOM is fighting the province to gain pay equity with obstetricians.

How do we value this work, which is traditionally a woman’s job, against the traditionally male (although increasingly gender balanced) field of obstetrical medicine? Of course, it’s not a direct comparison. Midwifery and obstetrics are clearly not the same job …but there are equivalencies. Obstetricians, on average, make at least twice as much as midwives do. Is that appropriate?

Most people don’t know enough about midwifery to have a conversation about the subject. This film could change all that. 

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Julie Chipman, RM & clients

            

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Marlene Sagada, RM

FILMMAKER STATEMENT

What’s my motivation? Well, for one thing, I know a terrific story when I see one. My previous work is proof of that.

As well, I’ve given birth twice. When my son was born, I was 16 years old: a runaway, in Calgary General Hospital. I was scared, uninformed, and acted upon. The second time, aged 32, I was in my own home, in Toronto, with my loved ones and midwives. I felt informed, calm, and cared for. My two birth experiences were polar opposites, so I truly appreciate the difference that midwifery care can make. This film is my attempt to describe that difference.

One of the midwives at my daughter’s birth was Tia Sarkar, with whom I have been developing this idea for over twenty years. Tia is a loyal friend, a dedicated cyclist, and a skilled co-creator of art and adventure. Born and bred in Toronto, Tia is one of Ontario’s most senior midwives. Her faith in me is why we’re here.

Most of us only glimpse magic a few times in our lives, but these women handle miracles every day. Being invited to document the work of Riverdale Midwives is an incredible creative opportunity. I am deeply honoured by their confidence in my ability to render their story, and I feel primed to meet the challenge.

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RIVERDALE MIDWIVES

© Conceptafilm 2018

Written & Directed by Connie Littlefield                                     connielittlefield@gmail.com