The World Health Organization has declared 2020 the “year of the nurse and the midwife.” However, when it comes to midwives’ compensation in Ontario, there’s little to celebrate.

The Ontario government sets the compensation structure for health care providers like doctors, nurses, and midwives. Currently, Ontario’s midwives are being paid approximately 53 per cent of what an average Community Health Centre (CHC) family physician earns, despite analyses showing that the calculated value of midwives’ work  amounts to 91 per cent of the value of CHC physicians’.

What this means is that the work of midwives in Ontario is being devalued—by a staggering 38 per cent. This pay gap demonstrates how our ideas about the value of women’s work have impacted the way health care providers’ compensation is structured. 

This isn’t new information. The Association of Ontario Midwives (AOM) has been fighting to secure pay equity for midwives in Ontario since 2013, when it filed an application with the Human Rights Tribunal of Ontario against the provincial government. The application alleged that the Ontario government continues to undervalue midwifery—the world’s most woman-dominated field—on the basis of gender. 

In 2018, the Human Rights Tribunal ruled in the AOM’s favour: they found that “the Ontario government, as the employer of midwives, [was] responsible for the midwifery gender pay gap.” 

Despite the Tribunal’s ruling that the Ontario government and the AOM must negotiate new pay structures, the Ford government has yet to take any action to close this pay gap. 

In fact, in December 2018, the provincial government cut all provincial funding to the Ontario College of Midwives, the regulatory body for Ontario’s midwives. In July 2019, the Ford government challenged the Tribunal’s 2018 ruling on the basis that midwives’ pay imbalance is due to their “different level of training and education, as well as [their] different roles, responsibilities and scope of practice,” not their gender. 

These obstructions to equity are disappointing. 

The work midwives do is incredibly valuable. Between April 1, 2017 and March 31, 2018, midwife-assisted births accounted for 18 per cent of births in Ontario. These births have been shown to have lower C-section and episiotomy rates than physician-led ones. 

Across Canada, midwives strive to be at the forefront of inclusive care for trans, gender-queer, intersex, and marginalized communities. The care mandate of Canadian midwives puts the decision-making of each patient in their own hands, with an emphasis on informed choice. There’s no other Canadian health care field taking the same steps to prioritize patients’ autonomy and comfort.

Midwives deserve an equitable wage for providing patient-focused services to nearly 20 per cent of our province’s birthing population—services the Ford government continues to devalue.

Tegwyn is The Journal’s Assistant Lifestyle Editor. She’s a fourth-year history student.