by NOEMI LOPINTO

Montreal women had better decide what kind of birth they want before they become pregnant or they may end up giving birth in a hospital. Not that that's necessarily a bad thing, but if your pregnancy is normal, says Mirabelle Lavoie, there is absolutely no reason for it.

Lavoie is a member of Groupe Maman, which is part of the Coalition de femmes pour la pratique sage-femme, an umbrella group for more than 13 women's associations. They are calling upon the Minister of Health and Social Services, Philippe Couillard, to create more birthing homes in Montreal and across the province.

"Midwives should be first in line for normal pregnancies," says Lavoie. "But in Quebec, we don't have enough birthing centres to give mothers the choice."

Groupe Maman are "militant mummies" with an ideological slant - they believe that the hospital system is incompatible with the natural process of giving birth. But most importantly, Lavoie says, hospital births are a waste of time and money. There are currently eight birthing homes in Quebec, two in Montreal. The waiting lists at birthing centres are hundreds long, with the two Montreal centres refusing 1,000 women last year.

More midwives are on the way, albeit slowly. Since the Université de Québec à Trois Rivières opened a midwifery program in 1999, only 20 students have graduated the four-year program at a rate of 10 a year, adding to the 57 already practising. But many of the new grads are working as waitresses, as birthing "helpers" or simply waiting for a centre to open up.

Three months ago, Quebec adopted a law which effectively legalized home births. But the government hasn't moved forward with insurance coverage, which effectively prevents freelance midwives from being able to assist home births. The Coalition is demanding that the government accelerate the insurance process as well as finance the development of new birthing homes in Quebec.

Midwives are considered civil servants, which is why a birthing home must be established by the government. The centres must have links with hospitals and CLSCs. Hélène Gingras, media representative for the Minister of Health, says the process of setting up new centres takes time. "The government is already conducting studies for certain regions," says Gingras. "We are looking at feasibility reports right now. It's also a question of resources, we have to have enough midwives. [Last school] year there were only 20 new graduates from UQTR. But the willingness is there."

But the Coalition wants to see concrete plans for the future. "The Minister expresses a lot of good will, but what is the action plan?" asks Lavoie. "We want to know that there are plans to set up a certain amount of centres in the nearby future. Maternity is a fundamental process for a woman, it changes something. So in that optic, a midwife is for women who want to take control of their lives, rather than submit to a bunch of rules. They provide a service which is adapted to the woman, not the other way around."