However, the students said, working from home did not get in the way of their valuable experience.

PIKE-Net, housed at the Rady Faculty of Health Sciences’ Indigenous Institute of Health and Healing – Ongomiizwin Research, is a student mentorship network program that provides a variety of supports and opportunities for undergraduate and graduate students interested in Indigenous health research.

This year, 14 students took part in 13 different Indigenous health research projects with guidance from 18 mentors.

“When the order to stay home happened, we were just starting the matching process between our registered mentors and interns, and it quickly became a scramble to see how we could adapt the program,” said Ashley Edson, PIKE-Net program coordinator.

She said mentors adapted projects to focus on Indigenous health and wellness issues around COVID-19, supported flexible work hours, and shifted all workshops to online. “It was challenging because the heart of this program has always been the relationships we build and the mentorship shared between each other.”

Nichol Marsch

Nichol Marsch, a Metis UM fine arts graduate, is part of the program for her second summer, as she prepares to enter the occupational therapy program in the College of Rehabilitation Sciences.

“My background is in the arts, but I’ve always had an interest in science, and this program has been a really good entry point into that field,” she says.

Marsch is working with mentors Dr. Cara Brown, department of occupational therapy, and Dr. Patty Thille, department of physical therapy, on a scoping review for a project on self-management education and support in Indigenous communities.

“It’s about how to deal with chronic illness in day-to-day life, which is especially important for communities that don’t have constant access to health care,” she says.

Marsch, 28, is originally from Winnipeg and grew up near Stonewall, Man. While working on her arts degree, she worked part-time in medical device reprocessing, which led to an interest in prosthetics and orthotics. She learned about occupational therapy while in PIKE-Net last summer.

“I thought it seemed like a really cool profession that aligns with a lot of my interests,” she says.

“The one pitfall is that we didn’t get to go into the communities this summer, but the college has community partners that they work with and they’re always looking for ways to engage with them that are helpful.”

Jordan Gelowitz

Third-year Max Rady College of Medicine student Jordan Gelowitz also joins the program for a second year. Gelowitz is working with Dr. Kellie Thiessen, associate professor, College of Nursing on a project about wellbeing associated with maternity care in northern regions.

“Our big question for the moment has been, ‘how do you define wellness from an Indigenous context?’” he says, noting his role involves reviewing feedback from the communities. This includes mothers who have delivered in their communities, those who delivered in Winnipeg, policymakers and health-care staff. “They each have their own perspective on the issue, and that is important. It has really brought to mind that health care is really complex.”

Gelowitz, 26, says his interest in maternity care goes back to his childhood, growing up in Big River First Nation near Saskatoon.

Gelowitz said he’d recommend the program to any Indigenous students who are interested in research that will make an impact.

“PIKE-Net is designed to learn research in a fun integrated way,” he says. “I found in medicine there are a lot of different research opportunities, but the thing I wanted was something that had more flexibility and more of a focus on Indigenous health.”

Zoe Quill

Third-year faculty of science student Zoe Quill joins PIKE-Net for the first time. The genetics major is working with clinical researcher Dr. Alison Dart and pediatric endocrinologist Dr. Brandy Wicklow at the Children’s Hospital Research Institute of Manitoba on the iCARE study, the largest observational study of youth with type 2 diabetes in Canada.

Quill, a member of Sapotaweyak Cree Nation near Swan River, Man., says the research is of interest to her because she’s known many people affected by the disease.

“The study is kind of unique because it determines not only the biological risk factors, but also the psychological and social factors – so their overall wellbeing,” she says.

As part of the research, Quill, 20, is doing phone surveys with affected families to determine how they’ve been coping with the effects of COVID-19.

“It’s been really great,” she says. “I know the pandemic has caused us to work from home, but I still feel like I’m working in-person. PIKE-Net and iCARE have really stepped up to make the most of this experience.”

The funding is part of $10.4 million in funding from the Canadian Institutes of Health Research (CIHR) in U of M health research projects. Fifteen researchers at the U of M were funded by CIHR, and were among 369 researchers across the country to receive $275 million in support.

“Health research is one of the most important investments we can make as a nation,” Winnipeg South Member of Parliament Terry Duguid, Parliamentary Secretary to the Minister for the Status of Women, said at a funding announcement at the Helen Glass Centre for Nursing on March 15.

Elder Katherine Whitecloud of the Assembly of First Nations and Dr. Kellie Thiessen were funded for a project looking connecting Indigenous and Western health-care systems to improve maternal care initiatives.

Dr. Kellie Thiessen, associate professor and director of the upcoming Bachelor of Midwifery program, was awarded $810,901 for a project she’s working on with Elder Katherine Whitecloud, who represents Manitoba on the National Advisory Council on Child Welfare for the Assembly of First Nations.

The project looks into connecting Indigenous and Western health-care systems to improve maternal care initiatives in remote Canadian regions. It examines maternity care policies and programs in four geographically similar jurisdictions – Northwest Territories, Nunavut, Nunavik and northern Manitoba – and aims to identify delivery models that are integrated, cost-efficient, culturally appropriate and that support the ability to maintain health and wellness within one’s own community.

“Through research, we learned the sacred spirit, the spirit of child, has been taken out of the remote communities here in Manitoba and across the country and this has had a detrimental impact,” Thiessen said.

Whitecloud added there is a strain on families in isolated communities when mothers would have to travel to Winnipeg to deliver their babies, sometimes being gone from their families for up to six weeks.

“What’s happened is we’ve disconnected our children,” she said, noting that close relationships to extended family are important for a child’s “knowing”, or what Western research has termed “genetic memory.”

“I have that knowing in me from my ancestors, where I instinctively know how to manage situations, and that knowledge remains with me,” she said.

Dr. Roberta Woodgate, professor and Canada Research Chair in Child and Family Engagement in Health Research and Healthcare, received grants for two projects.

The first, which received $458,999, aims to provide evidence to improve respite care for families of children with complex care needs and conditions in Manitoba.

“Caring for children with complex care needs can be overwhelming and at times not good for the well-being of families. Respite care or short breaks from care can help relieve family stress,” she said, noting that the demand for respite care continues to exceed supply. “Working with a family advisory committee and various service providers and stakeholders, we’re going to look at developing a better model for respite care for families with children in the province of Manitoba.”

Her other project, which received $539,324, looks to understand non-suicidal self-injury in youth. She estimates that 18 per cent of youth engage in self-harming behaviours like cutting, self-hitting, pinching, scratching, burning, minor overdosing and interfering with wound healing.

The project was inspired by a previous study of hers that looked at anxiety in young people.

“The youth in that study mentioned that self-harm is seldom talked about and when it is talked about it is misunderstood. We’re going to be looking at their experiences, what they think they need, and also how to improve social support services and health services for them,” she said.

Among the research techniques Woodgate will use in her projects are innovative arts-based methods. The respite project will use photography and digital storytelling, while the self-harm study will employ a method called ‘body mapping’, which incorporates painting, drawing and other techniques. 

“Arts-based research methods can provide new ways to explore, understand and share people’s lived experiences,” she said.

“These researchers are doing cutting-edge studies that will benefit individuals coping with disabilities, distress, and many serious life-threatening conditions,” says Dr. Digvir Jayas, vice-president (research and international) and Distinguished Professor, University of Manitoba. “Their work is testament to the outstanding calibre of transformational research conducted at the University of Manitoba and at our affiliated partner organizations.”

The researchers and their projects are:

Benedict Albensi

Pharmacology and Therapeutics, Max Rady College of Medicine; Investigator, St. Boniface Albrechtsen Research Centre, Children’s Hospital Research Institute of Manitoba
Project: Sex-based differences associated with mitochondrial dysfunction in Alzheimer’s disease
Funding: $725,985

Women have a higher risk of acquiring Alzheimer’s disease (AD) and it’s not known why. Differences in cellular mechanisms (genetics, metabolism), hormonal changes, and/or lifestyle factors between men and women may be at the root cause, but no one knows for sure. This study aims to bring a clearer picture into view of the biological processes underway in the onset of Alzheimer’s disease.

Michael Czubryt

Physiology and Pathophysiology, Max Rady College of Medicine; Investigator, St. Boniface Albrechtsen Research Centre
Project: Targeting scleraxis to combat cardiac fibrosis
Funding: $1,017,450

Heart disease is the primary cause of death in the western world. Cardiac fibrosis is a stiffening of the heart caused by many forms of heart disease. Fibrosis dramatically increases the risk of death and disability independently of other risk factors (up to 17 times), yet no treatments for cardiac fibrosis are available to patients. Czubryt’s laboratory has identified a protein (scleraxis) as a powerful cause of fibrosis, and initial data indicates that interfering with scleraxis can reduce fibrosis. This study will further probe this relationship in the hop of finding new treatments for fibrosis.

Ian Dixon

Physiology and Pathophysiology, Max Rady College of Medicine; Investigator, St. Boniface Albrechtsen Research Centre
Project: Ski is a negative regulator of cardiac fibrosis
Funding: $684,675

Patients surviving a heart attack or those with hypertension develop chronic heart disease. These patients make too much collagen in their heart muscle, wherein non-muscle cells called myofibroblasts secrete excessive collagens, which stiffens the heart. Most of the “glue” (extracellular matrix) between muscle cells in healthy hearts is made of tough collagen proteins. Too much collagen leads to cardiac fibrosis, which results in weak muscle contraction and relaxation. Despite this, there is currently no treatment for cardiac fibrosis, nor are there any specific cardiac drugs approved to fix cardiac fibrosis. In recent years, we have found a new protein called Ski. Ski turns off this over-deposition of matrix, in diseased heart cells. Further, we have made progress of how Ski actually achieves this positive change. We are now poised to extend our understanding of how Ski corrects cardiac fibrosis and this study aims to bring about the design new Ski-based therapies to treat cardiac fibrosis, for the prevention of heart failure.

Paul Fernyhough

Pharmacology and Therapeutics, Max Rady College of Medicine; Investigator, St. Boniface Albrechtsen Research Centre
Project: Muscarinic receptor antagonism as a novel mechanism for sensory nerve repair
Funding: $1,090,125

Objective Diabetic sensory neuropathy and chemotherapy-induced peripheral neuropathy (CIPN) are neurodegenerative diseases characterized by loss of nerve fibers in the skin. Both diseases cause significant pain and eventually lead to sensory loss. The impact of these diseases on human health is enormously damaging and there are no therapies. Recent work in Fernyhough’s lab has uncovered an endogenous signaling pathway in neurons that negatively modulates nerve fiber growth of sensory neurons. This study will enable the lab to broaden in scope and permit this therapeutic approach to be performed in a wide range of distal dying back neurodegenerative diseases.

Edward Giesbrecht

College of Rehabilitation Sciences
Project: Evaluation of a peer-led eHealth wheelchair skills training program: Training to Enhance Adaptation and Management for Wheelchair users (TEAM Wheel)
Funding: $566,099

Mobility impairment is the third most common disability; nearly 300,000 Canadians use a wheelchair or scooter because their disability makes walking difficult. Many Canadians receive their wheelchair while in hospital and must learn to contend with the social and environmental challenges of use when they return home. Because of shorter hospital stays and reduced access to outpatient rehabilitation services, wheelchair users often receive little training in how to operate and manage their mobility device. Without the appropriate skills, wheelchair users can experience health declines, diminished physical activity, and restricted participation in activities of life. The impact of reduced independence can have social and financial costs for the individual, their caregivers, and the health care system. Training to Enhance Adaptation and Management for Wheelchair users (TEAM Wheel) is a novel intervention designed to address this important transition to wheelchair use.

Tiina Kauppinen

Pharmacology and Therapeutics, Max Rady College of Medicine; Investigator, Kleysen Institute for Advanced Medicine, Health Sciences Centre and Children’s Hospital Research Institute of Manitoba
Project: Microglia and cognitive impairments in offspring exposed to gestational diabetes mellitus
Funding: $1,051,875

Maternal diabetes is the most common complication in pregnancy affecting up to 18 per cent of pregnancies. Maternal diabetes increases offspring risk for developing various health problems. Population studies have demonstrated that maternal diabetes increases offspring risk to have learning and memory deficits, and behavioral issues. Maternal diabetes is associated with elevated inflammation status, which can be detrimental for the developing brain. This study will identify the role of brain immune cells and the mechanism by how they can impair brain cells function. It will also assess whether maternal gestational diabetes differentially affects male and female offspring. The ultimate goal is to identify targets for drug development and promote healthy brain development and, thus prevent cognitive impairments in children of mothers with gestational diabetes.

Alyson Mahar

Community Health Sciences, Manitoba Centre for Health Policy, Max Rady College of Medicine
Project: Understanding cancer burden and outcomes for Canadians living with intellectual and developmental disabilities
Funding: $298,352

Not all Canadians have the same cancer risk, receive the same quality of healthcare after a cancer diagnosis, or have the same prognosis. This may be the result of many things including how much money someone has, their education, where they live, or discrimination within the healthcare system that causes people to be treated differently, regardless of how sick they are. Although cancer is a leading cause of death for Canadians living with intellectual disabilities and developmental disabilities (IDD), they may be less likely to receive high quality cancer treatment compared to other Canadians. Because people living with IDD are more likely to live in vulnerable circumstances (such as those described above), this may impact how quickly their cancer is diagnosed, their access to life-saving treatment and result in worse outcomes. The goal of this project is to determine whether or not Canadians living with IDD are more likely than Canadians who do not have IDD to be 1) diagnosed with cancer; 2) diagnosed with incurable cancer; 3) not receive the right cancer treatment; and 4) to die of their cancer. This study will highlight ways to improve the quality of care provided. We will work with our policy partners to ensure this information is usable and informative to the care of underserved cancer populations.

Brian Mark

Microbiology, Faculty of Science
Project: Development of a therapeutic modality to treat GM2 gangliosidoses
Funding: $547,740

Tay-Sachs disease and Sandhoff Disease (also knows as the GM2 gangliosidoses) are inherited neurodegenerative diseases that result from genetic mutations that inactivate an enzyme known as HexA. HexA is a protein in our cells that degrades GM2-ganglioside (GM2), a molecule found primarily on neurons of the central and peripheral nervous system. HexA degrades GM2, and if it is not active, GM2 rapidly accumulates and causes severe neurological disease.The rate of GM2 accumulation depends on how severely the genetic mutations impact HexA activity. Mark’s lab has recently engineered HexA to markedly improve its stability and function for enzyme replacement therapy. This study will use the engineered enzyme, known as HexM, to develop an enzyme replacement therapy that will be evaluated in models of GM2 gangliosidosis in combination with a drug known to rescue residual HexA activity in cells. The approach holds promise to reduce GM2 accumulation and reverse the progression of this debilitating family of neurological diseases.

Aaron Marshall

Immunology, Max Rady College of Medicine
Project: Control of B cell metabolism by the PI3K pathway: applications for autoimmunity
Funding: $956,250

The immune system is critical to human health. In order to develop vaccines and treatments for diseases where the immune system malfunctions (such as autoimmunity, inflammatory diseases or immunodeficiency), we need to better understand the fundamental mechanisms governing immune responses. Our research deals with the arm of the immune system responsible for producing antibodies, which are specialized proteins that bind to microorganisms and target them for destruction by the immune system. Antibodies are secreted into the blood and mucosal surfaces by cells called B lymphocytes. This study aims to define the molecular signaling pathways that regulate the activities of B lymphocytes during normal immune responses or abnormal autoimmune responses. The work is identifying new molecular pathways that can be targeted to shut down B cells and treat autoimmune disease.

Kirk McManus

Biochemistry and Medical Genetics, Max Rady College of Medicine; Investigator, Research Institute of Oncology and Hematology, a joint institute of the University of Manitoba and CancerCare Manitoba
Project: Exploring and Exploiting Reduced USP22 Expression in Colorectal Cancer
Funding: $807,075

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in Canada, and although advances in treatment options have improved the overall survival for early stage CRCs, about 50 per cent of individuals are still diagnosed with late stage disease that is often incurable. The development of highly specific, anti-cancer treatments is a significant research challenge; however, recent efforts suggest that exploiting the mutated genes and abnormal pathways that drive cancer development may hold tremendous clinical potential. Accordingly, greater insight into the mutated genes and abnormal pathways driving CRC formation is needed so that new treatment strategies and drug options can be developed that exploit them. McManus’s lab will build on its past discoveries to identify novel drug targets and lead chemotherapeutics that will be tested in pre-clinical studies to ideally and ultimately deliver new therapeutic options to individuals diagnosed with CRC.

Leslie L. Roos and Marni Brownell

Community Health Sciences, Manitoba Centre for Health Policy, Max Rady College of Medicine; Investigator, Children’s Hospital Research Institute of Manitoba
Project: Health, Well-Being, and Disease-Birth to Adulthood in Manitoba
Funding: $244,799

Why are some children healthy and others not? Why do some children perform well in school and others drop out? Why are some youths arrested while others never come near the justice system? The population-based Manitoba data enable research on the consequences of birth, childhood, and adolescent experiences for health and well-being over the first 20 years. This study will explore the degree to which predictors of poor young adult outcomes occur early enough to allow the possibility of intervention. Roos’s lab will analyze Manitoba’s data on several government projects designed to improve children’s wellbeing.

Frank Schweizer

Chemistry, Faculty of Science; Medical Microbiology, Max Rady College of Medicine
Project: Preclinical studies on aminoglycoside-derived antibiotic adjuvants (AGDAAs)
Funding: $646,425

According to the United Nations (UN) and the World Health Organization (WHO) antimicrobial resistance (AMR) is one the largest threats to public health and economic growth. Recently, the WHO for the first time divided pathogens into three categories according to the urgency of need for new antibiotics: critical, high and medium priority. The most critical group of all includes multidrug resistant bacteria that pose a particular threat in hospitals, nursing homes, and among patients whose care requires devices such as ventilators and blood catheters. To overcome the bottleneck in antibacterial drug discovery, this study aims to develop helper molecules (adjuvants) designed to enhance membrane permeability, reduce efflux of antibiotics and prevent or delay resistance development against these pathogens. The overall goal of this proposal is to identify optimized helper molecules capable of rescuing antibiotics from resistance in animal models of infection against multidrug-resistant priority pathogens and to understand their mode of actions.

Kellie Thiessen and Katherine Whitecloud (Assembly of First Nations)

College of Nursing and Children’s Hospital Research Institute of Manitoba; and
Project: Welcoming the ‘Sacred Spirit’ (child): Connecting Indigenous and Western ‘ways of knowing’ to inform future policy partnerships to optimize maternal child health service delivery initiatives in remote Canadian regions
Funding: $810,901

Ongoing and historical colonial health practices have systematically diminished the health and well-being of Indigenous communities. One critically important primary healthcare service that shows the impact of colonial relations is maternal/child healthcare. There is the “absence of teachings regarding the ‘Sacred Spirit’ (child) along with the responsibilities and preparation for ‘life-giving’ across the childbearing continuum (preconception, pregnancy, birth and post-delivery). Strategies to embrace and include Indigenous knowledge, values, teachings, and stories are essential for a healthy life in Indigenous communities; the absence of these strategies disrupts the relations among youth, young parents, families, and communities. In this study, we explore maternal healthcare delivery systems and services across 4 remote Canadian jurisdictions. Our exploration includes Indigenous and Western world views and aims to improve the health of communities by bringing back the ‘Sacred Spirit’ [child]. The teaching tells us that achieving this equates to maintaining wellness. We have and will continue to actively engage Indigenous and non-Indigenous members in 4 remote Canadian jurisdictions each involved in delivering or receiving maternal care. Data sources include interviews, focus groups [story-telling], and document analysis. The outcome will be identification of maternity care delivery models that are integrated, cost-efficient, culturally appropriate, and effectively supporting persons to maintain health and wellness within their own community.

Roberta Woodgate

Canada Research Chair in Child and Family Engagement in Health Research and Healthcare, College of Nursing; Investigator, Children’s Hospital Research Institute of Manitoba and St. Boniface Albrechtsen Research Centre
Project 1: Designing a Responsive and Integrative Model of Respite Care for Families of Children with Complex Care Needs and Conditions (CCNC) through Patient-Oriented Research
Funding: $458,999

Children with complex care needs and conditions (CCNC) are those with chronic physical and developmental disabilities who require multiple services. Caring for children with CCNC is an immense undertaking for families that involves constantly coordinating multiple needs and services in a complex system with limited supports. As such, family well-being can be greatly impacted. The goal of this study is to provide evidence to inform the design of a new model of respite care that can respond to the diverse and changing needs of families of children with CCNC in Manitoba (MB).

Project 2: Non-suicidal self-injury among youth: Perspectives of youth who self-harm, their families and service providers
Funding: $539,324

Self-harm among youth is a major public health concern. Usually first occurring in early adolescence, it is estimated that 18 per cent of youth engage in self-harming behaviours at some point in their lives. These may include cutting, self-hitting, pinching, scratching, burning, minor overdosing and interfering with wound healing. Recent media reports reinforce that self-harming provokes a great deal of suffering among youth and their families, who struggle to access appropriate care. Likewise, service providers find it difficult to treat youth who self-harm. While self-harming can have a significant impact on a youth’s life, it is poorly understood. Before we can develop effective services and supports, we first need to gain an understanding of self-harm from the perspectives of youth who self-harm and their families as well as service providers who support them. The aim of this study is to increase our understanding of the experiences and needs of youth who self-harm and their families. This information is essential in order to design better services and supports for this population.

Rieger and Thiessen, both assistant professors in the College of Nursing, Rady Faculty of Health Sciences, say they’re also excited that their CHI awards for Patient and Public Engagement in Health Research in the Design and Grant Development Phase, will let other researchers know these valuable opportunities are available each spring and fall.

“This grant is wonderful for a novice researcher like myself, or any researcher with a new idea, because it really helps to refine and develop emerging ideas through engaging with patients, in order to submit a more meaningful and relevant grant application at the provincial and national level down the road,” said Rieger, who has a bachelor’s and a PhD from the U of M’s College of Nursing. 

Dr. Kellie Thiessen, CHI awardee

Added Thiessen, who is also a U of M PhD graduate, “This supports our initiatives for patient engagement research, which is instrumental in relationship building and bringing people to the table to hear their voices and have them inform projects from the outset.  It allows you to pay for travel to bring them here, pay honoraria, really honour the time they’re giving to the project.”

Thiessen’s award was based on her research entitled, “Welcoming the Sacred Spirit (child): Connecting Indigenous and Western ‘ways of knowing’ to inform future policy partnerships to optimize maternal child health service delivery initiatives in remote Canadian regions.”

There are many remote and rural communities where women have to travel to give birth, she explained.  This has financial and psychological costs, and has a huge impact on families and communities.

“It fragments communities by taking out birth out of the cycle of life. There are a lot of traditional ceremonies around preparing for the coming of the ‘sacred spirit’, the child, into a community, and those are diluted down when birth can’t happen in the community,” Thiessen said. 

Her research is looking at maternity care policies and programs in four geographically similar jurisdictions (Northwest Territories, Nunavut, Nunavik, and northern Manitoba) to identify and describe exemplar maternity care models in remote Canadian regions.    

Rieger’s research is entitled, “Engaging Patients and Elders in an Exploration of Indigenous Women’s Experiences of Breast Cancer Using Digital Storytelling”, which she worked on with the support of Drs. Marlyn Bennett, Tom Hack and Donna Martin.

“We’ve been talking about the significant survival disparities for First Nations women with breast cancer,” said Rieger. “There’s been some important quantitative work that’s been done recently, but there still needs to be more work done to explore what’s influencing those poor outcomes and what needs to change.” 

The CHI grant is funding the first phase of her research which will see the team engage First Nations women and an Elder for their perspectives on the feasibility, meaningfulness, and cultural safety of digital storytelling as a research method, and to receive input on the research questions.

The research awardees each received $2000 as part of the award. While the money is helpful, some of the other benefits are equally if not more valuable for junior researchers including networking with past awardees, research supports, and free consultations regarding patient engagement.

“It’s really exciting that two nurse researchers have received this award because it’s going to help them build their teams, engage with patients, and establish a strong foundation for their work going forward,” said Dr. Donna Martin, associate dean of research in the College of Nursing.

The award winners from previous rounds of callouts have gone on to receive larger grants down the road which is exactly where Rieger and Thiessen have their sights set.

“This is like a seed, the grant money will allow us to plant a seed not just by ourselves but with patients, elders, community members,” said Rieger. “We’re planting this seed together and we’re hoping the seed will grow into a large tree.”

From the time a woman learns she’s pregnant to the day a new baby arrives, there are hundreds of questions to be answered and countless decisions to be made.

Having a baby is a life-changing event, even when it’s not a first pregnancy. Many women say that having the right care—professionals who understand your needs and respect your choices—is vital.

Dr. Kellie Thiessen is an assistant professor and director of the midwifery program at the College of Nursing. With over 20 years of experience in health care, she knows first-hand what it means to guide a woman through the first months of a pregnancy all the way through to labour.

“There are a number of key differences between various models and philosophies of maternity care,” explains Thiessen. For starters, women who want a choice of birthplace outside the hospital won’t be given that option by most other healthcare professionals. Midwives have smaller caseloads, offer longer appointment times, and develop a personal relationship with their clients, even visiting expectant and postpartum mothers in their homes.

“When you show up at a client’s door for an appointment, often she’ll just kind of melt,” says Thiessen. “They look forward to someone coming to their home.” Travelling during pregnancy or with a newborn can be challenging—even more so if there are other children in the family who have to come along to mom’s healthcare visits. In a rural or remote community, making it to an appointment can be challenging.

But even more important than overcoming practical challenges is the way an early postpartum visit can identify the onset of serious problems before they start. “With the standard model of maternity care, often a new mother won’t see her doctor again for two weeks after she gives birth,” says Thiessen. The first days and weeks are critically important, says Thiessen. “If she’s in trouble, breastfeeding might have stopped, postpartum depression can set it. A midwife can be there to see what’s happening before it’s too late.”

Anecdotal evidence like this about the success of midwifery is overwhelmingly positive, says Thiessen. Overall, she hears three key things. “One is that we don’t have enough midwives to fulfil client demands. Second, midwives provide excellent care to their clients, and third, midwifery is a cost-effective model of care.”

However, Thiessen points out that so far, there isn’t much grounded evidence supporting these sentiments. Ultimately, while midwifery has seen a great deal of reported success since it became regulated in Manitoba in June 2000, it’s time to ensure we’re getting a clear picture.

Her research project, entitled Outcomes and Costs of Maternity Services in Manitoba, analyzes outcomes and costs associated with three types of maternity care providers in Manitoba: family practice physicians, obstetricians/gynacologists, and registered midwives.

“The reality is, we work in a system that has fiscal budget restraints,” Thiessen points out. “It’s clear that mothers and babies are receiving a great deal of handson care, but is it cost effective? Are there innovative health service delivery models that could provide optimal client outcomes and savings to the overall health-care system? We’re now more than 15 years into the service and haven’t looked at that piece at all.”

Thiessen says that this study is the first time that the midwifery profession in Manitoba has really been engaged in this level of academic research. “No midwife has ever held a formal tenure-track academic position who is actively leading research related to the midwifery profession and those related topics,” she says. “Our interprofessional team of researchers will help provide significant insight and depth going forward.”

Kellie Thiessen, RM, RN, PhD
Assistant Professor and Director, Midwifery Program, College of Nursing

Featured Research: Identifying innovative models of maternity care to improve perinatal and system level outcomes

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