Midwifery in Bermuda could be line for an overhaul — just as a new book is published calling for more choice in childbirth on the island.

The Ministry of Health told The Royal Gazette it was “actively engaging” with Bermudian and overseas midwives to find ways to improve the “outdated regulatory framework” for the profession.

A ministry spokesman said the discussions included how to tackle “some of the limitations impacting midwifery practice in Bermuda”.

Sophia Cannonier, a childbirth companion, or doula, who is about to release a self-published book, The Home Birth Movement: A Push for Childbirth Rights in Bermuda, said a review of policy was overdue.

Ms Cannonier claimed in her book that true midwifery had been eradicated in Bermuda because babies are delivered by obstetricians at the King Edward VII Memorial Hospital and there are no midwives able or willing to conduct home births.

Her book, written with Charlene Macielag, asked the Government to invest in training for Bermudian midwives and for the hospital to allow all designations of midwife to practise, rather than just certified nurse-midwives.

She added that health insurers should provide full coverage for home births — at present only offered by Colonial — so women have more choice about where to have their babies.

Ms Cannonier said: “Unfortunately, our midwifery programme died. For one reason or another, we never had a push to keep this going.

“I just feel like I needed to do that push. I need people to buy this book and understand where we are coming from.”

She added: “Home birth is an important option for mothers to have and all birth choices should be possible to Bermudians.”

Ms Cannonier suggested island midwives could work with obstetricians and be available to women with low-risk pregnancies who wanted to give birth at home.

The Ministry of Health spokeswoman said: “The ministry is committed to addressing issues of cost, choice and safety by improving healthcare professionals’ regulation.

“The current proposed amendments under development for midwifery are one area of focus.

“In Bermuda, midwifery practice is limited due to an outdated regulatory framework, which includes a restricted scope of practice.

“The ministry is actively engaging with local and overseas midwives and other stakeholders to enhance and improve the regulatory framework for midwifery.”

The spokeswoman added that the first phase involved a transfer of regulatory oversight from the Bermuda Medical Council to the Bermuda Nursing Council.

Improvements in the criteria for registration and re-registration and the creation of a code of conduct are also on the cards.

The second phase will involve consultation with “multiple stakeholders to address some of the limitations impacting midwifery practice in Bermuda, such as prescribing rights specific to midwifery and formalising collaborative practices to ensure safe care of women and babies”.

A Bermuda Hospitals Board spokeswoman said there were two Bermudian midwives at the hospital, although only one was licensed to practise on the island.

She added: “BHB’s policy is that babies are delivered in hospital by obstetricians, although most of the care throughout an uncomplicated labour is provided by the maternity nursing staff.”

“All 20 maternity nursing staff are trained and have practised as midwives in their respective jurisdictions and one has gone through the local midwife registration process, which requires taking an additional written exam set by the Bermuda Medical Council.

“All nursing staff on maternity are registered nurses, as well as trained midwives, and they have the skills and training required to care for mothers in labour and to deliver a baby should a physician not be present at the time of birth for some unforeseen reason.”

• The Home Birth Movement: A Push for Childbirth Rights in Bermuda is available to pre-order on Amazon