midwifery

What is Midwifery?

Midwifery is a health care profession in which providers offer care to childbearing women during pregnancy, labour and birth, and during the postpartum period. They also care for the newborn and assist the mother with breastfeeding. Midwives are autonomous practitioners who are specialists in low-risk-pregnancy, childbirth and postpartum. They generally strive to help women to have a healthy pregnancy and natural birth experience. As such, many say that is the reason why they often have a lower rate of interventions. Midwives are trained to recognize and deal with deviations from the normal. Obstetricians, in contrast, are specialists in illness related to childbearing and in surgery. The two professions can be complementary, but often are at odds because obstetricians are taught to “actively manage” labor, while midwives are taught not to intervene unless necessary.

What do midwives do?

A midwife can basically perform all of the same routine prenatal, labour and post-natal care as a doctor, as long as the pregnancy is low risk. Midwives are registered health care professionals who provide primary care to women throughout pregnancy, labour and delivery, as well as care for both mother and baby during the first six weeks following the birth.

Midwives work together in group practices. A woman receives care from a small number of midwives. During regularly scheduled visits to the midwifery practice, midwives provide clinical examinations, counseling and education. If complications arise during pregnancy, labour or the baby’s first six weeks, care will be transferred to a physician.

What kind of training do midwives have?

Midwives qualify for registration either by graduating from the Ontario Midwifery Education Program, which is a Bachelor of Health Science in Midwifery, four-year university degree program, or by successfully completing the International Midwifery Pre-registration Program, offered through the continuing education division at Ryerson University.

Is there a charge for midwifery Care?

There is no fee charged for midwifery care [in Canada]. Midwifery care, including prenatal, birth and postpartum care, is paid for by the Ontario [provincial] Ministry of Health and Long-Term Care.

Where can I have my baby?

Midwives offer you the choice of a home or hospital birth.

How often do I see a midwife?

Midwives work collaboratively in group practices. A woman receives care from a small number of midwives. Visits to a midwifery practice occur on a regular basis, during which time midwives provide clinical examinations, counseling and education. The appointment schedule for prenatal care (before the baby is born) is the same as with obstetric care from a physician, but the appointments are routinely 30 to 45 minutes. Prenatal visits are once a month for the first 28 weeks, every two weeks until 36 weeks and then once a week until your baby is born. Midwives are on call for emergencies 24 hours a day.

When should I contact a midwife?

As the demand for midwives is larger than the number of midwives available, it is best to contact a midwife as soon as you find out you’re pregnant.

How do I get a midwife?

To find a midwifery practice near you can search the listings on parentcentral or check out the Association of Ontario Midwives website. For a listing of Midwives in Ontario, click here.

What is the difference between a doula and a midwife?

A birth doula is a trained labour support person who provides emotional and physical support to a labouring woman and her partner. While she is not a medical professional, she can offer a wide range of comfort measures during labour, from massage to aromatherapy to continuous reassurance and coping techniques.

A midwife, on the other hand, is a trained primary caregiver. Like a doula, she too provides emotional and physical support to a labouring woman and her partner, but also is able to tend to the low-risk medical needs of healthy pregnant woman, and catch the baby.

Can I have a midwife and a Doctor?

You can have either a midwife or a doctor for your pregnancy, birth and newborn care. Midwives, obstetricians and family physicians are all considered primary caregivers. A primary caregiver takes sole responsibility for your care. Having two caregivers is viewed as a duplication of health care services.

Why would I choose a midwife instead of a doctor as my primary caregiver?

Many women find the comfort of having a midwife with them throughout their whole pregnancy and six weeks post-partum invaluable. Midwives are on-call and available to their clients 24 hours a day, 7 days a week. With a midwife, pregnant women and their families make decisions that are based on informed choice.

What kind of diagnostic tests can a midwife order?

There are a wide range of tests that a midwife can order. For example, a midwife can arrange for appropriate ultrasound and genetic screening, as well as standard initial laboratory and diagnostic tests.

What happens if something goes wrong?

If, during midwifery care, a health concern arises beyond the scope of midwifery practice, your midwife would consult with the appropriate health care professional. Occasionally, this may result in a transfer of your care to an obstetrician, or for your baby to a pediatrician. If your care is transferred, your midwife remains with you in a supportive role. Should complications arise during labour, your midwife would transfer care to a physician, if necessary, or arrange for your transport to hospital if you were labouring at home.

How long do I continue to see a midwife after the baby is born?

The midwife provides care for you and your baby until six weeks postpartum (after the baby is born). The midwife will visit you at home (or in hospital) within 24 hours of the baby’s birth and come for an additional three or more visits within the first two weeks postpartum, to support and assist you with infant feeding and newborn care, and to monitor your health and your baby’s health. Visits then continue at the clinic until the final visit at six weeks following birth.

Source: The Association of Ontario Midwives (AOM), The College of Midwives of Ontario, Photo: Mark van Dam of Barrie midwife Kerstin Helen-Thompson and expectant mom Elizabeth Horrell.