What is a Midwife?

Midwives are registered health professionals who are trained and licensed to provide complete prenatal, birth, postpartum and newborn care. Midwives practice within accepted community standards for maternity caregivers, while providing a holistic, personalized and educational approach to the childbearing experience. Midwives provide lengthy prenatal and postpartum appointments in home or clinic and can order all necessary prenatal lab work, ultrasounds, and if desired, genetic screening tests. Midwives provide current, evidence based information to assist parents in making informed decisions and are on call 24 hours a day. Midwifery care is completely free if you have a BC CareCard and you can choose to have your baby at home or in hospital. You may transfer into a midwife’s care at any time during your pregnancy.

The Midwifery Model of Care offers you:

• Personal, individualized care that respects physical, emotional and cultural diversity.
  
  
• Informed choices in pregnancy and birth including a choice of birth place.
  
  
• Support and empowerment to discover your body’s natural ability to grow a healthy baby and have a healthy birth.
  
  
• Family-centered care that welcomes spouses, family members, and siblings in the childbearing process.
  
  
• An opportunity to build a strong and trusting relationship with your caregiver.
  
  
• Non-interventive care based on the most recent medical research available.
  
  
• Sensitive, continuous, one to one care during labour and delivery.
  
  
• In home postpartum visits the first week after delivery.
  
  
• Consultation and collaboration with physicians should the need arise.

Is midwifery care safe?

There is a large body of evidence that supports midwifery as a safe choice for low risk, healthy women. Midwifery is the standard of care in New Zealand, Australia, England and Holland where research has shown excellent outcomes for women and babies.  In Canadian studies comparing midwifery and physician led care, midwifery clients experienced lower rates of forceps, vacuum extractions, cesarean sections, episiotomies, infections and babies born requiring resuscitation.  Stats Canada released a recent survey indicating that midwifery clients are more satisfied with their care than clients of other maternity care providers therefore midwifery consumers are proven to be SAFE and HAPPY!

Is midwifery care legal?

Yes, since 1998, midwifery has been regulated through the Health Professions Act, by the College of Midwives of British Columbia.  Check out the CMBC website at www.cmbc.bc.ca
Registered Midwives undergo rigorous education as well as written and practical examinations to become licensed in BC.

Do I have to pay for midwifery care?

In BC, the Ministry of Health pays for the services of registered midwives.  If you are covered under MSP all you have to do is show your BC Care Card.

Can I have a midwife and a doctor at the same time?

MSP will only cover one primary care provider for the duration of your pregnancy and birth, to six weeks postpartum.  The choice of caregiver is yours and you may transfer into midwifery care at any time in your pregnancy.  Midwives are experts in deciding when a second opinion is required and will consult with family doctors, obstetricians and pediatricians should complications arise.  In this situation, a mom or baby may see both caregivers for as long as the consultant deems necessary.  At six weeks postpartum, your care is transferred back to your family physician. 

Can I have a midwife and still give birth in the hospital?

Midwives support a women’s right to choose the place of birth and offer women home or hospital birth.  Also popular, is the option of labouring at home as long as desired and then going to hospital for the birth.  Research has shown that delayed admission to hospital in labour improves outcomes for moms and babies.  Midwives provide continuous support and monitoring of mom and baby, in person and  in the setting of choice when active labour is established.  All Registered Midwives maintain hospital privileges and this practice delivers babies at Lion’s Gate Hospital, St Paul’s Hospital and BC Women’s Hospital. 

Does having a midwife mean I can’t use pain medication?

The appropriate use of a range of natural and pharmaceutical pain relief options, including ordering epidurals, is part of the midwifery scope of care.  Most important in midwifery practice is that women feel supported and respected regarding birth preferences.  While midwives excel in helping women achieve “drug free” deliveries, medication use in labour is a personal choice and can sometimes be a beneficial intervention.  Your midwife can help you decide if/when medications may be useful. 

When and where do I see my midwife?

Women may book into care at any point in their pregnancy, but early booking is recommended, as space is limited.  Midwives see their clients with the same frequency as one would see a GP or OB for prenatal care: every 4-5 weeks until 28 weeks, then every 2-3 weeks until 36 weeks, then weekly until delivery.  Visit schedules are customized when clients need more or less visits for any reason.
This practice offers clinic and home visits, days, evenings and weekends.  Appointments are 30 to 45 minutes long, allowing your midwife to assess your physical and emotional health, share information, and answer your questions.  After your baby’s birth, home visits are made as needed, usually every second day for the first week.  Then home or clinic visits take place at 2, 4 and 6 weeks postpartum.  In between visits, your midwife is on call by pager 24/7 should concerns arise.

What is the difference between a midwife and a doula?

Doulas are trained to provide labour support but do not provide medical care and do not deliver babies.  Some doulas are also registered massage therapists, chiropractors or naturopaths.  Midwives provide medical care as well as labour support and can perform detailed assessments to monitor the health and well-being of you and your baby.  Doulas work as part of the team, with a midwife or doctor and nurse. Doulas provide continuous emotional and physical support to the labouring woman and her partner and are an excellent addition to the birth team.  For more information about doulas, contact the Doula Services Association of BC.