Frequently Asked Questions

Midwifery in Ontario

A registered midwife is a health care provider who is trained to provide care to both mother and newborn during normal pregnancy, labour, birth, and the first six weeks of your baby's life. When women and babies are healthy, midwives provide primary care similar to the care that a family doctor would provide, including ordering blood tests, ultrasounds, and other routine assessments. Midwives are skilled in providing emergency care, detecting complications, and providing care together with physicians and other specialists when consultations are needed.

Midwifery is a self-regulated profession, and registered midwives work under the oversight of the College of Midwives of Ontario, which sets core competencies and registration requirements that midwives must maintain. The role of the College of Midwives of Ontario is to ensure that midwives provide safe care to families.

The word "midwife" comes from roots that mean "with woman" and midwives themselves may be men or women, although most are women.

Midwives provide care with a focus on promoting normal labour and birth, and client-centered care. When you work with a midwife during your pregnancy, you have the option of giving birth in or out of hospital, you receive early postpartum care in your home, and you have access to on-call care and support when you need it. By caring for you in your home in the first few weeks of your baby's life, midwives can support you in getting more rest and adjusting to parenting. This model of care also allows midwives to support the breastfeeding relationship if you choose to breastfeed your child.

Midwifery care is structured so that you become familiar with the care providers who will be with you during labour by allowing for longer appointment times and keeping your midwifery team small. In labour, you will receive care from a midwife who you know and trust, as well as from a second midwife toward the end of labour who you may have met during pregnancy. We call this continuity of care. Longer appointment times, plus the trusting relationships that midwives often develop with our clients, mean that you get more time to learn about your options, allowing you to make truly informed choices.

We view pregnancy and birth as significant events in your life, and so your social, emotional, and cultural needs are accorded importance alongside your needs for physical care.

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A doula is a person with training and experience in providing emotional and physical support during labour and birth, and sometimes in the postpartum period. Midwives also provide labour support, but we are regulated health care professionals with training in prenatal care, labour and birth, and postpartum care for both you and your baby. Doulas and midwives often work together, and you can have a doula at your birth along with your midwife. Because your midwife will be thinking about your clinical care during labour, you and your partner or other support person might find it very helpful to have support from a doula in addition to your midwife.

Doula services are not covered by public health care coverage, and most doulas charge a fee for their work.

Midwifery in Ontario is funded through the Ministry of Health and Long-Term Care. There is no cost to women for midwifery services. You can access midwifery care even if you don't have coverage through OHIP, although you may be billed for lab tests and other health care services.

Midwives are trained in many different settings and models around the world. In Ontario, many midwives are trained in the Ontario Midwifery Education Programme (MEP), a four-year degree program that is run out of Laurentian University, Ryerson University, and McMaster University. Midwives who are qualified to work in other Canadian provinces can apply for reciprocal status and work in Ontario. Midwives who were educated outside of Canada must pass the International Midwifery Pre-Registration Programme, a one-year equivalency program.

We also continue to learn through ongoing educational opportunities at conferences, in peer review, and at interdisciplinary rounds in hospitals, as well as in our roles as preceptors and educators for students in the Midwifery Education Program. Midwives are the only health professionals that recertify in Neonatal Resuscitation yearly as well as attending Emergency Skills sessions every second year.

Accessing Midwifery Care

You can call us as soon as you find out that you're pregnant! Your first appointment can be scheduled for your first trimester, depending on when you learn that you're pregnant and when you call.

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It is never too late to contact us! You can start seeing a midwife at any point in your pregnancy. If you've already seen a doctor, your doctor can transfer your prenatal records to your midwife with your permission.

We endeavour to provide care for as many women as possible as we recognize that we are the only obstetric care providers in the area. Availability varies monthly, but we encourage you to contact us to discuss midwifery care further.

In many cases, women who think they are high risk have complications that a midwife would consider within her ability to manage. For instance, midwives routinely take care of women over the age of 35 and women who have had previous caesarean or forceps/vacuum deliveries.

Although there are some cases in which a midwife will be unable to provide primary care to you throughout your pregnancy, midwives often work in consultation with doctors to provide you with excellent care. If health concerns come up during your prenatal care, your midwife can arrange referrals to doctors and can usually continue to be part of your care team.

Midwives adhere to regulations set out by the College of Midwives in deciding when to consult, and when a doctor must provide your prenatal care. There are certain chronic conditions that necessitate specialist care; feel free to call the clinic to discuss your concerns if you have a health condition and are interested in midwifery care.

Yes! Both women planning a vaginal birth after caesarean and women choosing an elective repeat caesarean are eligible for midwifery care.

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Although your doctor is welcome to send a referral and forward any relevant pregnancy information, you do not need a doctor's referral. You can call us directly. It is best to contact a midwife as soon as you find out you're pregnant. We do often have openings for clients later in pregnancy and encourage you to call anytime.

Contact our office if you are unsure which midwives are the closest to you. We can discuss whether it is possible for us to provide your pregnancy care or we can direct you to other midwifery practices if they would be more appropriate based on your location and choice of birthplace.

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Absolutely! We would love to hear from you. We can discuss the differences in midwifery versus physician care as well as answer any questions that you might have.

Care in Pregnancy and Beyond

Yes! Midwives can administer many pain medications, including nitrous oxide (gas) and narcotics, and your midwives will support you in any pain relief choices that you make. Nitrous oxide is available in hospital and portable cylinders are available for women choosing home birth. If you opt for an epidural, the obstetrician on-call and nurses will be asked to join your circle of care. Your midwife will still attend your delivery, take care of your baby, and do postpartum care. As well, midwives are skilled and knowledgeable in many natural pain relief options, and will often suggest position changes, massage, breathing for relaxation, and hydrotherapy (taking a shower or a bath) to help manage your pain if you want to avoid using drugs.

Yes! Midwives are trained to provide safe care in hospital as well as in out-of-hospital settings. We are privileged at Peterborough Regional Health Centre and enjoy good working relations with the staff. We want you to have your baby where you want to!

Home birth is an option for most women. Your midwife will discuss your choice of birthplace throughout your pregnancy and may recommend a change in plans if concerns arise. We will support you to have your baby where you want to!

Studies show that planned home birth attended by midwives in a jurisdiction where home birth is well-integrated into the health-care system is at least as safe as hospital birth. The equipment that a midwife brings to a home birth is similar to the equipment in a community hospital, including oxygen, medications to stop bleeding, and sterile instruments. Women who plan a home birth can choose to move to hospital during labour. About 25% of women who plan home birth transfer to hospital, most often because of a long labour. If it becomes medically necessary to go to the hospital during your labour, your midwife is trained to make this decision. A home birth is not appropriate for all women. Your health during pregnancy and labour and your personal circumstances are considerations to discuss with your midwife when making this decision. Hospital birth, as a back-up for home births, is part of what makes home birth safe.

Midwives have extensive training in managing common emergencies that happen during labour and birth, and can manage these emergencies in both home and hospital settings. If you're choosing to have a home birth, your midwife will bring medications and supplies to your home that will allow her to manage an emergency if it comes up. Midwives maintain professional relationships with emergency medical services that allow them to transfer in to hospital quickly and easily when needed.

If you have a caesarean section, an obstetrician will deliver your baby. Your midwife will continue to be part of your care team, and will provide postpartum care to you as usual.

For the first 28 weeks of your pregnancy, you will usually see your midwife every four to six weeks. From 28 to 36 weeks, your appointments will be every two to three weeks. After 36 weeks, you will see your midwife every week until you give birth.

In the postpartum period, your midwife will see you either in the hospital or at home a number of times, often on days 1, 2, 4, 6, and as needed after that time. Your midwife will continue to follow you in clinic until you and your baby are discharged to other care providers at six weeks postpartum.

Haliburton & Bancroft Midwives

A small team of midwives offering prenatal, birth and postpartum care for women and newborns with the option of home or hospital birth for low risk women.

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