The Three Principles of Midwifery Care in Ontario:
- Continuity of Care:
- Midwifery care is available to women throughout their pregnancy, labour, birth, and the first six weeks after birth. Midwives spend time developing relationships with women and are available 24 hours a day, seven days a week.
- Informed Choice:
- Women are active decision-makers in the care they receive. Midwives provide information to help women make informed decisions.
- Choice of Birthplace:
- Midwifery clients may choose to give birth at home or in hospital. Our midwives have privileges at both Leamington District Memorial Hospital and Windsor Regional Hospital, and work collaboratively with other health care practitioners.
The practice of midwifery is the assessment and monitoring of women during pregnancy, labour and the post-partum period and of their newborn babies, the provision of care during normal pregnancy, labour and post-partum period and the conducting of spontaneous normal vaginal deliveries. (Ontario Midwifery Act, 1991)
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.
Midwives qualify for registration either by graduating from the Ontario Midwifery Education Programme, 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.
There is no fee charged for midwifery care in Ontario. Midwifery care, including prenatal, birth and postpartum care, is paid for by the Ontario Ministry of Health and Long-Term Care.
Midwives offer you the choice of a home or hospital birth. Whichever setting you choose, you and your baby will receive comprehensive and safe care.
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. Appointments are 30 – 45 minutes. The appointment schedule for prenatal care (before the baby is born) follows the standard obstetric care model. 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.
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 who provides care to women throughout their low risk pregnancy, labour and birth, and provide care to both mother and baby during the first six weeks following the birth. 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. When you choose a midwife, you have the choice of giving birth in either a home or hospital setting.
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.
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.
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.
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.
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.