Midwifery Frequently Asked Questions
What is a registered midwife? / What training do midwives have?
A registered midwife in Ontario is a midwife who meets all the standards of the College of Midwives of Ontario. In Ontario, the Midwifery Education Program is a specialized four year university degree (offered at Ryerson, McMaster and Laurentian universities). Ongoing recertification and training continues to ensure that midwives have all the skills they need for providing great care. Many midwives in Ontario have been trained in other countries, and often have many years of experience. These midwives have completed Canadian examinations and have proven to the College of Midwives that they meet Ontario’s registration standards.
How much does it cost to have a midwife?
The Ministry of Health covers all the costs associated with midwifery care for Ontario residents.
I have heard that you have to have a home birth if you have a midwife. Is that true?
That is not true. Our midwives deliver babies at home, at the Guelph General Hospital and at Groves Memorial Community Hospital in Fergus. We provide home birth for healthy low-risk clients who choose that option.
What can I expect from midwifery care? Will I still get ultrasounds?
Midwives provide all of the care that you need from early pregnancy through labor and birth and they care for you and your baby for 6 weeks after the baby is born. We are able to order all of the tests that you will need (including ultrasounds).
You will have appointments every four weeks until 28 weeks of pregnancy, then every two weeks until the last month of pregnancy when your appointments will be weekly. After the baby is born, you (and the baby) will continue to have appointments with your midwives until the baby is about 6 weeks old.
Can I have an epidural/medication for pain if I have a midwife?
Yes! Midwives are very skilled at helping clients who want to have a baby without using medical forms of pain relief but we are able to access the full range of medications used in childbirth for people who want or need them.
What happens if there are any problems? What if there is an emergency during the birth or need for a caesarean section?
Midwives are part of the maternity care team in your community. If there are any concerns about you or your baby your midwives will arrange for consultations with the appropriate health care provider like an obstetrician.
Part of midwives’ training is how to respond to a variety of emergencies that might occur during labour and at the time of birth. Midwives are annually recertified in neonatal resuscitation. At home births, midwives carry oxygen, resuscitation equipment and medication to control postpartum hemorrhage. Midwives are trained to suture tears and episiotomies.
If you require caesarean section, your care will be transferred to an obstetrician for the delivery and your midwife will remain present and part of your health care team. Though your hospital stay may be slightly longer, your postpartum care will remain with your midwives.
What is the postpartum (after birth) care like?
Midwives provide at least 3 visits in the first week after the birth wherever you are: at home or in the hospital. We travel to you so you can get the rest that you need after having a baby, provide a great deal of assistance with breastfeeding and watch for early signs of problems such as infection or jaundice. At 2 weeks, 4 weeks and 6 weeks, you and your baby will be seen in the clinic. Additional appointments may be suggested by your midwives on individual basis.
What are the advantages of midwifery care?
Midwifery clients are encouraged to make informed choices about their care, with longer appointments to discuss their care and questions. Often, clients feel a greater relationship of trust with their midwives and value having someone they know at their birth. Midwives tend to give more individualized care. The at home early postpartum care is also something that women tend to appreciate.
I’m already seeing a doctor–Is it too late to consider a midwife?
Absolutely not! Midwives are happy to take clients at any time in their pregnancy. Call our office to see if we still have space.
Can I see a midwife and a doctor?
No. OHIP will cover one primary care provider (registered midwife, family doctor or obstetrician) for the duration of your pregnancy and birth, and up to six weeks postpartum. You will have to make a choice of who you want to care for your pregnancy and birth.
Midwives are specialists in normal, so if complications develop midwives will then arrange for a family physician, obstetrician or pediatrician to become involved in your care. You still should see your family physician for any non-pregnancy related heath issues/concerns.
How many midwives will I meet during my pregnancy?
At Family Midwifery Care, we function in pods (teams) of 2 — 3 midwives. You will get to know the midwives on your team during your pregnancy. When you go into labour, a midwife from your team will attend you. However, there are rare occasions when your midwife may be at another birth or may need to be off-call to rest to ensure safe care, and another midwife may answer you. While you are in care, midwives are on call for you 24 hours a day, 7 days a week, all year long.
How long are prenatal appointments?
Appointments are 30 — 45 minutes long. The longer appointments provide time to answer your questions and discuss your pregnancy care. The first two appointments usually are about an hour long.
Can my partner or my other children come to my appointments?
Absolutely! We encourage you to bring any of your support people you would like… including your children.
What is the difference between a midwife and a doula?
A midwife is a primary care provider responsible for you and your baby in pregnancy, labour and in the postpartum. Doulas do not provide medical care and do not deliver babies. Doulas can provide great supportive care. Studies have shown that having a doula present during labour can decrease a woman’s need for pain medication and improves outcomes. Even women with midwifery care can benefit from having a doula at their labour and births.
How long would my hospital stay be if I have my baby at the hospital?
When you are in the care of midwives and have had an uncomplicated vaginal birth, you have the choice of going home around 3 hours postpartum (early discharge) or to stay for up to 24 hours postpartum. Your midwife will visit you within the first 24hours after the birth at home (or in the hospital if you are there).
What can I expect from a hospital birth with midwives?
Please see our page about Hospital Birth
Is early discharge from hospital safe?
Hospital stays have gotten shorter for everyone in the past decade. When there were no complications with the pregnancy and the birth, early discharge is a safe alternative because you have a midwife available to you by pager 24 hours a day. Your midwife will give you clear instructions on when to call before your discharge from the hospital and will visit you at your home within 24 hours after the birth.
What about safety and home birth?
There is a lot of good evidence to show that home birth is safe for low-risk healthy clients with midwives in attendance. This is a choice for women and families in the care of midwives. Midwives bring portable versions of emergency equipment and supplies such as suction, oxygen, intravenous fluids, tools and equipment to suture tears and drugs for the prevention and treatment of postpartum hemorrhage (heavy bleeding). Our training includes management of the rare sudden emergencies that might arise at a home birth. If you are considering this option your midwives will discuss home birth with you.
What are my options for vaginal birth after caesarean (VBAC)?
Midwives support women who want a trial of labour for a normal vaginal birth after a previous lower segment c-section. Research shows that for many women it is a safe choice with lots of benefits and a high success rate. If a trial of labour is not successful, a repeat c-section would be performed by the obstetrician on-call at the hospital, and your midwife would accompany you in the operating room. Discuss your personal circumstances with your midwife to see if your medical history and your motivation make VBAC a good choice for you.
VBAC Client Handout (Family Midwifery Care of Guelph)
Association of Ontario Midwives–VBAC Clinical Guideline
Society of Obstetricians and Gynecologists: Pregancy and VBAC pamphlet (patient handout)
Society of Obstetricians and Gynecologists–VBAC Clinical Guidelines
International Cesarean Awareness Network