What is Midwifery?
Midwife means "with woman". To midwives and their clients, pregnancy and birth are normal, healthy life events. Midwifery promotes normal childbirth and the prevention of health problems. In 1994, midwifery became an integrated part of the Ontario healthcare system and is provided free of charge to residents of the province. Midwives provide care in both the hospital and home setting.
A midwife is a primary caregiver, which means that she can provide all the care necessary for a healthy woman and her baby throughout pregnancy, birth and for six weeks afterward. Midwives refer women and babies to family doctors or specialist doctors like obstetricians and pediatricians if the care becomes complicated. Even if care is transferred to a doctor at the birth, midwives will remain involved in the care as a support to the mother and baby. As primary caregivers, midwives do the following:
- care for healthy, pregnant women and their babies
- see women for all prenatal visits and give prenatal education
- order laboratory and ultrasound testing if needed
- arrange for consultations with or transfers to doctors if needed
- give some medications during pregnancy, labour, birth and the postpartum (after birth) period if needed
- take responsibility for primary care during labour, birth and postpartum including delivering the baby
- examine the newborn and care for mothers and babies for six weeks after the birth
You do not need a referral from a physician to use midwifery services; you can call us directly. However, it is best to call as early in pregnancy as possible to ensure that we have space for you.
There are currently over 400 midwives registered with the College of Midwives of Ontario.
What are the principles of midwifery care?
There are three important principles of midwifery care:
Continuity of Care
Midwives usually work in small groups and are on 24-hour call. A pregnant woman will get to know a small group of midwives (2-4) to ensure that she is comfortable and familiar with the caregivers who will attend her birth. Generally, two midwives will attend each birth and share the care throughout the pregnancy, labour, birth and after the birth for six weeks. They will offer education, counselling, advocacy and emotional support. Each midwife will take the time to build a relationship of trust and safety with each woman. If medical problems develop during pregnancy, labour, birth or postpartum, midwives work closely with specialist physicians and nursing staff.
Midwives encourage each woman to take an active part in her care throughout her pregnancy and birth and will provide information to each woman so that she can make choices about her care. Midwives provide sufficient time during prenatal care to discuss questions about important issues like nutrition, birth plans, breastfeeding and parenting. Midwives recognize and support the mother as the main decision-maker.
Choice of Birthplace
The pregnant woman chooses whether she wants to give birth in a hospital or at home under the primary care of the midwife. Midwives are trained to attend births in both places as well as to help individual women choose the safest place for them. Many women who opt to have a hospital birth spend time at home with their midwife before going to hospital.
A midwife's training prepares her to be responsible for decisions about labour, delivery, postpartum and newborn care both at home or in hospital. A midwife works closely with other community midwives, doctors and nurses to maintain a high standard of care.