What is a registered midwife?
Midwives are formally trained and fully integrated primary healthcare professionals who provide comprehensive care to women during pregnancy, labour and birth, and the first six weeks postpartum. Across the rest of the world, most babies are born into the hands of capable midwives. The term ‘Registered Midwife’ is a protected title in BC, and indicates that the midwife has met the standards to register with the College of Midwives of British Columbia, and maintains her status through ongoing recertification and training.
What are the advantages of midwifery care?
Midwifery clients experienced lower rates of forceps, vacuum extractions, caesarean sections, episiotomies, infections and babies born requiring resuscitation in studies where midwifery care was compared to physician-led care.
Midwifery clients are encouraged to make informed choices about their care, and have access to all routine medical testing during their pregnancy including blood work, genetic testing and ultrasounds. In addition, midwifery clients benefit from knowing and trusting their midwives, with whom they develop a close relationship during pregnancy. Paramount to midwifery practice is that women feel respected and supported so that they are able to experience pregnancy, give birth, and become mothers with power and dignity.
What kind of training do midwives have?
Midwives come from a variety of backgrounds, all of which comply with rigorous set of standards set by the College of Midwives of British Columbia. Many midwives train overseas and others complete degree programs here in Canada. Ask your midwife about her individual training.
I’m already seeing a doctor; is it too late to consider a midwife?
Community Midwives Kelowna is happy to take clients at any time in their pregnancy, provided we still have room, and your pregnancy is within our scope of care. Contact us with any questions or to book an initial appointment.
I’ve been told that I’m “high risk.” Can I still see a midwife?
Some women with certain medical conditions or complications of pregnancy are indeed best cared for by a physician, and these situations are listed in the College of Midwives of BC’s guidelines. However, the best way to find out if you are too high risk is to book a consultation with a midwife to discuss your case. Many of the reasons people think they are ‘high risk’ do not preclude you from midwifery care. For example, women often think they are ‘high risk’ for being over the age of 35, struggling to get pregnant, or previously having a miscarriage. In fact, we care for women in these circumstances all the time.
Can I see a midwife and a doctor?
No. The Medical Services Plan 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. The choice of caregiver during your pregnancy is up to you.
However, should complications develop in the course of yours or your baby’s care, midwives will arrange for a family physician, anesthetist, obstetrician or pediatrician to become involved in your care to ensure you get the safest and most appropriate care for you and your baby. Of course, you are welcome to see your family physician at any time for non-pregnancy related issues. Once your baby is about six weeks old, your care is transferred back to your family physician, who will resume care of you and your new baby.
What if there is an emergency during the birth? What if I need a caesarean section?
Midwives are trained to handle a variety of emergencies that might occur during labour and at the time of birth, and are annually recertified in neonatal resuscitation. At home births, midwives carry oxygen, resuscitation equipment and drugs to control postpartum hemorrhages. 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 the whole time. Follow-up care remains the same whether you have a vaginal or caesarean birth.
Can I have pain medication during labour with a midwife?
Yes. The appropriate use of a range of natural and pharmaceutical pain relief options, including epidurals, is part of the midwifery scope of care. Midwives support your choice of pain relief options during labour.
Can I have a midwife and give birth in the hospital?
Yes. Our midwives hold privileges to attend births at Kelowna General Hospital.
Midwives offer the choice of birthplace to healthy, low risk women based on the principles of informed decision making. On average, 70% of births attended by midwives occur in hospitals. This number varies by practice and community. For more information on home birth in BC read the CMBC Home Birth Handbook for Clients. You can read a large study on homebirth in British Columbia, literature as complied by the American College of Nurse Midwives or also an annotated guide to the available home birth, literature as compiled by the Division of Midwifery, UBC.
How many midwives will I meet during my pregnancy?
Currently at Community Midwives Kelowna, you will get to know two to three midwives during your pregnancy. When you go into labour, one of your midwives will attend you. While you are in care, your team of midwives is on call for you 24 hours a day, 7 days a week, 365 days a year.
Do I have to pay for midwifery care?
No, in British Columbia, the Ministry of Health pays for the services of Registered Midwives. If you are covered under the BC Medical Services Plan, all you have to do is show your BC CareCard. If you do not have a CareCard, please contact us to learn more.
When do I make my first appointment?
As soon as you have a positive home pregnancy test. Midwives can formally confirm the pregnancy with a simple blood test if you desire.
How often do I come for appointments?
Generally, your appointments will follow the standard antenatal schedule in BC- every 5 weeks until you are 28 weeks pregnant, every 3 weeks until you are 36 weeks pregnant and weekly thereafter until you have the baby. After you have the baby, we usually see you about three times in the first week at home, and then three or four times in the clinic until your baby is six weeks old. However, we often adapt this schedule to ensure that you get the personalized care that you need.
How long are prenatal appointments?
Appointments are generally 30 minutes long, with an hour long initial appointment and discharge visit. This gives you and your midwife lots of time to get to know each other, ask questions and to help you prepare for birth and for caring for your baby. Women who have already had a baby (or two, or three….) might not want or need such long visits, and can mention this when booking appointments. Between visits, midwives provide 24/7 call coverage for urgent care or concerns.
Will I have access to the same tests and prescriptions that I would have had with a doctor?
Midwives offer a complete panel of prenatal laboratory tests, genetic screening and diagnosis options, ultrasound imaging and many other tests and procedures for women and newborns. A midwife’s scope of practice includes the use of many medications that may be indicated in pregnancy, during birth including emergency situations or pain medication, and for mom or baby postpartum. If medication or testing is required outside of this scope of practice, midwives consult with and refer to physicians as indicated for more specialized care.
Can my partner or my other children come to my appointments?
Certainly. You are welcome to bring whichever support people you would like. Prenatal appointments are a great opportunity for your partner to meet the midwives and have his or her questions answered, and for your children to get comfortable with the midwives and participate in your pregnancy.
What is the difference between a midwife and a doula?
Although there are some similarities between midwives and doulas in the sense that both provide emotional support and suggestions for coping with labour, the biggest difference is that your midwife is responsible for monitoring the health and well-being of you and your baby, and the progress of your labour. Doulas provide you with uninterrupted support, but they do not provide medical care, and do not deliver babies. There is good evidence demonstrating that the presence of a doula decreases a laboring woman’s need for pain medication and improves outcomes.