What is a Midwife?
What is the Parents' role and responsibility?
Home or hospital, who decides?
What happens if there are complications?
What should I take to the hospital?
What items do I need for a home birth?
What are the signs of labour?

What is a Midwife?

Midwives see pregnancy and childbirth as normal states for the healthy woman. The midwife provides continuity of care throughout the pregnancy, birth and postpartum period. She carefully watches and guides assisting the family to give birth, respecting their choices and values.

By the definition accepted by the International Confederation of Midwives and the World Health Organization a midwife is:

A person who, having been regularly admitted to a midwifery education program, duly recognized in the country in which it is located, has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery.

She must be able to give the necessary supervision, care and advice to women during the pregnancy, labour and the postpartum period to conduct deliveries on her own responsibility and to care for the newborn and the infant. This care includes preventative measures, the detection of abnormal conditions in the mother and child, the procurement of medical assistance and the execution of emergency measures in the absence of medical help. She has an important task in health counseling and education, not only for the patients but also within the family and community. The work should involve antenatal education and extends to certain areas of gynecology, family planning and child care. She may practice in hospitals, clinics, health units, domiciliary conditions or in any other service."

As of January 1, 1994 any midwife practicing in the Province of Ontario must be registered with the College of Midwives of Ontario (CMO). All of the midwives in this practice are registered with College of Midwives. We are also members of the professional organization for midwives, the Association of Midwives (AOM).


What is the Parents' role and responsibility?

We encourage our clients to be responsible for the health of both themselves and their babies. Following a balanced diet, participating in good prenatal care and getting adequate sleep and exercise are all helpful. We also request that parents acquire the knowledge and skills necessary for labour, birth and early parenting either through prenatal classes or self-education. For women planning to breastfeed their babies we recommend attending a support group such as La Leche League in the last few months of your pregnancy.

If you are planning to have your children at your birth we recommend that you have another adult present to care for their needs. Obviously, this person should also feel comfortable with being present at your birth.

A midwife's care is individualized for each particular client. It is important for you to make us aware of your expectations. In order to be effective as caregivers, we require that parents keep us well informed of problems or situations which may affect their care.


Home or hospital, who decides?

There are distinct risks and benefits to any place of birth. It is the responsibility of parents to become as informed as possible, to weigh those risks and to make decisions appropriate for themselves. As midwives attending births at home, we believe planned homebirth is a safe option for healthy mothers with low risk pregnancies. Adequate prenatal care is the most important factor in detecting and avoiding possible complications. Continued monitoring throughout the labour and birth process allows for assessment of possible complications and their appropriate management. Difficulties however, can arise during labour and birth most of which are not life threatening and can be dealt with at home or safely transported to hospital. There are some rare circumstances when the use of technology available in a hospital may be essential for the safety of mother and/or baby. Choosing to give birth either at home or in a hospital means acceptance of certain risks which may be life threatening. A good consultation arrangement with physicians in hospital is essential for management of situations which fall outside of normal. We can provide you with information of some of the complications which may arise, and we encourage you to discuss with us our experience in dealing with them.


What happens if there are complications?

In pregnancy and labour, complications sometimes do arise. Midwives are trained to identify problems. You and your midwife would then consult with the appropriate health care professional.

In some cases your care is transferred to a physician and your midwife provides supportive care.

Midwives carry monitoring and resuscitation equipment to all home births.

Midwives are prepared to respond appropriately to emergency situations, and they update their skills on a regularly basis.


What should I take to the hospital?

You should take:
• Mother's Health Card and Blue Hospital Card.
• 2 pillows in distinctive cases.
• 1 small unopened bottle of olive oil (for perineal • massage during birth).
• 1 small box of Kleenex.
• 1 small box of "Overnight" sanitary pads (without special surface e.g. not Always brand).
• Soap and other toiletries.
• Drinks e.g. juices, Endura, Gatorade.
• Food for the mother and partner.
• Thermometer (leave at home for use after the birth).
• Tube Vaginal lubricant (Astroglide or KY Jelly for use at home after birth).

Optional Birth Items

Large Comfortable T-Shirt or nightie for labour
Hot Water Bottle	1 Large Towel
Warm Socks	2 pairs Disposable Panties
Music. Battery operated tape/CD player
Change for vending machines
Deck of cards or other labour activities

Going Home Items

Packing Instructions

It may be useful when packing for the hospital to organize things into two bags. One with items for the mother to use in labour. The other one for things to use after the birth (e.g. baby items) You can leave the second bag in the car with the car seat. After the birth, the second bag and the car seat can be brought in.

What items do I need for a home birth?

• 1 small unopened bottle of olive oil (for perineal massage during birth).
• 8 large garbage bags (6 to cover the pillows, 1 for used linen, 1 for garbage).
• 1 large plastic sheet (to cover the bed) e.g. paint drop sheet or old shower curtain.
• 8 diaper pins (to pin plastic sheet to the bed).
• 6 pillows for comfort.
• 1 large hand held flashlight with new batteries or good bright lamp (goose neck type).
• 2 medium sized basins, bowls or pots.
• 1 gel pack or bag of frozen peas.
• 1 small box of "Overnight" sanitary pads (without special surface e.g. not Always brand).
• Food for the mother and partner.
• 1 portable space heater (as needed).
• Thermometer (leave at home for use after the birth).
• Tube Vaginal lubricant (Astroglide or KY Jelly for use at home after birth).
• Home birth package available from midwifery practice at 36 weeks with under pads, peribottle and registration forms.

Optional Birth Items

Large Comfortable T-Shirt or nightie for labour
Hot Water Bottle	1 Large Towel
Warm Socks	2 pairs Disposable Panties
Music. Battery operated tape/CD player
Deck of cards or other labour activities

Linen, Preparing for Birth

Preparation of Linen

The linens are for use during the birth so you may want to use older items. Machine wash and rinse in hot water. Machine dry thoroughly (when dry to touch, leave in for an additional 10 minutes.) Fold and store in a clean place.

Preparation of Birth Bed and Pillows

In early labour, put a clean bottom sheet on the bed, then cover it with the plastic sheet. Finally put the other clean sheet over the plastic sheet. Pin down the corner with diaper pins. Put pillows into garbage bags and tie or tape closed then puncture the bag to release the air. Fit into pillow cases and pin the open end with diaper pins.

Please collect and store all birth supplies together (e.g. in box, laundry hamper or drawer)

What are the signs of labour?

• Menstrual-Like Cramps (constant or come and go, just above pubic bone)
• Low, Dull Backache (constant or comes and goes)
• Pressure (feels like the baby is pushing down; feels heavy)
• Abdominal Cramping (with or without diarrhea)
• Increase or Change in Vaginal Discharge (mucousy, watery, light or bloody)
• Fluid Leaking from the Vagina
• Feeling Bad
• Uterine Contractions that are 10 minutes apart or closer (may be painless)

If you feel any of these symptoms, even if your baby is not due yet, you should page your midwife.