Our practice includes a growing number of registered midwives and midwifery students. As low-risk obstetrical healthcare providers, we conduct births either in your home or in the hospital setting. Our practice group has hospital privileges at North York General Hospital where we work to our fullest scope of practice.
To enhance continuity of care, clients will usually alternate their prenatal and postnatal appointments between their two or three assigned midwives. This ensures you know at least two midwives well.
Two midwives will attend your birth, and at least one of those midwives will be your known midwife.
Is a Midwife the same as a Doula?
In a word, no. Doulas are great resources to have at a birth regardless of who your care provider is, but they are not healthcare providers.
Midwives undergo a rigorous 4-year training program to become licenced healthcare providers who are funded by the Ministry of Health and Longterm Care just like doctors and nurses are. Doulas may have formal or informal training to support your emotional and physical comfort during labour and are hired and paid privately by their clients.
We feel it is vitally important to educate new midwives as the demand for midwifery services increases. Our practice is a teaching practice and participates in the education and supervision of midwifery students. You will meet and get to know the students who are working in our practice. If a student is attending your birth, it will be someone you know and have met prenatally as part of your “team” of midwives. Students are involved in all aspects of midwifery care, including prenatal, labour and birth and post-part care with supervision dependent on their level of study.
Can I have a Midwife and a Doctor?
No, but that does not mean that you don’t have access to a doctor. As primary care providers your Midwife is trained to provide all routine pregnancy care, as well as deliver your baby and care for both of you for 6 weeks after. Midwives are also trained to identify when complications happen in a pregnancy.
If part of your care requires the attention of a specialist – for example an Obstetrician, an Edocrinologist, a Genetic Counsellor – your Midwife will arrange an appointment for you but remain in charge of the rest of your care.
In rare cases, a pregnancy can develop serious complications that make it best suited to an Obstetrician. In this case your Midwife will transfer your care to one of our colleagues at North York General Hospital, but she will remain available to you for supportive care.
Can I still have an epidural?
Yes! Once your Midwife has assessed your labour and determined that it’s time to stay at the hospital, you can request an epidural. This will be placed by the anaesthesiologist on call and your Midwife will continue to manage your labour as before.
What if there’s an emergency during my birth?
Midwives have extensive training to identify complications and emergency situations. Our scope of practice includes treating many emergencies, including hemorrhage (when Mom loses too much blood) and resuscitating newborns who are not breathing. However, we also know that many urgent situations benefit from a team of people with a variety of skills. If your care requires more team members your Midwife will call in our collegues from nursing, respiratory therapy, paediatrics and obstetrics to assist.
If your Midwife has determined that you require care that is outside of the midwifery scope (for instance a Caesarean section) she will consult with the appropriate specialist. North York General hospital has 24-hour on call obstetricians and paediatricians in hospital to respond quickly in emergencies. At all times your Midwife will remain available to you, even if an Obstetrician needs to take over your care.
Labour And Birth
For each client, we work in a team that includes two registered midwives, and a midwifery student. One Midwife (usually your primary Midwife) will assess your early labour and remain with you throughout your active labour. The second Midwife will arrive near the time when the baby will be born.
Our care throughout labour includes monitoring labour progress, mom’s well-being, baby’s heart rate and position, delivering the infant and placenta and suturing if required.
Following the birth we remain with you until we are confident that all is well with both mother and baby – usually 2-4 hours. We perform a complete physical exam of the baby, help with breastfeeding, continue to monitor mom’s well-being and give information and guidance to the family.
In situations where birth plans change, we continue to provide parents with information about their options and give support in making decisions.
After the birth your midwives will visit you at home usually on days one, three and five. Between days ten and fourteen we will see you again either at home or in the clinic depending on your particular circumstance. The last two visits are between three and four weeks and at six weeks postpartum.
Who can be with me during my birth?
Anyone you like. There is no limit to the number of support people you can have. However, many of the labour and delivery rooms have limited space and you should keep in mind that there is no designated waiting area outside of the room.
In planning who will be with you, it’s important to remember that labour takes a long time – on average 12 hours for a first baby. And there are many things to do in the hour after the baby is born. It is usually best only to have the people who are going to be actively helping you during labour. Your family who are eager to meet the baby can join you later and won’t miss out on anything.
If you are planning to have your older children present, it’s best to have an adult whose only job is to look after their needs.
When to page your Midwife
- Vaginal bleeding that is more than spotting and not after intercourse
- Severe abdominal pain, nausea or vomiting
- Severe headaches, dizziness or blurred vision
- A marked decrease in baby’s after 27 weeks of pregnancy
- Fever >38 degrees C or 100.4 degrees F
- Signs of preterm labor (before 37 weeks)
- Water breaks
- Hot, red area on calf
- Rhythmic, regular labour contractions
- Pain or burning when urinating
- Any urgent concerns about you or your baby