Frequently Asked Questions about Midwifery in Ontario

 

I'm new to Ontario...is midwifery legal here?

After many years of work by consumers and midwives, midwifery became a legally recognized health profession in Ontario, with the proclamation of the Midwifery Act on January 1, 1994.

How much does it cost to hire a midwife?

Midwifery is fully funded by the Ontario Ministry of Health for all residents of Ontario. Therefore, there is no cost to you to use midwifery services. If your midwife offers prenatal classes, there may be a charge to you for that, as it is not generally included as part of midwifery services.

I like the idea of a midwife, but I want to have my baby in a hospital. Can I do that?

Midwives support a woman's choice of birthplace, be that home or hospital. Midwives have admitting privileges at hospitals, just as physicians do, and can provide complete childbirth care for you and your baby in the hospital setting.

Speaking of physicians, do I need to see a doctor during my pregnancy as well?

Midwives are primary care providers, which means that you do not need a referral to enter care with a midwife and you do not need to see a doctor; in fact, some women will come to their midwife for pregnancy testing. Midwives can order blood tests and ultrasounds, and provide complete childbirth care. If you should require medical attention unrelated to your pregnancy, then you would need to be seen by your physician. During your pregnancy, your midwives are available to you on-call 24 hours a day.

What happens if I develop problems during my pregnancy? How does the midwife deal with them?

Midwives are guided by the College of Midwives of Ontario document called "Indications for Mandatory Discussion, Consultation and Transfer of Care", with respect to a woman's medical history or problems that arise during pregnancy. If a problem arises during pregnancy, your care may be handled collaboratively with a specialist (usually an obstetrician), or completely transferred to obstetrical care. If your care is transferred, your midwife would provide supportive care for you during the labour and birth, and resume caring for you and your baby after the birth, providing all is well. Similarly, if your baby develops any problems after the birth, specialist care would be consulted as needed.

How often do I see a midwife?

We see you prenatally once a month until 28 weeks gestation, biweekly until 36 weeks gestation and weekly until you have your baby.

How long do you look after me?

Your midwife will be responsible for your care during pregnancy, childbirth and for the first six weeks postpartum. She will also care for your baby during that time. After that, care for you and your baby is discharged back to your family physician.

What kind of training do midwives receive?

Midwives practicing in Ontario have been educated through various routes. The midwives who practiced prior to legislation underwent an assessment process through the Michener Institute of Technology prior to registration. Midwives trained in other countries may have their education and training assessed by the College of Midwives of Ontario and be registered after having met standards set by the College. The midwives in Thames Valley Midwives are graduates of the Ontario University Midwifery Education Programme, a four-year baccalaureate degree which is offered at McMaster, Laurentian and Ryerson Universities or have received formal midwifery training in another jurisdiction and have then had their credentials recognized.

What happens if there is an emergency during the birth? Can the midwife handle that? What if I need stitches?

Midwives are trained to handle a variety of emergencies that might occur at the time of birth, and are required to recertify in Neonatal Resuscitation each year to maintain their registration. At home births, midwives carry oxygen, resuscitation equipment and drugs to control bleeding. Midwives are trained to suture tears and episiotomies.

How often does the midwife see me after the baby is born?

Your midwife will stay with you for at least two hours after the birth of your baby, and then visit you on days 1, 3 and 5 postpartum, and sometime during the beginning of the second week. She may visit more often, if needed. As in your pregnancy, your midwife is on-call for you 24-hours/day during this crucial time. At two, four and six weeks, you will be asked to come to the clinic to have you and your baby checked.

I've heard that it's almost impossible to get a midwife, is this true?

It is true that the demand for midwifery services in Ontario currently far exceeds our ability to provide care. In other words there aren't enough midwives in the province! If you desire midwifery care and are pregnant, please call as soon as possible! Waiting until you confirm you pregnancy with your physician may mean that you will be placed on a waiting list for our care..

Choices You Have

 

When you book into our care, we will provide you with information on choices that you have during your care. Early in your care we will offer you a genetic test called Integrated Prenatal Screening. As this decision needs to be made prior to 11 weeks gestation, we have provided a link to some reading material here.

 

Integrated Prenatal Screening