Frequently Asked Questions
TO
MIDWIFERY CARE
Welcome to the
WHAT IS A MIDWIFE?
"She must be able to give the necessary supervision, care and advice to women during pregnancy, labour and the postpartum periods, to conduct deliveries on her own responsibility and to care for the newborn infant. This care includes preventative measures, the detection of abnormal conditions in 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 counselling and education, not only for the patients, but also within the family and community. The work should involve antenatal education and preparation for parenthood, 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."
MIDWIFERY FUNDING
REGULATION OF MIDWIFERY IN
The
ORGANIZATIONS INVOLVED IN THE
College of
416 327-0874
www.cmo.on.ca
Association of
416 425-9974
www.aom.on.ca
Canadian Association of Midwives (
www.canadianmidwives.org
MIDWIFERY IN
Continuity of Care:
Midwifery care is available during all trimesters of pregnancy on a 24-hour on-call basis from a team of midwives known to the woman.
Informed Choice:
Women are actively encouraged to participate in their care; midwives promote decision-making as a shared responsibility, with the woman as the primary decision-maker.
Choice of Birth Location:
Midwives support choice of birthplace and are the only care providers who provide the choice of both home and hospital birth.
SCOPE OF PRACTICE
Women are seen by midwives for all pre and postnatal visits. Midwives can order laboratory and ultrasound testing and will arrange for consultation and/or transfer of care to other health care providers if necessary. We provide primary care during labour and conduct normal births on our own responsibility. A midwife will examine the newborn and provide care for both mothers and baby up to six weeks following birth. We can also prescribe and/or administer certain drugs during pregnancy, labour, birth, and the postpartum period.
ABOUT US
HOW TO CONTACT US
A midwife is available 24 hours a day, 7 days a week by pager for labour and other urgent concerns. If your concern does not require an immediate response, you can leave a message at the office for a particular midwife on her voice mail or a general message at the main number, and we will return your call as soon as possible. It is a good idea to have both the office and urgent number with you at all times.
Urgent # - 1-866-775-8818
Office Number: 905-209-0330
If you believe that you are in labour, or you have an urgent concern, call the Urgent number above and ask for the midwife that is “on call” for your particular team. If you are unsure, ask our receptionist or a midwife which team you are with.
DO I SEE A DOCTOR DURING MY PREGNANCY AS WELL AS A MIDWIFE?
No. Midwives are primary caregivers for women during pregnancy. A midwife can order any tests that you may need. However, if at any time there are any complications, it may be necessary for you to have a consultation with a physician or your care may be taken over by a physician. Also, you may need to see your family physician for any conditions which are not related to your pregnancy.
WHAT HAPPENS IF YOU SEND ME FOR A PHYSICIAN CONSULTATION?
If a consultation is necessary during pregnancy, you may see an obstetrician in his/her office. If the consultation is done during labour you will see theon-call obstetrician at the hospital. The physician will give advice to you and your midwife as to what he/she suggests for your care. Sometimes, if your pregnancy has significant risk factors, it may be best to transfer your care to a physician. In this case, your midwife will continue to provide supportive care and will normally still attend you in labour and care for you and your baby following birth.
Please refer to the
WHAT IS TEAM MIDWIFERY?
In order to provide comprehensive care, the midwives at Markham Stouffville Midwives work in a team of midwives (2-4 midwives) who ‘share’ thecare of you and your newborn baby. You will have the opportunity to meet each midwife on your team throughout your pregnancy and before you give birth. One of the midwives on the team will be on call when you are ready to have your baby.
While you will get to know some midwives in the practice more than others, it is important to remember that you are receiving care from a midwifery team rather than an individual midwife. Considering that this group of practitioners chooses to work together, you will generally receive the same style of care.
At the time of birth, it is safest to have two trained caregivers in attendance. This will usually be one of the midwives on your team plus another midwife from the practice or a senior midwifery student. Occasionally, this second person will be a labour and birth nurse.
PRENATAL CARE SCHEDULE
We have developed a prenatal care schedule based on evidence and tailored to your care needs. For example, the frequency and timing of prenatal visits may vary depending on whether this is your first baby or whether or not you have any risk factors. Roughly, visits become more frequent as your pregnancy advances. Your midwife will discuss this schedule with your once you have completed your booking visit with us.
WOMEN’S ONLY GROUP CARE
We offer three women’s only groups during pregnancy and one mom and baby group following birth. These groups are a great opportunity to meet other women who are expecting babies around the same time as you. A midwife will facilitate group discussion and many relevant topics will be discussed and shared within the group. There will be an opportunity for a quick check-in with the midwife to palate and listen to your baby. If you attend a group session, this can replace your usual visit for the same time. Studies on group antenatal care tell us that women rate this type of care very highly and greatly value the connections with other women in the group. For more information visit http://www.scbp.ca/
MIDWIFERY STUDENTS
In addition to the Registered Midwives, midwifery students are normally associated with our practice. These students may be enrolled in the Midwifery Baccalaureate Program (MEP) or completing a bridging program for internationally trained midwives (IMPP). Currently in
Midwifery Students are supervised by the midwives in our practice and also maintain close contact with their tutor at the university.
Student midwives, who develop a relationship with you over a number of visits, accompany us and provide care appropriate to their levels, with your permission. We are committed to ensuring that the quality of care we provide is enhanced by the presence of student midwives. We support clients to be teachers of students by giving them and us feedback at all times. We encourage you to talk with us about the presence of students and, especially, to raise any concerns, as midwifery education is an important part of our practice. We see pregnant women as important teachers for student midwives, and we very much appreciate their support of midwifery education.
WHAT ARE MY OPTIONS FOR PLACE OF BIRTH?
You may choose to have your baby in your home or in the hospital. The midwife can provide you with information to make an informed decision about the appropriate place for you to give birth.
Some women choose to give birth at home rather than a hospital in order to ensure having a relaxed atmosphere in a secure and familiar environment. The issue of safety with homebirth is important to parents and midwives. Many studies have examined the safety of home birth, and the evidence has determined that home birth is as safe as hospital birth when women have received proper prenatal care and have been screened appropriately. In addition, woman who birth at home have fewer interventions that women who birth in hospital. This is true for the newborn as well.
Each midwife at our practice has privileges at
We will support the woman's choice of birthplace and ask that you carefully consider the information available and any recommendations we may make. Midwives are comfortable and fully trained and equipped to provide primary care to women in both settings--home or hospital.
WHAT TYPE OF EQUIPMENT DOES THE MIDWIFE HAVE FOR A HOME BIRTH?
REGISTERING AT THE HOSPITAL
We will provide you with a form and information about this. When you pre-register you will receive a book about hospital care and other helpful resources. You may also book a hospital tour at that time and register for a breastfeeding class conducted by a lactation consultant.
HOW LONG WILL I STAY AT THE HOSPITAL AFTER THE BABY IS BORN? Midwives at our practice and across the province have a much earlier discharge program than physician care. This plan will take into consideration how both mother and baby are adjusting in the immediate period after birth. If both you and the baby are well and you have met expected milestones, your midwife can discharge you from hospital within 4 hours following birth.
It has been our experience that early discharge is safe and works well for families in midwifery care. After the initial euphoria from the baby’s birth passes, women and their babies (partners too) are in great need of a good sleep. You are far more likely to sleep well at home in your own bed with access to your own washroom. There are other potential benefits to early discharge, such as less risk of infection, enhanced bonding for the entire family, and reduced sibling rivalry. Should you or your baby experience any difficulties, a longer hospital stay will likely be recommended. You should discuss your plans with your midwife during pregnancy and again following the birth of your baby.
As well as being available to you by pager from the time you leave the hospital, you can expect to see a midwife within 24 hours of discharge. DO I NEED TO TAKE PRENATAL CLASSES? We encourage our clients, especially first-time parents, to attend a childbirth education program. Our prenatal classes are available as a six-weekseries on a week night. If this will not work for your schedule, there are other options for classes in your community. Please speak with our receptionist about classes and to book a spot. WHAT SHOULD I DO IF I CAN'T MAKE AN APPOINTMENT?
WHAT SHOULD I DO IF I HAVE A PROBLEM OR A CONCERN REGARDING MY CARE?
Please feel free to speak directly with your midwife about any problems or concerns that you might have regarding your care. We strive for open communication with our clients and rely on you to give us feedback. If you are not comfortable with this, you may contact one of the other midwives and your concern will be addressed at a practice meeting of the midwives in our office. In addition, you will be given a client satisfaction survey at the end of care where you can give us feedback and remain anonymous if you wish.
AM I GUARANTEED ONE OF THE MIDWIVES FROM MY TEAM WHEN I AM IN LABOUR?
This is almost always the case! However we cannot guarantee it.
Very rarely and only for safety reasons would we ask a midwife from our practice (who we known and work with) to look after you or perhaps see you for a scheduled appointment. For example, the midwife on your team may need relief to rest before safely continuing care or she may have more than one person in labour and cannot split her time in order to provide you with the best care. Even when this happens, it is usually only for a discrete amount of time and one of the midwives on your team will try to care for you as soon as they are able. We know this can seem disappointing at first, but we ask that you trust our judgment as to who can give you the best care at that time. Most women tell us that they were very happy with the care they received from all of the midwives, even if it was someone they were meeting for the first time.
PRENATAL CARE
Prenatal care is an important part of preparing for birth and offers you the opportunity to learn about the changes your body goes through as pregnancy advances. In addition to clinical care and testing, time during visits is spent getting to know you, your plans and concerns, and answering your questions about pregnancy and birth
LABOUR AND BIRTH
Once your big day arrives and your page us, a midwife (possibly a senior student who reports to your midwife) will do a telephone assessment with you. At that point, you may be reassured that this is early labour and instructed when to call back or the midwife may decide it is time to assess you in person. This assessment may take place at your home, in the clinic, or at hospital. If you are found to be in early (latent phase) labour and there are no concerns with your health or the baby, we will normally recommend that you remain at or go back home where you will be most comfortable. You will be given instructions about when you should be seen next. Once active labour is established, a midwife will remain with you and monitor you and your baby and support you.
POSTNATAL CARE
During the first few days at home following birth, you can expect a visit from a midwife and/or a senior midwifery student 2 to 3 times. Those visits will focus on newborn care, breastfeeding, postnatal recovery, and adjusting to a new baby. Your midwife will advise you of the best schedule for the remainder of postnatal visits. New mothers and mothers who require extra assistance or babies with risk factors may require additional visits. At a minimum, you should return to the clinic with your baby at 2 weeks and 6 weeks of age.
WHAT ARE MY RESPONSIBILITIES AS A CLIENT?
CAN I SEE MY RECORDS?
Of course, they are your records after all.
All records that are kept by us during your care are available for you to view at anytime. Please feel free to ask your midwife any questions that you have regarding your records. At 36 weeks, a complete set of records will be transferred into a binder, which you will be given, and should be kept by you until after the birth of the baby at which time they are returned to the clinic. It is important that you remember to bring the binder with you to your visits.
At discharge, our receptionist will copy the newborn visit record so you may take this with you to baby’s first doctor appointment.
OUR BACKGROUNDS