1.You believe that midwives are not “real” health care providers and are not safe.
Midwives in Ontario are regulated primary health care providers. We have extensive training which you can read more about here. Midwives are regulated by the College of Midwives of Ontario Midwives just as doctors are regulated by the College of Physicians and Surgeons. We have hospital admitting privileges, can order labs and ultrasounds and prescribe medications. Care provided by midwives is as safe as care provided by physicians. In Ontario, information is collected about every pregnancy and birth in the province. The data has shown that equally excellent outcomes for moms and babies can be expected from your midwife, family physician or obstetrician. The only significant difference is that rates of intervention tend to be lower among midwifery clients compared to obstetric patients. This is true of provincial averages but not all hospitals or obstetricians have intervention rates higher than the midwifery averages.
2. You believe that you can’t afford midwives or that they aren’t available in your community.
In Ontario, midwifery care is paid for by the Ministry of Health and Long Term Care – just like care by nurses, family physicians and obstetricians. There are over 700 registered midwives across the province – probably in a community near you. You can find a midwife by going to OntarioMidwives.ca or call us! We’re happy to help you find your local practice.
3. You believe that you are too high risk for midwifery care.
Midwives are experts at low-risk pregnancy, birth, post-partum and infant care. But low risk doesn’t mean no risk. Here are just a few things that people often think makes them too high risk for midwifery care but that is well within our scope of practice: Previous cesarean section(s), twins pregnancy, unusual ultrasound findings, low-lying placenta, gestational diabetes, history of pre-eclampsia or eclampsia, maternal age over 35, history of repeated urinary tract infections, previous vacuum or forceps assisted birth, previous episiotomy or 3rd-4th degree tear, baby requiring resuscitation, maternal spinal issues, too much bleeding at last birth… The list really goes on and on. Basically, if you are an insulin dependent type one diabetic or are in heart failure or multi-system organ failure, if you recently had an organ transplant or are pregnant with 3 or more babies, then you should go directly to an obstetrician. Otherwise, you might be surprised to find that you are not too high risk for midwifery care. Call us and ask. If you are too high risk then we will tell you right away.
4. You believe that having a midwife means that you have to have a home birth or that you can’t have an epidural.
Having a midwife means that you have the option of having hospital, home, or birth centre birth. Having a midwife means that you have the option of having an epidural, narcotics, entenox (laughing gas), or an unmedicated birth, or a water birth. Choosing midwifery care does not mean you are opting out of standard obstetric options. It means you have access to some additional options and choices. One of the three main principles of midwifery care in Ontario is informed choice. Your midwife will give you as much information as you want in order to make decisions that are right for you and then your midwife will support those choices and decisions.
5. You have a great relationship with one of our excellent obstetricians or family physicians who attends births, you had a really great experience having your baby last time and you want the same care again.
You are right. Midwifery care is not for you. You might actually like midwifery care, but if you have a relationship with a care provider that meets your needs then that is fantastic! We respect and appreciate the care that our colleagues provide and know that their patients get excellent, high-quality, considerate care.
Genia Stephen is one of the registered midwives at Generations Midwifery Care. To learn more about her, click here.