WHAT IS A MIDWIFE?
Midwives are experts in healthy pregnancy and birth.
In BC, registered midwives offer primary clinical maternity care to healthy pregnant clients and their newborn babies from early pregnancy, through labour and birth, until about six weeks following delivery. We practice evidence-based, client-centered maternity and newborn care and are an established part of the BC health care system.
Midwives listen, observe, educate, guide and care. We order and interpret tests and screen for physical, psychological, emotional and social health. We are with clients during pregnancy, labour and birth, normal and complicated. We catch (also known as “deliver” babies--but it’s you who’s doing the delivering). We do home visits after the baby is born. We help with breastfeeding and adjusting to life with a new baby. We work together and with other health professionals.
DO I NEED A REFERRAL FROM MY DOCTOR TO SEE A MIDWIFE?
No referral is required. Simply contact the clinic or fill out an intake form online.
ARE MIDWIFERY SERVICES REGULATED?
Yes. Midwives are registered with and regulated by the College of Midwives of British Columbia (CMBC) according to the BC Health Professions Act, the Midwives Regulation and the CMBC Bylaws. Midwives have been regulated and legally recognized as autonomous health care practitioners in BC since 1998.
ARE THE COSTS OF MIDWIFERY SERVICES COVERED IN BC?
Yes, the BC Ministry of Health covers the cost of midwifery services for all BC residents with a valid Carecard or BC Services Card through the BC Medical Services Plan (MSP).
CAN I HAVE A DOCTOR AND A MIDWIFE?
The BC Medical Services Plan covers only one primary care provider for the duration of your pregnancy and birth, to six weeks following birth for healthy pregnancies. The choice of care provider during your pregnancy is up to you. In the Comox Valley you may choose either a midwife or family doctor as your primary care provider. Our local obstetricians do not offer primary care but are available for consultation for higher risk pregnancies.
Midwives are experts in healthy pregnancy and normal birth, and consult with specialists such as obstetricians and paediatricians as the need arises. Six weeks after delivery, when your midwifery care is completed, your care will be transferred back to your family doctor who will resume responsibility for the health of you and your new baby. If you do not have a family doctor, your midwife can assist to find one for your family.
I AM NOT COVERED BY MSP. CAN I STILL HAVE A MIDWIFE?
If you are not covered by MSP, feel free to contact our clinic and speak with us about the option of paying for your care privately. Midwives do not charge you more than we would bill MSP, however those fees do not include supplies, laboratory tests and blood work, ultrasound scans, or any hospital or physician charges, including the costs associated with hospital births.
If you are a refugee covered by the Interim Federal Health Program (IFHP) you can call the Midwives Association of BC (MABC) at 604-736-5976 to find a midwife registered with Medavie Blue Cross in your area.
WHEN SHOULD I CALL TO MAKE MY FIRST APPOINTMENT?
Contact us as soon as you know you are pregnant. We want to ensure that you have prompt access to the care that you need.
HOW OFTEN DO I SEE A MIDWIFE?
Midwife visits happen on a similar schedule to most maternity care providers’ in BC. Most visits in the first part of pregnancy are scheduled every 4-6 weeks and last between 30-45 minutes. As of 28 weeks visits are every 2-3 weeks. Visits are often every week during the last month of pregnancy. Our longer visits allow for physical, emotional and social health assessments, time for informed decision making and the development of a trusting relationship between clients and their care providers.
After your baby is born, visits usually take place wherever the new family resides. This may be in the hospital after a hospital birth or at home. After the first week or two, visits are scheduled in the clinic and continue for about six weeks when your care is transferred back to your family doctor. Between visits, we provide 24/7 call coverage for urgent care or concerns.
HOW MANY MIDWIVES WILL BE INVOLVED IN MY CARE?
Our practice has four midwives working in a shared care model. You will have have opportunities to meet all the midwives in our group before your birth. We share client care and work collaboratively. We also occasionally have locum midwives who work with us in the event of vacation coverage or illness.
The CMBC Midwifery Model of Practice highlights the concept of continuity of care in providing safe, individualized care.
WHAT IS THE WORKING RELATIONSHIP BETWEEN MIDWIVES AND OBSTETRICIANS?
We enjoy collaborative working relationships with our consultants. As midwives we consult with family doctors, obstetricians, pediatricians and other specialists as the need arises. A transfer of care occasionally is necessary in urgent situations. With transfers, unless a complication arises early in pregnancy (and requires a complete transfer of care) we typically remain involved in your care in a supportive role, with care often transferred back to us completely once the issue has resolved.
WILL I HAVE ACCESS TO THE SAME TESTS AND PRESCRIPTIONS THAT I WOULD HAVE HAD WITH A DOCTOR?
Yes. We offer a complete panel of prenatal laboratory tests, genetic screening and diagnosis options, ultrasound imaging and many other tests and procedures for clients and newborns. Our scope of practice includes the prescribing and use of many medications that may be indicated in pregnancy, during labour (including in emergency situations or pain medication) and postpartum. If medication or testing is required which is outside of our scope of practice, we will consult with a physician as indicated for specialized care.
COULD COMPLICATIONS RULE OUT MIDWIFERY SERVICES?
Most families who are interested in midwifery care are able to access it. However some conditions are best managed by a specialist. During your initial visit, we will be able to give you an idea of whether the care you need is covered by our scope of practice.
Should complications arise while you are in our care at any time, we follow provincial guidelines that help inform the decision to consult with or transfer care to the appropriate consultant or other specialist. https://www.cmbc.bc.ca/wp-content/uploads/2018/05/Indications-for-Discussion-Consultation-and-Transfer-of-Care.pdf
CAN I CHOOSE WHETHER I GIVE BIRTH AT HOME OR IN HOSPITAL?
Yes. As midwives we offer the choice of homebirth to healthy, low-risk clients based on the principles of informed decision making. Waterbirth is also an option for families considering homebirth. On average in BC, 30% of births attended by midwives occur in home, and 70% in hospitals.
For more information on home birth in BC, you can read the CMBC Place of Birth Handbook.
WHAT PAIN RELIEF OPTIONS ARE AVAILABLE FOR ME?
As midwives we offer a range of natural (massage, acupuncture, position change recommendations, verbal encouragement, breathing techniques, and more) and pharmaceutical pain relief options, including access to epidurals. It is important to us that you have access to the information necessary to make informed decisions about the use of pain relief options. These options are discussed during your prenatal visits as well as during prenatal classes.
WHAT HAPPENS IF I HAVE TO HAVE A C-SECTION?
Midwives have a 42% lower caesarean section rate than the provincial average. However, in certain circumstances a caesarean birth may be recommended as a safer option than a vaginal birth. An obstetrician will then become involved and will perform the caesarean. In most situations midwives are involved in the decision making process, and will be present during a caesarean birth to provide support, care to the baby, assist with skin to skin/breastfeeding in the OR as desired, and will resume postpartum care afterwards.
WHAT IF I HAVE A PROBLEM UNRELATED TO PREGNANCY?
During pregnancy, clients continue to see their family doctor or specialist physician for health issues unrelated to pregnancy.
WHAT IS THE DIFFERENCE BETWEEN A MIDWIFE AND A DOULA?
Doulas do not provide medical care and do not deliver babies. Midwives are trained to provide all the necessary medical care and to monitor the health and well-being of you and your baby.
Doulas work as a part of the team, with a midwife or doctor and nurse. Doulas provide continuous emotional and physical support and are a positive addition to the birth team for clients who want extra support. For more information about doulas, please visit the BC Doula Services Association. If you or your partner are Indigenous, you may qualify for a free doula through the BC Association of Aboriginal Friendship Centres.
AM I HIGH RISK IF I AM OVER 40 YEARS OLD?
Many people who are 40 years or more have healthy pregnancies and uncomplicated deliveries. Although there is a higher rate of certain pregnancy conditions, you are not considered to be too high risk for midwifery care just because of your age. We will get to know you and your health history just like we do with all of our clients and will help you to make the best plan for your pregnancy and birth. There are some additional tests and care plans that will be offered to you to help you have the healthiest pregnancy possible. We will discuss this further with you at your prenatal visits.
https://www.ontariomidwives.ca/sites/default/files/2017-10/In-due-time-pregnancy-beyond-40-English.pdf
ARE THERE ANY CULTURALLY RELEVANT RESOURCES OR SERVICES AVAILABLE TO ME IF I AM INDIGENOUS?
Yes. Your midwives will be happy to discuss these with you. We are committed as a practice to working towards the decolonization of birth. We have all accessed Indigenous Cultural Safety training, recognizing that cultural humility and the process of learning about cultural safety will be ongoing. We are each members of the Indigenous Women’s Sharing Society (PUT LINK IN HERE) and look forward to continuing to share and learn about different resources that are available to our indigenous families.
