What is Midwifery care?
Midwives are experts in normal childbirth. Midwifery care focuses on promoting a healthy pregnancy, labour, birth, and newborn. Midwives aim to prevent complications and to diagnose any potential problems early, in order to intervene appropriately to prevent the problem from worsening wherever possible. By the time a woman who is cared for by a midwife goes into labour, she has had 9 months of comprehensive care in which she has learned about the processes of labour and birth and has come to a greater understanding of her own body. Through this approach, most midwife-led births are accomplished without intervention, and with the woman feeling confident and sure of her own body’s abilities.
Midwives have standards that guide their practice in providing care and guiding when it is appropriate to consult or transfer care to a physician. Midwives may also consult with each other for unusual situations. When a woman is no longer within the parameters of ‘normal,’ either a family practitioner or an obstetrician is consulted. If is it appropriate for care to be transferred to a doctor, the midwife will continue to attend the woman in a supportive role.
Midwives provide 24 hour ‘on-call’ coverage for emergencies and for care during labour. Midwives also encourage the use of comfort measures and emotional support to reduce the need for medical pain relief during labour.
Sometimes, however, technology or drugs are necessary and/or requested by women. Midwifery clients can access these interventions when needed.
Midwifery care is based on the following beliefs:
- Childbearing is a normal physiological process that requires physical, emotional, and social adaptations by the woman and her family
- Although, as midwives, we are trained to recognise deviations from normal, it is our special role to protect and respect normal pregnancy, labour and birth. This practice combines the traditional art and science of midwifery
- We provide support and encouragement with and understanding of the emotional aspects of pregnancy, labour, birth, and the importance of birth as a family event
- Enhancement of the family’s sense of responsibility for their own healthcare is an important aspect of the professional relationship. Midwives promote decision making as a shared responsibility between the woman, her family, and her caregiver, but the woman is recognised as the primary decision-maker. She is encouraged to actively participate in and make choices about the manner in which her care is provided throughout her pregnancy, birth, and post-partum experience. Midwifery care includes education and counselling which enable a woman to make informed choices about her care, and where, how, and with whom she will give birth
- Fundamental to midwifery care is the understanding that a woman’s caregiver will respect and support her so that she may give birth with power and dignity. Continuity of care is an important aspect of midwifery. This is accomplished by the presence of known and trusted caregiver
Midwifery is individualized to suit each woman’s needs, but a typical course of care involves pre-natal, labour, birth, and 6 weeks of post-partum care.
Prenatal clinic visit schedule
A woman can expect to see a midwife about once per month until 8 months, twice a month during the 8th month and thereafter weekly until the birth. At each appointment we will be assessing the growth and development of your baby, assessing your general health, and discussing issues such as diet, relief of pregnancy discomforts, work adjustment, preparation for breastfeeding, and so on. During these visits you will always have an opportunity to discuss with the midwife any questions or concerns you may have. Appointments are approximately 30 minutes long but there may be times when shorter, longer, or more frequent visits are necessary.
*Please note: due to the unpredictable nature of labour and birth, there may be rare occasions when your clinic appointment will have to be rescheduled at very short notice.
Early labour: If it is during the day you can notify us directly. Depending on your individual circumstances, we might then arrange to assess you at an appropriate time and place. Even if you have chosen a hospital birth, early labour happens at home.
Active labour and birth: The midwife on call will provide you with continuous care, support, and assessment during the active phase of labour and birth. If you are at home, the backup midwife is called as the second attendant around the time of birth. If you choose a hospital birth, you will stay at home until you decide with your midwife when to leave for the hospital. In hospital, your midwife will work with a nurse who has been assigned by the hospital to provide nursing care. Regardless of your place of birth, your midwife will be with you for the birth and for a few hours afterwards. Midwifery clients who have a normal vaginal birth in hospital have the option of going home a few hours following the birth, however, if it is your first experience of breastfeeding, it may be wise to stay longer to facilitate learning this skill.
Postpartum Care: regardless of where the birth takes place, we strongly encourage you to have a post-partum plan, which includes having practical support available at home. Your midwife will visit you in your home for the first week after your baby is born to provide assistance with breastfeeding and after birth care. We visit most of our clients in their homes 3 to 5 times during the first week after the baby’s birth.
At 2, 4, and 6 weeks post-partum you and your baby will return to clinic for check ups. We track the baby’s weight gain and assess both mother and baby’s recovery and progress. The final visit is scheduled for when the baby is approximately 6 weeks old. This visit can include a pap smear and pelvic exam. Following discharge from our care, a copy of your medical records is sent to your family physician.
What if complications develop?
The vast majority of the births we attend involve healthy mothers and babies and are uncomplicated, spontaneous vaginal births. Complications can occur at any birth, regardless of the site or caregiver. If a complication develops, we will discuss choices, consult with an obstetrician and, if necessary, transfer a client’s care to a specialist. If possible, we will continue with shared care. If you are later in your pregnancy and a transfer of care is required, midwives are permitted by the College of Midwives to stay involved in a supportive role.
Midwives are trained and skilled in detecting deviations from the normal in both mother and baby, and in those situations, we refer to an appropriate physician. We are thoroughly trained and prepared to use emergency measures when necessary.
The midwife-client relationship is based on mutual trust and respect. We will respect and facilitate your choices, but we ask our clients to recognise and respect our professional guidelines as set out by the College of Midwives of British Columbia (CMBC). These guidelines were created to facilitate safe care for you and your baby.
We request that all our clients participate actively in decision making about their care. We expect our clients to do their best to maintain good health during their pregnancies. A balanced diet, plenty of fluids, adequate rest, relaxation, exercise, and complimentary therapies all contribute to healthy pregnancies. We endeavour to provide clients with reading and information appropriate to the stage of pregnancy, as the pregnancy progresses.
We ask that parents acquire knowledge and skills necessary for labour, birth and early parenting. We are able to supply information about organized prenatal classes in your area. Clients must also make plans to have support for the first couple of weeks following the birth.
Midwifery care is individualized according to the needs and circumstances of our clients. It is important for you to make us aware of your expectations and lifestyle. In order to be effective as your primary caregiver, we require that you keep us well informed about problems or situations that may affect your care.
We are pleased and honoured to share this special and very memorable time in your life with you