+What is a Midwife?

ICM International Definition of the Midwife - A midwife is a person who has successfully completed a midwifery education program that is duly recognized in the country where it is located and that is based on the ICM Essential Competencies for Basic Midwifery Practice and the framework of the ICM Global Standards for Midwifery Education; who has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery and use the title ‘midwife’; and who demonstrates competency in the practice of midwifery. Scope of Practice The midwife is recognised as a responsible and accountable professional who works in partnership with women to give the necessary support, care and advice during pregnancy, labour and the postpartum period, to conduct births on the midwife’s own responsibility and to provide care for the newborn and the infant. This care includes preventative measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical care or other appropriate assistance and the carrying out of emergency measures. The midwife has an important task in health counselling and education, not only for the woman, but also within the family and the community. This work should involve antenatal education and preparation for parenthood and may extend to women’s health, sexual or reproductive health and child care. A midwife may practise in any setting including the home, community, hospitals, clinics or health units. Revised and adopted by ICM Council June 15, 2011 Due for review 2017

+When should I contact a midwife?

It is best to contact a midwife as soon as you find out you are pregnant. Not only is demand for midwives high, but it is also beneficial to access prenatal care at the beginning of your pregnancy. Some clinics do have openings for clients later in pregnancy. Call anytime. You do not need a referral to see a midwife.

+How many midwives are there in Ontario?

There are close to 700 registered midwives practicing in 100 clinics throughout the province. In 1994, Ontario became the first province in Canada to regulate midwifery. Since that time, Ontario midwives have attended more than 180,000 births, including 35,000 home births.

+How are midwives trained and regulated?

Registered midwives complete a four-year university degree through the Ontario Midwifery Education Program (offered at three Ontario universities). If a midwife has been trained outside of Canada, she completes the International Midwifery Pre-Registration Program, offered through Ryerson University. Once a midwife has completed her training, she is licensed by the College of Midwives of Ontario. Newly registered midwives are required to complete a mentorship year with an experienced midwife.

+What happens at a prenatal appointment?

During regularly scheduled visits to the midwifery clinic, midwives provide physical examinations and assessments, support and information. Appointments are on average 30-45 minutes long. Prenatal visits are usually once a month for the first 28 weeks, every two weeks until 36 weeks and then once a week until your baby is born. Most women will see their midwife 11-12 times before they go into labour.

+What happens at appointments once my baby is born?

Midwives provide care for both mothers and babies for six weeks after the birth. Whether your baby is born at home or in the hospital, your midwife will provide care in your home within 24 hours of the birth. Clients will have about six midwifery appointments during the six weeks following the birth, including several in the first few days and weeks. Midwives monitor the health of mother and baby and provide breastfeeding support. Midwives remain available by pager 24 hours a day, every day. After six weeks, clients are discharged from midwifery care and will see their family doctor for care.

+Can I have a homebirth with a midwife?

Yes. Midwives provide the option of a home or hospital birth. About one in four women in midwifery care chooses a home birth. In some communities, birth centres are also available as a third option to support normal birth.

+What pain relief options are available?

Midwives offer a range of natural and pharmaceutical pain relief options, including access to epidurals in hospital. Pharmaceutical pain relief can only be accessed at a hospital birth. Many women use water, massage and other methods as an effective way to relieve pain at home, birth centre and hospital.

+Can midwives run the same kinds of tests as doctors?

Yes. Midwives can arrange all routine prenatal testing including ultrasound and genetic screening, as well as standard laboratory and diagnostic tests. Midwives discuss the results with clients and provide information and follow-up. If you do not have insurance to cover these tests such as OHIP then you are responsible for payment for these tests.

+Am I too old or too young to have a midwife?

There are no age restrictions for accessing midwifery care. Anyone with a normal and low-risk pregnancy is eligible for a midwife. The majority of births are normal and low risk.

+What happens if there is a problem with my pregnancy?

Midwives are experts in normal pregnancy and birth and provide safe care for both mother and baby. If a health concern or a complication arises, your midwife may consult with a physician. Situations that require consultation with, or transfer to, a physician are set by the College of Midwives of Ontario. If needed, your care is transferred to a physician (for example, in the case of a caesarean section). Your midwife will continue to provide supportive care and resume primary care when possible.

+Can I have a midwife and a doctor?

No. Women can have either a midwife or a doctor for pregnancy, birth and newborn care. Midwives, obstetricians and family physicians are all considered primary caregivers. A primary caregiver takes responsibility for your care.

+What is the difference between a doula and a midwife?

A birth doula is a trained labour support person who provides emotional and physical support to a labouring woman and her partner. While she is not a medical professional, she can offer a wide range of comfort measures. You would find and pay your doula yourself. Doula services are not covered by the Ministry of Health and Long-Term Care. If you are considering having a doula at your birth, talk about it with your midwife.e

+I am a midwifery student from another country, and I would like to do a placement at a clinic in Ontario. How do I arrange this?

International students or students from jurisdictions outside of Ontario seeking placements in Ontario midwifery practices are encouraged to contact practices directly regarding placement availability. Ontario Midwifery Education Program students are prioritized for placement, and practice availability may vary. Each practice oversees its own schedule and staffing. All student midwives doing placements in Ontario are required to have liability insurance, which is typically provided through your educational institution. It is recommended that you have a copy of the insurance policy before approaching practice groups.