What is a Midwife?
Midwives are health-care professionals who provide government-funded expert primary care to pregnant people and their newborns. Through pregnancy, labour, birth and the first six weeks after birth, you will be cared for by a small group of midwives. This continuity of care means that you are likely to know the midwife who delivers your baby.
You can choose to have a midwife or a doctor, not both. As midwives are experts in low-risk pregnancy and birth, midwifery clients will not see a physician unless there are concerns or complications. If complications arise, midwives can consult with physicians or, if necessary, transfer a client’s care to a physician. If care is transferred, midwives continue to support their clients and resume primary care when it is possible. You don't need a referral from a doctor to have a midwife, just contact your local clinic directly.
A midwife is not a doula! A birth doula is a trained labour support person who provides emotional and physical support to those giving birth and their families. While not medical professionals, doulas can offer a wide range of comfort measures. You would find and pay your doula yourself, as doula services are not covered by the Ministry of Health. If you are considering having a doula at your birth, talk about it with your midwife.
Appointments
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. On average, you'll see your midwife approximately 12 times before you go into labour. After your birth, midwives provide care to you and your baby for six weeks. You 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 both client and baby and provide breastfeeding support. Midwives remain available by pager 24 hours a day, seven days a week. After six weeks, clients are discharged from midwifery care and will see their family doctor for care.
Availability
It is best to contact a midwife as soon as you find out you're 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. Use our Find a Midwife tool to contact the closest clinic in your area. You do not need a referral to see a midwife.
Midwives typically work in groups; clients receive care from a small number of midwives and will usually know the midwife who attends the birth of their baby. If clients have urgent concerns, their midwives are available 24 hours a day, seven days a week.
Choice of Birthplace
Choosing a midwife doesn't necessarily mean choosing a home birth (although it is an excellent, safe choice). In fact, 80% of all midwifery-attended births happen in hospital, and all registered midwives have admitting privileges at at least one of the 94 Ontario hospitals that has midwives. Other clients give birth at home, or, in select communities, at a birth centre. Midwives understand that every client is different and respected as the person who makes informed choices about their care. Together with your midwife you choose where to have your baby.
Cost
Midwives are part of the Ontario health-care system and their services are completely funded by the Ministry of Health. Ontario residents who are not currently covered by OHIP can still receive midwifery care with no charge.
Eligibility
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. 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 support and resume primary care when possible.
Testing & Prescribing
Midwives can arrange all routine prenatal testing, including ultrasound and genetic testing, as well as standard laboratory and diagnostic tests. Test results are sent to the midwives who discuss them with their clients.
Midwives offer the same routine tests during pregnancy as family physicians and obstetricians, including blood tests, urine tests, genetic screening, ultrasound, gestational diabetes screening, pap tests, swabs for sexually transmitted infections, and testing for Group B Streptococcus (GBS). During appointments, midwives will talk to you about what each test looks for, how it is performed, possible advantages and disadvantages, and any risks involved. Some tests are performed in the midwifery clinic, others are may take place at a hospital or medical lab in your community. Test results are sent directly to the midwives so they can discuss them in detail with their clients and provide follow up, if necessary. In addition to arranging tests, midwives can also prescribe certain drugs related to clients’ care, such as those used to ease morning sickness or antibiotics to treat infections like GBS and mastitis (an infection of the breast tissue).
When attending home births, midwives bring medications that may be needed to control bleeding or manage other situations. During labour, midwives offer a range of natural and pharmaceutical pain relief options. Water, massage and other methods are popular and effective ways to relieve pain during births taking place at home, hospital or birth centre. Access to epidurals is only available in hospital.