What is a Midwife, and why would I consider one over an OB.
This is an important question to research before getting pregnant. It is difficult to get a midwife in London, ON and surrounding area. To get a midwife you can call your local midwifery clinics, or visit them online. You will fill out an intake form and they will call you if you are accepted. This needs to be done by 6 weeks usually otherwise it can be difficult to get a midwife. I will be speaking about Ontario Midwives specifically in this blog post.
What is a Midwife - "Midwives are health-care professionals who provide free, 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."
Why does this matter? With an OB you have a very slim chance of that doctor actually delivering your baby. ALSO - your appointments are booked when your OB is on call. That means if your prenatal appointment (which is at the hospital) is on a day that they are particularly busy you could wait up to 3 hours for your 15 minute appointment.
Going to see a midwife in comparison is like having coffee with a friend. Its casual, not rushed, and if they happen to be at a birth they will call you and reschedule you. Also if you have other children they have toys, and are very accommodating for toddlers at appointments.
Can I have an OB aaaaand a Midwife? - "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."
Why this is important: In many countries it is the standard of care if you are a LOW RISK PREGNANCY that you receive a midwife. You don't see an OB unless there is a higher risk issue. In that case is it not difficult at all to see an OB. Your midwife will still over see your care, be there to help you with questions, and you will have the extra benefit of an OB if needed. The majority of pregnancies however are low risk and can be easily handled by the midwifery model of care.
When you have a midwife they are with you for over 50% of your labour, usually much more. They are with you for 3 hours afterwards, and they also visit your home for your post partum visits in the first week. Hear that, you don't have to leave your home with your sweet newborn! They come to YOU! This ALONE is worth having a midwife. You can page them with any emergency concerns, and they visit day 1, 3, and 5 to make sure you are ok. With an OB when you leave the hospital after baby, you don't have a follow up appointment until 6 weeks. That means you are at home with questions, concerns, and you don't have access to your care provider unless you go to the hospital. (If you have an OB having a doula can also help because we can be your question answerer in non-emergency situations.)
An OB checks on you a couple times in labour usually. You do get a nurse the whole time (and the nurses I've met at LHSC are lovely) but you don't have a personal relationship with them and that can feel a bit strange when you're in some intimate moments of your birth. The OB (and a resident, or two) come in when you are pushing, and not even for all of the pushing, JUST when baby is crowning. They swoop in, catch your baby, stay to do the repairs (or have the resident do them) and head out.
Is a Midwife like a Doula? - "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 and Long-Term Care. If you are considering having a doula at your birth, talk about it with your midwife."
Do I have to have a home birth if I have a midwife? - No, absolutely not. Midwifes have privileges in our local hospitals and can do hospital births. They also can provide you the resources and education needed to consider a home birth. They are the only care provider who can offer you the choice of home, hospital, or birth centre. Midwives are covered completely by OHIP.
Why a midwife, in my opinion...
For me it was an obvious choice. I was planning an intervention free birth and Midwifery is historically more supportive of that birth goal than obstetrics. Once you are in a hospital with an OB there is an high chance you will be treated like you are a sick patient who needs saving. I personally don't feel that Pregnancy and Labour is something I needed to be saved from. A Midwife walks with you through the process. Listening to your body with you and not trying to over manage things. They are more in tune with you, your goals, your partner, and they use those personal relationships to better evaluate your coping and provide you with options appropriate for you specifically. When anything escalates to higher risk they always err on the side of caution and will consult an OB.
If you have any further questions, the website Association of Ontario Midwives is a wonderful resource for learning about Midwifery and dispelling the myths. They are highly educated and experts in their field. *anything quoted has been taken directly from their website*