Midwife means “with woman”. A midwife is a specialist in normal pregnancy and birth. She works with other caregivers, including family physicians, obstetricians, pediatricians, lactation consultants, counsellors, and public health, to provide families the best possible care during the childbearing year. In Alberta, and around the world, midwives have excellent safety records. The midwifery scope of practice includes providing primary care to low risk women and their newborns through pregnancy, birth and 6 weeks postpartum. Registered midwives have complete access to laboratories and diagnostic services and are able to prescribe and carry select medications when needed. Accordingly, your midwife can order prenatal lab work, ultrasounds and prescribe certain pregnancy related medications. Hospital admitting privileges are available in most regions where midwives practice, or in most cases, low-risk clients are able to choose to deliver in a birth center (where available) or at home.
HOW ARE MIDWIVES TRAINED?
All Registered Midwives in Alberta have at least the equivalent of a Bachelor’s Degree in Midwifery. They have demonstrated a high level of competency as required by the College of Midwives of Alberta through rigorous written, clinical and oral examinations. Midwives have skills in normal birth and the identification of high risk situations that may require a more involved type of care. They come from a variety of educational backgrounds and have many different skill sets. All midwives are trained in emergency skills and are capable of handling emergencies related to birth for both the pregnant person and newborn.
Midwifery care is a safe choice for low-risk, healthy women. It is endorsed by many organizations that strongly influence maternity care in our country, including the Society of Obstetricians and Gynecologists of Canada (SOGC). Women and babies actually tend to fare better in countries where midwifery care is the norm. Midwifery clients experience lower rates of forcep and vacuum deliveries, cesarean sections, episiotomies, infections, and babies requiring resuscitation, when compared with women in the same risk group delivering with physician-led care.
Midwifery is a fully funded service through Alberta Health Care. It is billed directly to AHS and there are no up front costs or fees to our clients. Depending on your choice of birth place and if you choose to use waterbirth, herbs, aromatherapy, oils, or homeopathics, you may expect to spend about $50-$200 on supplies. This cost is determined by you, and your particular needs and choices. Midwives do not always supply a pool for water birth in the home, and this option may come at an expense as well. Pools for in hospital waterbirth are supplied, however there is an associated cost for supplies needed for the pool.
HOW MANY CLIENTS DO YOU TAKE/YEAR/MONTH?
Midwives believe that it is very important to provide comprehensive care to all of their clients. Due to this philosophy, we can only accommodate a certain number of clients per year. Usually, this number is somewhere around 40 births per year, per full-time midwife. Our funding comes from Alberta Health Services and is, at times, restrictive based on the number of people requesting midwifery care. Alberta Health Services and Prairie MIdwives has been working diligently to try to increase funding, so that we can accommodate the demand for midwifery care. Usually our demand is quite high which results in us having to make some difficult decisions. A consultation is simply a means of meeting one another and discussing your needs. It is a chance for you to ask questions and feel comfortable with your choice to access midwifery care. It also gives us a chance to see if you are a candidate for low-risk care. We believe that offering consultations to our potential clients is an important step in the process, but does not guarantee that we can give you care. We do carry a wait-list for clients as well in case spaces open up for around the time you are due.
HOW OFTEN DO I SEE THE MIDWIVES?
Midwives typically welcome clients into care between 8-10wks, when they have had a consultation and then schedule an initial appointment. They are then seen every 4-5 wks until 28 wks of pregnancy, then every 2-3 wks until 36 wks of pregnancy. They are then offered weekly visits until 41wks of pregnancy and then every 2-3 days after this. Certainly if there are labour concerns, your midwives are available 24 hours, 7 days a week, and may see you between appointments if questions or complications arise. As labour progresses the midwife may assess the client in their home, at the clinic, or in hospital and stays with them through active labour and delivery, either in their home, or in the hospital. After you have your baby, you generally see your midwife 12-24 hours after the birth (either in hospital or at home). We will then do home visits on or around Day 3 and 5. This gives you the opportunity to spend time with your new family in order to establish breastfeeding and bond with your new baby. We highly encourage you not to leave your home during this precious time. You and the baby will then see us in clinic at 2 weeks and 6 weeks postpartum in the clinic.
WHAT IF I LIVE OUTSIDE YOUR SERVICE AREA?
We do provide care to families in the central Alberta area, however in order to provide our best care possible it is difficult for us to travel a great distance for birth and postpartum visits. If you would like an out-of-hospital birth, you will have to make your own arrangements to birth within our service area and be prepared to stay for 1- 3 days postpartum. This is to facilitate your postpartum care and to ensure that you are getting the care that you and your new baby need. This can be discussed and options are available, please speak to your midwife.
Please fill out our intake form as soon as you know you are pregnant. We will contact you within 1 week of receiving your completed form. We will arrange a consultation visit with one of our midwives if we have availability at the time you are due. We feel it is important to meet with you and your partner or support team. Please keep in mind that we are a small practice and only take a limited number of clients each month to ensure quality, personalized care to our clients. It is not uncommon for us to fill up quickly.
DO I NEED TO SEE A DOCTOR?
Throughout your pregnancy, while you are under the care of a midwife, you will not need to see a physician routinely for pregnancy concerns. However, there may be times that seeing a physician is necessary. This would include concerns that aren’t related to pregnancy. If you do need to see your physician, please keep your midwives updated on your health. We care about you and like to know what’s going on. If you develop complications related to your pregnancy, we will provide a referral to an obstetrician if necessary, and be there to help guide you through the process.
DO I HAVE TO HAVE A HOMEBIRTH?
Many midwives, including the midwives at Prairie Midwives, have admitting privileges in hospital, just as a family doctor would. We can admit clients and provide care in hospital. We believe that choice of birthplace is an important aspect of your maternity care and strive to provide that option. Your midwife can help you make that decision as your pregnancy progresses. The decision about where to birth is a very personal one, and can only be decided by you. We are happy to accommodate both options freely.
CAN I HAVE AN EPIDURAL OR PAIN MEDICATIONS IF I HAVE A MIDWIFE?
Midwives are specialists in normal birth. Generally speaking, our clients share the common goal of natural childbirth and choose to deliver their babies with minimal intervention. Of course, it is impossible to predict what your birth journey will look like and there are times when intervention becomes necessary. This includes the use of medications, including epidurals. Many interventions in birth are, at times, useful, if not necessary. It is important to keep an open mind and be educated about all of your options. It is ideal that you feel supported, listened to, and feel a sense of achievement after your birth. We will discuss your options prenatally with you, including all methods of coping in labour.
WHAT’S THE DIFFERENCE BETWEEN A MIDWIFE AND A DOULA?
Doulas provide prenatal, labour, and sometimes postpartum support. Doulas do not provide care in a medical or clinical arena. They do not deliver babies, and are not responsible for ensuring the health and well-being of the mother and newborn. Doulas work as part of your team, along with a midwife or physician. They provide constant emotional support and are there for the duration of labour, including early labour where your midwife may not be directly present. Doulas are for partners too, and they are a very welcome resource at any birth.
WHO WOULD BE AT MY BIRTH?
It is your choice who to have at your birth. Your support team is very individual to you. This may include children and other family members. This may include friends. The choice is yours and will be discussed at your prenatal visits. Children and other family members may require some special preparation.
Generally speaking, there are two midwives at every birth. If you are planning a homebirth, midwives are required to have either two midwives, or a midwife and a Registered Nurse (RN), if a second midwife is unavailable. We have a small pool of RNs who are experienced in providing back-up for homebirths and may be called upon to attend your birth if the second midwife is unavailable. They usually arrive late in active labour and stay for a few hours after the birth. Your midwife will continue to provide your care.
If you are planning a hospital birth, midwives will provide the majority of your primary care and either a second midwife, or an RN will be present at your birth, usually right around the time of delivery and about an hour afterwards.
We believe that it is extremely important to foster the future of the midwifery profession. We may have midwifery students that are practicing with as at various stages of their education. Most of the time, you will have met a student and will have a sense of what they may be responsible for at your birth. The primary midwife will always be present with a student. Please feel free to ask our students or ask your midwives if you have any questions or concerns. Many facilities are teaching facilities and there are a variety of students who may request to be a part of your care, from midwifery students, to family practice residents (doctors), to nursing students. Your midwife will discuss with you if an opportunity arises and you should always know and feel comfortable with whomever is a part of your birth/care.
WHAT’S MY ROLE AS A MIDWIFERY CLIENT?
Your role as a client is to learn! Pregnancy and childbirth offers us many things, and the opportunity to grow a solid understanding of your body is just the beginning. For many people (and their partners), pregnancy is their first opportunity to learning about health and wellness. We offer diet counseling and discuss ways to maintain your health so that you have a healthy, low-risk pregnancy, birth, and postpartum period. Please ensure that you bring questions with you to your prenatal appointments so that we can be sure to provide you with comprehensive care. Informed choice is a big part of your care, so you want to make sure that you are reading and ‘doing your homework’ so as to make the best decisions for yourself and your baby. We can guide you along the way, but the work is yours!
WHAT IF I CAN’T GET CARE FROM PRAIRIE MIDWIVES?
We do wish we could accommodate the demand in Central Alberta for midwifery care, and are working hard to that end! We continue to, at times, have waitlists for care. There are other practices services Central Alberta that may be able to accommodate your care. West Country Midwives is located in Rocky Mountain House, and although they also have wait lists, you may want to contact them as well. Alternatively, Cochrane Community Midwives also has a midwife practicing in Central Alberta. If you are delivering in the traditional medical system, we highly recommend getting a doula to help support you along the way. Be prepared to read lots and seek as much information as possible. We wish you all the best on this very exciting journey! Please do not hesitate to contact us for future pregnancies if you continue to desire midwifery care.