Wednesday, May 2, 2012

Hip + Urban Mom: Using A Midwife

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Making a birth plan seemed a little silly to me. I mean, don’t we just ask for an epidural and have the doctor tell us when to push? After I got pregnant I learned that there are a lot of options, and many are less scary than those TV water births. One such option is to use a midwife.

Fortunately, I have the honour of soon being able to call Laura my cousin when she gets married this summer. She is also a training midwife, so who better to ask all about midwives. Laura Duivesteyn is a senior midwifery student at McMaster University. She will be completing her fourth and final year this fall/winter and looks forward to graduating next spring.

I asked Laura what a midwife is and she told me that “Midwives are primary health-care providers who are able to provide care for a woman’s entire pregnancy, labour and birth, as well as the first six weeks after birth for both mom and baby. Midwives are available to their clients by pager 24 hours a day, 7 days a week.”  She told me that midwives are trained to recognize situations that would need outside help and can transfer care to the most appropriate health care provider, such as an obstetrician, family physician, lactation consultant, or pediatrician. 

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I also wondered what it is exactly that midwives provide. She said that the schedule for seeing a midwife is the same as visits to your obstetrician. These visits tend to be a little bit longer and allow women to ask many questions and the midwife can monitor the woman’s blood pressure and weight gain, check the baby’s growth, heart rate, and position.  They are also able to order tests like ultrasounds and blood work. Laura said “When a woman is in labour, the midwife will meet her either at home or hospital for an assessment. Once determined to be in active labour, the midwife remains with the woman for the entire labour.”  

A midwife can offer support not only for the mother but also for any support people in your room, like your husband. Closer to the time of delivery a second midwife arrives so that there is one to care for you and one to care for your baby. “The midwives will remain for a few hours after the birth to monitor mom and baby, help establish breastfeeding, and ensure everyone is stable before leaving the home or hospital.” Afterwards the midwife will still be seeing you and your baby and help to monitor everyone and eventually discharge the mother back to the family doctor.

Laura stresses that there are important reasons to consider using a midwife:

1) Informed Choice - this is a standard that recognizes the woman as the primary decision maker, and should be actively involved her care. The midwife can explain all your choices to you.  

2) Choice of Birthplace - midwives are able to offer both home and hospital births to their clients.

3) Continuity of Care - during a woman’s course of care, she will meet up to a maximum of four midwives, two of which will likely be at her birth. Prenatal visits allow the woman to  feel comfortable with her midwife/midwives and for the midwives to know and learn about her, which leads to the ability to provide the most competent and comprehensive care.

Laura explains, “What drew me to a career in midwifery was the wonderful, comprehensive care women receive. Through the longer visits, 24/7 availability, discussions encouraged through informed choice and the non-authoritarian environment midwives provide, the woman is able to feel comfortable with her health care provider and express what her needs are, beyond just the clinical care.”

Finding a Midwife
Most midwifery clinics have websites and are easily found over the internet. The Association of Ontario Midwives (AOM) website has a very useful map of all Ontario clinics and their contact information. You can also call the AOM at (416) 425-9974 or 1-866-418-3773 to help find a clinic near you.

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