Pregnancy

What is a midwife (and why you might want a midwife deliver your baby in a hospital or at home)

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what is a midwife

Midwives provide primary care to healthy pregnant women and their babies. They offer support in hospitals and at home, throughout pregnancy, labour, birth, and the postpartum period.

Why consider a midwife?

A study in the British Medical Journal Open, found that women who receive care from a midwife were less likely to:

  • go into early labour
  • have a baby with a low birth weight, or
  • have an infant that is smaller or less developed than normal for the number of weeks in pregnancy compared to women in care of a physician.*

This may be because midwives typically have a relationship building model of care therefore offering longer appointment times and providing detailed informed consent around possible interventions.

Depending on where you live, midwives may deliver babies at home or in a hospital. They can order and interpret medical tests and results (laboratory tests, blood work, ultrasound scans, etc.).

Midwives may offer home visits after your baby is born. They can also help with postpartum care, breastfeeding and transitioning into life with a newborn.

Some also offer monthly group appointments! This offers patient the opportunity to connect with other pregnant women, and receive additional information about things like pregnancy, childbirth, postpartum care and newborn babies.

Regulations, referrals and when to transition back to your family doctor for care

In the U.S. and Canada, midwives are regulated by states and provinces.

You can either have a midwife or a doctor, but not both. But a midwife can refer you to an obstetrician if needed. For example, in situations with multiples and if a caesarian is needed (they will most likely be in the OR with the Mother).

A referral is not required for using a midwife. However they are specialized and qualified to offer safe prenatal care to healthy pregnancies and normal births. If you have a high risk pregnancy or experience complications, you may be referred to a doctor or OBGYN.

Approximately six weeks after delivery, you and your baby will transition back to your family doctor for ongoing care.

When and where to start looking for a midwife

You should start looking for a midwife as soon as you find out you’re pregnant. Depending on community and practice volume, finding an available midwifery practice can be difficult. It can be especially hard if you switch from a doctor to a midwife mid-pregnancy. If you’re looking for a midwife, consult with your healthcare provider.

For information, check out these external resources:

Midwives Alliance of North America
North America Registry of Midwives
American Colleague of Nurse-Midwives
Canadian Association of Midwives

*McRae, et al., Reduced prevalence of small for gestational age and preterm birth for women of low socioeconomic position: a population based cohort study comparing antenatal midwifery and physician models of care, BMJ Open: 2018 (https://www.calmparent.net/wp-content/uploads/2020/05/e022220.full_.pdf).

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