A midwife? What kind of animal is that?

The picture of the pregnancy test was taken, your parents were notified and you have already looked through 15 baby name websites. Now it's time to find a care provider that will be with you throughout the pregnancy. You call your friends, or maybe ask your family physician, and perhaps even look at the ratemymd website. In most cases, you end up with an OB/GYN - a medical doctor specializing on pregnancy and birth. Maybe somewhere along the way someone mentions the possibility of getting a midwife, but that sounds too strange and witchcrafty. You're not a hippie after all.

I say midwives are worth a second look.

I have been lucky to have a close friend who has given birth with the help of midwives a few months before me and she has provided me with the information that helped me decide on a caregiver. I would like to share everything I have learned about midwifery here since it was a truly great experience for me.

First I'd like to address the main myths that surround the practice of midwifery:

1. Midwives have no education - In Canada midwives have to go through a 4 year program in a university or a college (there are 8 such programs country-wide) and then pass exams to be recognized by the provincial regulatory bodies.

2. You have to pay to get a midwife - Midwifery care is covered by OHIP. Just like your OB/GYN or family doctor.

3. Midwives and doulas are the same - They are very different in fact. Doulas have no formal education and are not regulated by the government. They are nonmedical professionals who assists a woman before, during, or after childbirth, mostly providing moral support and help in the house and with the baby. Doulas are not covered by OHIP.

4. Midwives are only for those women that want to give birth at home - Vast majority of women in midwifery care give birth at the hospital. In fact most midwifery practices are affiliated with hospitals in the area of their practice and have good working relationships with the medical stuff.

5. I can't get an epidural if I give birth with a midwife - Yes you can and many women do. A midwife is not going to dictate your birth; you will be the one making all the decisions.

6. Midwives show up with some soap and a towel to home births - You have them confused with galaxy hitchhikers. Midwives bring with them huge bags full of equipment. They have oxygen tanks, IV fluids, surgical tools and various drugs. They are fully equipped to administer first aid at a home birth when needed. They also have cellphones and they know very well when to call an ambulance.

Now that these are out of the way, I'd like to discuss the reasons why one might opt for midwifery care:

1.     A midwife is guaranteed to be with you during birth - Each woman in midwifery care gets two midwives (and sometimes more if there are student midwifes). This way she is guaranteed to have one of her midwifes present at birth. She meets with both of them throughout her pregnancy to make sure she knows them well and is comfortable in their presence. In the case of OB/GYNs, not all of them are present during birth. When your OB/GYN is absent, another doctor, whom you're not familiar with and might not be comfortable with, takes care of you. It is very important to trust the person you're with during  birth since you are very vulnerable and dependable at this moment.

2.     Each visit with a midwife lasts about 45 minutes - From what I have heard, visits with OB/GYNs last from 5-10 minutes. Midwives take time to explain all the aspects of pregnancy to you and address any questions you might have. You are not rushed to vacate the office. 

3.     Midwives make sure you make informed decisions - Before each test they give you full information about it so that you can decide whether you want to test to be performed. They can also provide you with recent research findings on different topics in cases when the options are not clear cut.

4.     You are the boss of your pregnancy and birth - midwives are not going to dictate which tests you need to take or how you should give birth. You will be making all the decisions. They simply make sure you have all the necessary information and they give their recommendations but you have the final word.

5.     If you want a home birth, midwives are your only option - Doctors will not assist during home births. But again you by no means have to give birth at home if you have a midwife for a caregiver.

6.     Midwives are knowledgeable in non-medical interventions - They can suggest non-medical alternatives for pain relief, labor induction and other issues.

7.     Many of the blood tests you need (or want) to take during pregnancy are done by the midwife during your regular visits. You don’t need to go to a lab.

8.     Midwifery practices have libraries of birth and baby related books you can borrow.

9.     Midwives know what you're going through - It might not sound like an important argument, but being female, midwives can associate better with their patients. OB/GYNs for some reason tend to be mostly male and will never be able to fully understand the experience of pregnancy and birth.

10. Midwives are experts in natural birth - They have seen a lot of natural births (non-medicated) during their practice. They know how it works and how it looks like. Doctors on the other hand are trained on cases when something goes wrong. They are prone to look for problems.

11. Midwifery care does not end at birth - They take care of you and your baby for the next six weeks after birth. The first few visits take place in your house. Which OB/GYN would do that?

12. For your next child you are given priority - normally you'd have to wait in line to get a midwife the your first time. But if you are a returning 'customer' you are propelled to the start of the line and most likely will get the same midwife you had before.

To be fair, I would also like to talk about the potential drawbacks of midwifery care:

1.     It might be hard to get in – Since the number of midwifery practices is not large (only about 10 in the GTA) sometimes it is hard to get a midwife. It really depends on when your due date is and during what stage of your pregnancy you call. The earlier you start looking the better are your chances.

2.     Midwives can only take care of non-risk pregnancies - When they find a problem they have to refer you to a doctor.

3.     The word ‘midwifery’ has a confusing pronunciation. 

If you would like to learn more about midwives and their practices I recommend the following resources:

·      http://www.canadianmidwives.org/ - The website of the Canadian Association of Midwives.

·      http://www.ontariomidwives.ca/ - Ontario Midwives. You can use their map tool to find a midwifery practice.

·      http://www.cmo.on.ca/about_college.php - College of midwives of Ontario.

·      You can also ask me and if I can I’ll try to answer your questions.

In the next post I’ll try to be a little less formal and tell about my own personal experience with midwives.