How much does midwifery care cost?FAQ1ed

Midwifery care is fully funded by the Ontario government for all Ontario residents, even those without an OHIP card, so there is no cost to you! Hospital, lab and ultrasound fees are covered by OHIP. There is no additional cost for a home birth. If you choose to borrow a water birth pool, you will need to pay for a few supplies including a liner for the pool.

Do I need a referral?

No, you do not need a referral from a doctor. You are welcome to call our office or fill in our online Client Intake Form to request midwifery care for yourself. If you are not sure if midwifery care is right for you, you can book an appointment to come in and chat with one of our midwives.

When should I call in for care?

Midwives provide care for women from the beginning of pregnancy, and most women call in for care as soon as they know they are pregnant. Currently the demand for midwifery care in Ontario exceeds the supply, so women who call in for midwifery care later in pregnancy may find themselves on a waitlist. However, because we are a new and growing practice, we are usually able to take women into care at any point in pregnancy.

I’ve been told I’m “high risk” – can I still have a midwife?

We believe that all women should be able to access midwifery care. If you have a minor medical condition, we can provide most of your care and involve a physician as needed. Midwives can care for women who have previously had a caesarean section or a history of miscarriages, teenage mothers or those who are over 35 years old, and mothers with conditions such as hypothyroidism or mental health issues, among others. If you have a significant complication requiring extensive specialist involvement, we may be able to share your care with a physician.

How are midwives trained and regulated?

There are three pathways to becoming a Registered Midwife in Ontario. The first is to complete the four-year Bachelor’s degree in Midwifery that is offered at Laurentian, McMaster and Ryerson. The second is to train outside Canada and then complete the International Midwifery Pre-Registration Program at Ryerson University. The third is to train outside Ontario, register as a midwife in another province and then become registered in Ontario through the inter-provincial reciprocity agreement.

All Ontario Registered Midwives must be members of the Association of Ontario Midwives (AOM) and the College of Midwives of Ontario (CMO). The AOM provides midwives with Clinical Practice Guidelines, and arranges for liability insurance. The CMO provides guidelines and standards to ensure that midwives practice safely.

How do midwives keep up-to-date with their skills and knowledge?

All midwives must renew their Neonatal Resuscitation Program every year and complete Emergency Skills Training and CPR every two years. They must attend a minimum of three continuing education activities and six inter-practice peer reviews every year. As part of the annual Quality Assurance Program, midwives are required to review client evaluations and consider changes to practice if needed.

Our practice has a policy of regular, frequent emergency skills review that exceeds the minimum standards set out by the CMO. We believe that practicing together as a team allows us to be optimally prepared for any emergencies that may arise.

What tests can midwives order?

Midwives can order all routine bloodwork, urine tests, pregnancy tests, pap smears and infection screening, ultrasounds and genetic screening. If you need a test that cannot be ordered by a midwife, she will refer you to a physician who can order the test.

Where can I choose to have my baby?FAQ2ed

Midwives offer choice of birthplace to low-risk women – you can choose to have your baby at home or in hospital. Our midwives have privileges at Groves Memorial Community Hospital in Fergus and Louise Marshall Hospital in Mount Forest. If your pregnancy is high-risk then you may need to give birth at a hospital where we do not have privileges. For example, if you have a very preterm birth, you would need to give birth in a tertiary level hospital, likely in Hamilton – we would not be able to attend your birth but can provide care once you are home again. In some circumstances, if you are giving birth at a hospital nearby where we do not have privileges, one of our midwives may be able to attend your birth to provide labour support.

Do I still see a doctor if I have a midwife?

Women with normal, healthy pregnancies are expected to choose only one care provider: a midwife, family doctor or obstetrician. Seeing more than one care provider for the same routine care wastes our precious health care system resources. If you choose physician care and then decide during your pregnancy that you would like midwifery care, you can switch care providers. Similarly, if you choose midwifery care and then decide that you would prefer to see a physician, you may switch.

If your primary care provider is a midwife, and you develop a complication, your midwife will refer you to an appropriate specialist. You can continue to see your midwife for your routine care and see the specialist as needed.

When you are accepted into midwifery care, we will ask for your consent to share your information with your family doctor. If you agree, we will send your family doctor a notice to tell them that you are pregnant and in midwifery care, and when you are due. When the baby is born, we will let your family doctor know relevant details of your birth. At your final visit, we will send a letter to your doctor to let them them know how you and the baby are doing, and to let them know you are are discharged from midwifery care.