Is midwifery care the right choice for you?
Continuing education is a fundamental aspect of professional growth and knowledge transfer that we value at Proactive Pelvic Health Centre. Our therapists participate on a variety of peer, and multidisciplinary initiatives including international conferences, continuing education courses, peer mentorship, support groups, and medical seminars. We also serve as an educational site for Ryerson University and Laurentian University’s Midwifery programs, for students to learn about the scope of Pelvic Health Physiotherapy. We invited one of our students to write a guest blog for us about Midwifery.
Midwifery in Ontario
By: Nina Couto, B.A., Student Midwife Year 3, Laurentian University
What I value about midwifery is the myriad of skills we carry and can utilize. The vast numbers of placements and opportunities student midwives have in the Midwifery Education Program [MEP] help shape our approach into a well-rounded practice. Although it has a medical background, it is more of a holistic model. From this specific placement at Proactive Pelvic Health Centre for example, I am able to use my experience to help counsel women in my care by properly assessing pelvic floor health and to refer as needed.
8 Facts You May Not Already Know About Midwifery
- Midwives are registered health care professionals who provide primary care to women during pregnancy, labour and birth, including conducting normal vaginal deliveries, and providing care to mothers and babies during the first 6 weeks postpartum.1 Primary care refers to the first level of contact of services and/or care as an entry point to the health care system. Similar to family physicians, midwives are responsible to identify and coordinate consultation and referral for care outside their scope of practice. This is consistent with primary care principles of coordinating and integrating specialized services.2
- Midwives are a free service of OHIP and non-OHIP persons; all you have to do is self register with a practice in your community. The Ministry of Health pays for midwifery care in Ontario. For persons who do not have OHIP coverage, applicable fees will only be necessary for laboratory work, ultrasounds, hospital stay and/or specialized physician fees such as epidural administration, cesarean sections etc.
- Midwifery care is based on three philosophical principles: a) choice of birth place b) continuity of care provider (from pregnancy, labour, birth to 6 weeks postpartum for both woman and newborn) c) informed choice decision making by the client
- As midwives believe and support a woman’s right to make informed choices about each aspect of her care during pregnancy, labour, birth and the postpartum period for herself and her baby; appointments are longer than standard care. They typically range from 30-45 minutes. Women often report feeling in partnership with their midwives when making decisions about their care. They also report enjoying the continuity of care aspect with respect to getting to know a group of midwives who will look after you and baby before, during and after delivery.
- Whether your baby is born at home, in hospital or in a birth centre, midwives will provide care in your home within 24 hours of a birth to assess and monitor the well being of you and baby. Thus, if having a hospital birth, you may be discharged 3-4 hours after a normal vaginal delivery.
- Midwives will follow up with the woman and the newborn at home in the first weeks postpartum, to assess and monitor the well being of both. Midwives will also help establish and maintain breastfeeding, if that is the woman’s goal. After these visits. the woman and her newborn will follow-up in the clinic and will be discharged at 6 weeks postpartum.
- Midwives are available by pager 24 hours a day, everyday. Depending on the community, midwives will be able to assess and monitor the woman at home, clinic or in the hospital. In some scenarios, midwifery clients may experience less hospital triage visits and report more support with regards to establishing and maintaining breastfeeding.
- Through evidence-based research, midwifery-led care has demonstrated lower intervention rates, excellent clinical outcomes, and high rates of client satisfaction.3 Learn more about the research at the hyperlink provided.
A bit about world midwifery: The International Definition of the Midwife was created in the early 1970’s to establish a consistent vision for midwifery, despite international variation in models of regulation, practice and education. In 2011, the midwifery scope of practice was defined as focusing on normal child bearing with a client-centred model of care in both a community and hospital setting. This includes preventive health care, health promotion, health counseling and education. It envisions the midwife’s role in these areas as extending beyond the individual to encompass the family and the community. Other features recognize the midwifery scope of practice may extend to women’s health, sexual or reproductive health and child care.
1 About midwifery (Internet). Toronto: College of Midwives of Ontario; 2015. What does a midwife do?. Available from: http//cmo.on.ca/public-area/about-midwifery/
2 Ontario Education Centre. Health care 101 e-book (Internet). Toronto. eHealth Ontario. Available from http://www.ehealthontario.on.ca/images/uploads/pages/documents/Health_Care_eBook_Final.pdf
3 Spurgeon P, Hicks C., Barwell F. Antenatal, delivery and postnatal comparisons of maternal satisfaction with two pilot changing childbirth schemes compared with a traditional model of care. Midwifery 2011; 17: 123-132.
Angelique Montano-Bresolin is a graduate of the University of Toronto Physical Therapy program and has been practicing as a Registered Physiotherapist for over 20 years with a specialty practice in pelvic health. Her extensive post-graduate training has included courses to assess and treat all genders and ages with concerns such as: incontinence, abdomino-pelvic pain and sexual pain in many populations including: pre and postnatal, post-surgical, post-menopausal and post-cancer. In 2012, she founded Proactive Pelvic Health Centre in Toronto, Ontario.