What is a Midwife?

From the Midwives Association of BC:

What does a midwife do?

In a nutshell, midwives are experts in healthy pregnancy and birth.

Registered Midwives in BC offer primary maternity care to pregnant clients and their newborn babies from early pregnancy, through labour and birth, until about six weeks postpartum. What does this really mean? Midwives listen, observe, educate, guide, and care. They order and interpret tests and discuss results. They screen for physical, psychological, emotional and social health. They care for their clients during pregnancy, labour and birth, normal and complicated. They catch babies. They do home visits postpartum. They help with breastfeeding and adjusting to life with a new baby. They work together and with other health professionals. They practice evidence-based, patient-centered maternity and newborn care and are an established part of the BC health care system.

Is midwifery care regulated?

Midwives are registered with and regulated by the College of Midwives of British Columbia according to the BC Health Professions Act, the Midwives Regulation, and the CMBC Bylaws. Midwives have been regulated and legally recognized as autonomous health care practitioners in BC 1998.

Is the cost of midwifery care covered in BC?

BC Ministry of Health funding covers the cost of midwifery care for all BC residents with a Care Card through the BC Medical Services Plan. It is important to note that coverage is provided for only one type of health care provider for healthy pregnancies in BC. See “Can I have a doctor and a midwife?” below.

I am not covered by the BC provincial health care plan. Can I still have a midwife?

In many cases, yes. Contact us and we will discuss a financial plan. Midwives cannot charge you more than they bill the government, however that cost does not include supplies, laboratory tests and blood work, ultrasound scans, or any hospital or physician charges including the costs associated with hospital births.

Can I have a doctor and a midwife?

The BC Medical Services Plan covers only one primary care provider for the duration of your pregnancy and birth, to six weeks postpartum. The choice of caregiver during your pregnancy is up to you. Midwives consult with family physicians and other specialists such as obstetricians as the need arises. At six weeks postpartum, when your midwifery care is completed, you will be transferred back to your family physician who will resume responsibility for the health of you and your new baby. Families who do not have a family doctor are responsible for making arrangements for their ongoing primary care. Your midwife can provide you with more information on finding a physician for your family.

How often do I see my midwife?

Midwife visits happen about as often as visits with physicians in pregnancy and last 30-45min. In the first and second trimester your visits are every 4-5weeks. In the third trimester visits are scheduled more frequently and are often every week during the last month of pregnancy. Longer visits allow for physical, emotional and social health assessments and allow time for informed decision making and the development of a trusting relationship between clients and their care providers. Postpartum visits usually take place wherever the new family is. This may be in the hospital initially after a hospital birth, and then in the new family’s home once they have returned, or at home after a home birth. After the first week or two, visits usually happen back in the clinic and continue to about six weeks postpartum when your care is transferred back to your family physician. Between visits, midwives provide 24/7 call coverage for urgent care or concerns.

Will I have access to the same tests and prescriptions that I would have had with a doctor?

Midwives offer a complete panel of prenatal laboratory tests, genetic screening and diagnosis options, ultrasound imaging and many other tests and procedures for women and newborns. A midwife’s scope of practice includes the use of many medications that may be indicated in pregnancy, during birth including emergency situations or pain medication, and for parent or baby postpartum. If medication or testing is required outside of this scope of practice, midwives consult with and refer to physicians as indicated for more specialized care.

Can I choose where I give birth: at home or in hospital?

Midwives offer the choice of birthplace based on the principles of informed decision making. On average, 70% of births attended by midwives occur in hospitals.  For more information on home birth in BC read the CMBC Home Birth Handbook for Clients. You can read a large study on homebirth in British Columbia , literature as complied by the American College of Nurse Midwives or also An annotated guide to the available home birth , literature as compiled by the Division of Midwifery, UBC.

I’m more than half way through my pregnancy and I have been in the care of my family doctor until now. Can I transfer to a midwife or is it too late?

Yes, it is possible to transfer care at any time in pregnancy, however with the high demand for midwives, it may be difficult to find an available practice.

What is the difference between a midwife and a doula?

Doulas do not provide medical care and do not deliver babies. Midwives are trained to provide all the necessary medical care and to monitor the health and well-being of you and your baby. Doulas work as a part of the team, with a midwife or doctor and nurse. Doulas provide continuous emotional and physical support to the laboring woman and her partner, and are a positive addition to the birth team for couples who want extra support. For more information about doulas, please see the Doulas of North America Website or the BC Doula Services Association.