Frequently Asked Questions
- If I have a midwife, do I also see a doctor for prenatal care?
- Are your midwifery services funded through Alberta Health Services?
- Do you attend home births?
- Is homebirth supported by Alberta Health Services?
- Do you have hospital privileges?
- Do you attend hospital births?
- How often do people see their Midwife?
- How long are midwifery appointments?
- Do you work in a call rotation group?
- Do midwives attend births alone?
- What does a midwifery attended birth look like?
- How do you support long labours?
- Do you work with other birth workers or doulas?
- What if I need an epidural?
- What if I need a C-Section?
- Do you recommend routine induction of labour for going past the due date?
- Do you perform medical interventions during pregnancy, labour or birth?
If I have a midwife, do I also see a doctor for prenatal care?
No. Since Registered Midwives provide the same basic maternity care that is offered by family practice physicians, there is no need to double up prenatal care appointments. If pregnancy complications develop, both midwives and family practice physicians can recommend shared care or a full transfer of care to an obstetrician (high risk pregnancy specialist).
For clients who have pre-existing health conditions that need monitoring and/or medication, their midwife would provide all normal prenatal care, and a family physician (or walk in doctor) would continue to provide care as needed for any non-pregnancy related concerns (ie. thyroid medication, illness, injury etc.)
Can midwives order labs, ultrasounds and prescribe medications?
Yes. As a midwife, I can order labs, ultrasounds and prescribe medications that are relevant to pregnancy.
Are your midwifery services funded through Alberta Health Services?
Yes. I am currently providing publicly funded midwifery services for residents of Alberta through Prairie Midwives, who are funded through Alberta Health Services.
Do you attend home births?
Yes. Midwives are currently the only registered maternity healthcare providers who specialize in attending births in home and community settings. The majority of the families that I work with choose to birth at home.
Is homebirth supported by Alberta Health Services?
Yes. Registered Midwives are supported by Alberta Health Services to attend births in all birthing locations (home, birth centre and hospital), and all birthing people have the right to choose where they give birth. Midwives are experts in normal birth, and are currently the only health care providers who specialize in attending births outside of the hospital. Midwives are also fully integrated into the healthcare system as autonomous, primary care providers that have the ability to consult, care plan and collaborate with other specialists (Obstetricians, Paediatricians and Anesthesiologists) as needed.
The Society Of Obstetricians & Gynaecologists Of Canada supports planned homebirth, and published a statement in 2019 that included:
“In Canada, homebirth with a registered midwife or an appropriately trained physician is a reasonable choice for those who are evaluated to be at lower risk of obstetric or neonatal complications” (SOGC, 2019).
Do you have hospital privileges?
Yes. I have hospital privileges at Red Deer Regional Hospital as a primary maternity healthcare provider. As Registered Midwives are considered consultant staff members by Alberta Health Services, I can admit clients and their babies onto the labour & delivery and postpartum units and provide healthcare under my own authority, within the midwifery scope of care.
Do you attend hospital births?
Yes, I do attend hospital births at Red Deer Regional Hospital when families choose them, or when medical complications occur in pregnancy that make hospital birth the recommended option. The majority of the families that I work with plan to give birth at home, as community birth options are very limited and families who want to give birth at home often have a very hard time finding a care provider.
Families who know they would like a maternity care provider who provides medicalized care or who would like to access routine interventions such as induction at 41 weeks or routine epidurals, will likely be a better fit for physician care.
How often do people see their Midwife?
- Prenatal wellness visits (can be modified to what works best for your family):
- Every 4-5 weeks in clinic until ~28 weeks.
- Every 2-3 weeks in clinic until ~36 weeks.
- 36 week home visit for families planning home birth
- Weekly visits in clinic until birth.
- Postpartum wellness visits
- Home visits on days one, three and five postpartum.
- Clinic visits at two, four and six weeks postpartum.
How long are midwifery appointments?
I usually book 45 minutes for prenatal and postpartum appointments. I find this gives lots of time to meet the needs of the families that I work with, to answer questions, to geek out about birth and to get to know each other better. Sometimes people need a bit more time, sometimes less.
Do you work in a call rotation group?
No. I am a supported, solo practicing midwife currently working in a reduced caseload model. This means I take two families into care every month, and provide continuity of care from the initial appointment through to 6 weeks postpartum. I normally attend all prenatal appointments, the labour and birth and also provide all follow up postpartum care. Families who have care with me also have access to my 24/7 pager number for urgent/emergent concerns.
If I get very sick, have a family emergency, or if two births happen at the same time (which is rare), I am able to ask one of the other excellent midwives I work with at Prairie Midwives to attend you in labour or see you for an appointment. I also support my colleagues this way as well – We take care of each other to keep midwifery life sustainable, and to make sure families always have access to midwifery care.
Do midwives attend births alone?
Not usually. Midwives generally work in pairs as it’s recommended to have one midwife present for the birthing person’s needs and one midwife present for the baby’s needs in case complications occur. Occasionally, the baby may be born before the backup midwife arrives, but this is rarely a cause for concern.
In the hospital setting, nursing staff may be asked to provide extra support to the midwife during the birth and immediate postpartum (similar to how nursing would usually support physicians at the hospital).
What does a midwifery attended birth look like?
If a home birth is planned, once the birthing person is in active labour, they would call their midwife to attend them. The midwife stays with the family at home from active labour onwards in order to offer assessments, monitor baby’s heart rate and to support the birthing person in their labour progress. When the birthing person shows signs that the baby may be close to being born, the backup midwife is called to attend. After the family has been tucked into bed, and the birth pool has been packed up and laundry has been put on, the backup midwife goes home. The primary midwife usually stays for a little while longer to answer any remaining questions and to reaffirm the wellbeing of the new parents and baby before going home themselves around the 3-4 hour postpartum mark.
If a hospital birth is planned, the midwife would usually offer labour assessment at home first, once the birthing person is in active labour. Having a midwife do a home assessment and supporting labour at home until labour is well established, helps families avoid going to the hospital too soon (and having labour slow down or stall). When the family feels ready to move to the hospital, the midwife would usually call the hospital unit to give them a heads up that the midwife and family will be arriving soon. After the birth, if the birthing person and baby are well, it is standard for midwifery clients to be offered early discharge home around the 3-4 hour postpartum mark.
How do you support long labours?
I am very comfortable supporting longer, physiologic labours and births (which are more common for first time parents), and find that people cope with the intensity of labour best when they are well supported in their own space, have access to their own food and drink, can rest in the privacy of their own home, and have access to reassurance and care that reaffirms the normalcy of the situation. Natural pain relief during normal birth might include deep breathing, physical support from your partner or doula, water immersion, massage, counter pressure, unrestricted movement, and/or swearing like a pirate.
Do you work with other birth workers or doulas?
Yes. I’m very happy for families to create the birth team that they feel will best support their needs, whether that’s a small intimate support team, or a larger group made up of family, friends, doulas, photographers etc. I highly recommend that families consider hiring a doula or birth worker if they are able to, especially for first labours, which are often longer and often require more support for both the birthing person and their partner. As a midwife (and former birth doula/holistic birth consultant), I know the difference having doula support makes, even when you have a supportive partner and align well with your midwife.
If you are planning a hospital birth, I also strongly recommend that you consider hiring a doula or birth worker as unfortunately, I am not able to provide as much one-to-one, hands on support during the labour process due to increased workload and extra documentation required when attending births within a hospital birth setting.
What if I need an epidural?
It has been my experience that when birthing people are experiencing a normal labour, are well supported, have access to freedom of movement, feel private and safe in their own homes and are unhindered to behave how they need to throughout their labour, that epidurals and other pharmaceutical pain medications are accessed much less frequently.
Epidurals are most commonly accessed during planned hospital births, or when labour has not progressed normally due to baby being in an extra challenging position or when the birthing person has become absolutely exhausted. In these extra challenging circumstances, compassionate use of pain medication may absolutely be the next right choice, if the birthing person decides it is.
As I have hospital privileges, if an epidural is decided on, I am able to call the hospital and request they get a room ready for us. Once we arrive at the hospital, I consult with the anesthesiologist, who is the specialist who places the epidural. Once the epidural is in place and working well, I manage the epidural, provide the extra necessary monitoring and medical tasks, and continue to provide midwifery care in the hospital setting.
What if I need a C-Section?
C-sections sometimes become part of a family’s birth story, even when they have midwives and plan a home birth.
I do not perform caesarean sections as I’m not a surgeon. I am trained however, to identify abnormal situations, to make recommendations to transfer into hospital while providing continuous care and communicating with hospital staff. If a caesarean is needed, I can consult and arrange a temporary transfer of care to an obstetrician, who is an expert in surgical birth and in managing advanced complications.
Do you recommend routine induction of labour for going past the due date?
In our current birth culture, routine induction of labour before, or after the due date has become a standard expectation for families and caregivers alike, despite the fact that healthy babies may come anytime between 37-42 weeks and that pregnancy length varies from person to person depending on many factors, including family history and differences in each individual pregnancy. While we have access to technology such as ultrasound, which provides the most accurate means for pregnancy dating that we have available, the exact day that a baby “should” be born remains unclear.
I am trained and skilled in managing medical inductions of labour as part of the midwifery scope of practice, however induction of labour is a major intervention associated with an increase in potential complications for both the birthing parent and baby including an increase in cesarean section, especially for people having their first baby.
As the families that I work with are often looking to avoid routine intervention, I am very comfortable with supporting a wide variety of pregnancy lengths and am not asked to participate in routine induction of labour for going past the due date very often.
Do you perform medical interventions during pregnancy, labour or birth?
Many families are concerned about avoiding unnecessary medical interventions during pregnancy, labour and birth, due to increased social awareness and criticism around the hyper-medicalization of birth within western maternity care systems. Over the years, researchers, care providers, birth advocacy and human rights groups have raised concerns around rising induction and cesarean section rates, iatrogenic harm (complications that are caused by an intervention, that then require more interventions to treat) and increased rates of birth trauma experienced by pregnant people who report that they did not feel listened to or that they experienced coercive counselling from their caregiver and were not supported to make informed decisions around interventions that occurred during their births.
Interventions can include seemingly insignificant procedures such as vaginal exams, breaking the waters and continuous fetal monitoring, or they can be more invasive procedures such as inducing or augmenting labour with medication, cutting an episiotomy or performing a cesarean section.
Interventions are not inherently good or bad by themselves – their value depends on the context of the situation, and the values of the birthing family. The hoped for benefit behind every intervention is to increase the likelihood of a healthy outcome, while minimizing the chance of harm to the pregnant person, their baby, or both. However, despite good intentions, interventions also come with risks and potential consequences that need to be fully communicated to birthing families so that families can make informed choices that are best for them. Well placed interventions have the potential to be life saving, however when used routinely, often increase risk of complications without improving outcomes.
Whether or not a person considers an intervention necessary or unnecessary depends on their own philosophies and understanding of normal birth, the kinds of births they are used to seeing or supporting, the politics and cultural norms in their area, and their own understanding of the situation.
I am trained and skilled in performing a wide variety of medical interventions when medically indicated, however I do not routinely intervene at births, and only perform interventions after a full informed choice discussion if the birthing person accepts both the benefits and risks and has decided that the intervention is in their best interest.
Mockingjay Midwifery 