The Midwifery Model Of Care
Midwives view pregnancy and birth as normal family life events and understand that labour and birth work best when the birthing person feels private, safe and undisturbed (Buckley, 2016). The Midwifery model of care historically has promoted birthing people’s autonomy and the right to make informed choices about where, when and with whom they give birth. As midwifery has become further integrated into the healthcare system with midwives holding hospital privileges and able to offer hospital based birth, the midwifery and medical models of birth have become blended.
My Style Of Midwifery
Every midwife has their own philosophy for how they support birth. While one midwife might be a perfect fit for you, another may not. We are all different human beings, and different midwives. Every midwife has families that have absolutely loved them, along with families who strongly disliked their experience because that midwife wasn’t best aligned with what they wanted or needed. I truly believe that being well matched with the person you want to attend your birth matters.
Who I Am As A Midwife
I have a strong belief that pregnant people are connected to knowledge about the wellness of their pregnancy and baby in ways that I am not, despite the fact that I have attended births for over a decade. I trust pregnant and birthing people to make their own choices.
I am a more “hands off” midwife by nature, meaning that I generally give people their space so that they are able to feel private, safe and unobserved. This may look like “doing nothing”, but actually involves a lot of watchful waiting, careful assessment of labour, what contraction patterns are happening, etc. alongside offering other routine labour assessments (listening to baby’s heartbeat etc.). At the 36 week home visit, I usually ask how families would like me to show up for them, whether they have certain parts of labour that they would like more “hands on” support with or anticipate wanting more guidance through. Sometimes what birthing people want changes during labour. I try to be as fluid as possible to meet people’s needs as they arise.
I am very comfortable with undisturbed, physiologic birth, self managed care, and working with autonomous families who are taking responsibility for the outcomes of their own choices.
I primarily attend home births and also offer waterbirth. I do maintain hospital privileges, primarily for times when homebirth transfer is needed and am trained to provide hospital based interventions for moments where complications of pregnancy and birth are occurring. I have good collaborative relationships with surgical consultants (OB’s) in my community.
I openly discuss policies, birth politics and research (what we think we know, what we don’t know), because these are important aspects that create the complex environment that pregnant people often find themselves navigating throughout the childbearing year. These aspects also sometimes complicate the support that I can offer as a licensed Midwife. Being in my integrity as a Registered Midwife means giving truthful answers to families’ questions, even when the answer may be complicated.
Trauma Informed Midwifery Care
Trauma-informed midwifery care recognizes that pregnant people often have intersecting experiences throughout their lives that may make accessing reproductive healthcare more challenging. As a midwife, it is my responsibility and ongoing commitment to continue educating myself to better facilitate consent based, body and gender affirming, inclusive, anti-racist, anti-oppressive care.
- No mandatory tests, procedures or internal examinations during pregnancy, labour, birth or postpartum.
- All midwifery care is provided with ongoing, enthusiastic permission from the pregnant person, with the option to pause, slow down, or stop any aspect of care at any time, for any reason.
- Option for self-directed prenatal care, where the pregnant person decides what aspects of care they want, or do not want based on their own self identified needs.
- Option to catch your own baby, or have your partner receive baby.
- Option to guide out/birth your own placenta.
- Option to self insert the speculum if wanting to access pap testing.
I’m interested in creating connection, building relationships and getting to know each family’s beliefs, values and how they want to approach their birth. This takes time that isn’t always available in the conventional maternity care system setup. I’ve chosen to practice as a solo midwife, taking a small number of clients a month in order to sustainably facilitate 45 min- 1 hour long, individualized prenatal appointments that meet the needs of the families that I work with.
- Prenatal wellness visits (can be modified to whatever combination works best for your family):
- Every 4-5 weeks in clinic until ~28 weeks.
- Every 2-3 weeks in clinic until ~36 weeks.
- Weekly visits in clinic until birth.
- Home visits on days one, three and five postpartum.
- Clinic visits at two, four and six weeks postpartum.
- Access to routine ultrasound, if desired.
- Access to routine prenatal labs and postpartum testing for baby, if desired.
Holistic Birth Preparation
As part of providing longer prenatal care appointments, as a Birthing From Within trained mentor and community herbalist, I also offer holistic birth preparation along with routine clinical care. This includes:
- Access to Happy Healthy Child prenatal DVD series and Lending Library.
- Space for partners and chosen support people to meaningfully participate and engage in prenatal care, ask questions, do their own self exploration around birth topics and receive support of their own.
- In depth discussion around common birth topics including:
- Physiologic birth.
- Variations of normal in gestation, options for waiting for baby and the evidence around due dates.
- Creating a plan for supporting early labour at home.
- Cultivating a pain coping mindset for active labour.
- Holistic stages of birth (a non-linear map for a non-linear process).
- Baby’s transition from in-utero to breathing room air.
- Placental birth process.
- Choice of birthplace.
- Identifying core beliefs and core fears.
- “What ifs?”
- “Safe” vs. “Risky”
- Exploring common cultural/media fears around labour and birth.
- Optimal support for the hormonal blueprint of labour, birth, postpartum and infant feeding.
- Cultivating resilience when faced with challenges during pregnancy, labour, birth and beyond.
- Discussing compassionate use of pain medication.
- Navigating routine practices, interventions and recommendations.
- Making a postpartum support plan.
- Physiologic birth.
- Counselling around optimal nutrition for pregnancy.
- Information about herbal support during pregnancy, labour, birth and postpartum.
- Referral for alternative therapies and practitioners.
- Birth Story Listening for previous birth or traumatic life experiences.
Midwifery Care During Miscarriage & Pregnancy Loss
I’m acutely aware that pregnancy loss comes in many forms and as much as we might try, not all pregnancies continue, and not all babies live. I experienced my own pregnancy losses in 2004 and in 2021, and have supported many of my clients through difficult diagnoses and miscarriages of their own. As part of my Bachelor’s of Midwifery education, I sought out advanced clinical training and was placed at the Early Pregnancy Loss Clinic at South Health Campus and also completed a placement in abortion care at Kensington Clinic. I was trained in supporting pregnancy loss in both home and hospital settings with and without medication. Many families find value in reframing miscarriage and abortion as a birth process, and so offer in person and phone support as requested by families going through pregnancy losses of all types.
Please Note: While I do have the clinical training, Midwives are not currently supported to prescribe medication for either miscarriage or abortion care. If medication management is desired for pregnancy loss, referral can be provided for physicians in the community.
Open communication around your needs, questions, concerns and any aspect of decision making is highly encouraged. If an aspect of your prenatal care is not working for you, please let Lisa know.