The Midwifery Model Of Care
Pregnancy, labour and birth are normal family life events that 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.
Midwives All Have Different “Flavours” Of Practice
Every midwife (and physicians too) have their own philosophy for how they support birth. While one caregiver might be a perfect fit for you, another may not. We are all different human beings, with different experiences and comfort levels as a result of those experiences. Some midwives attend births primarily in the hospital and practice within a more medicalized model. Some midwives primarily attend home birth and practice more within a physiologic birth model. There is no one “right” way to approach birth, however it’s important to get an idea where along the spectrum of practice your caregiver sits and whether that person’s practice matches your needs.
My “flavour” of Midwifery
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. I know that pregnant people care the most about the health of their baby, and I trust pregnant and birthing people to make their own choices, even when those choices may challenge my comfort as a midwife.
I believe that it’s best to support the physiologic birthing process whenever possible and reserve recommending interventions and hospital birth for abnormal situations. I do my best to minimize unnecessary interruptions and encourage the family to create their own space together in order to feel private, safe and unobserved, which helps assist labour progress, the rotation of the baby through the pelvis and keeps pain manageable. I view my role during labour as being a skilled, watchful consultant in service of the family. I am comfortable with undisturbed, physiologic birth, self managed care, and working with families who are taking responsibility for the outcomes of their own choices.
I value scientific evidence as part of my midwifery practice and geek out about statistics and research, while also respecting that traditional teachings and ways of knowing are also valid forms of evidence that are essential to the cultural and spiritual wellbeing of many families. I work with both pharmaceuticals and herbs, and am knowledgable and skilled in offering both medical and natural interventions when they are needed.
I specialize in home birth (which is funded by Alberta Health Services and is supported by the Society of Obstetricians & Gynaecologists of Canada) and have hospital privileges and good collaborative relationships with the Obstetricians in my community, who are skilled at supporting high risk situations and can provide surgical interventions that Midwives and Family Physicians cannot.
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 provide consent based, body and gender affirming, inclusive, anti-racist and 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.
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 I offer in person and phone support as requested by families going through pregnancy losses of all types.
Please Note: While I 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.