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, even when those choices challenge me physically, emotionally, psychologically or spiritually.
I am more of a “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 how labour sounds, 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 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 birth, self managed care, and working with autonomous families who are taking responsibility for the outcomes of their own choices.
I mainly attend home births and waterbirths as these are my specialty. I do maintain hospital privileges and have good collaborative relationships should a family I’m working with choose a hospital birth, or if a change in plans is desired or needed in labour.
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 you. 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.
Use Of Technology
I have access to and am trained to utilize technology, medical equipment, prescribe medications and to interpret lab results and order ultrasounds when requested by the families that I work with. Ultrasounds, lab tests and dopplers offer information, have their own risks and benefits and have room for misinterpretation. While these tests can never give us a 100% full and complete picture of any situation, they can offer useful information at times.
Induction of Labour
I am trained to manage medical inductions of labour for postdates and am required to offer that standard of care at 41+3 wks, however most of the families I work with choose to wait for labour, which I am very comfortable with, so I do not find myself participating in postdates induction very often.
I am very comfortable supporting longer, physiologic labours (especially 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 privacy, and have access to reassurance and other natural pain relieving techniques including water immersion.
Compassionate Use Of Pain Medication
I believe that compassionate use of pain medication is appropriate if the birthing person decides it is, especially for more complex labours, and am trained to manage epidurals. It has been my experience that when birthing people are well supported, have access to freedom of movement, feel private, safe and unhindered through their labour that epidurals are requested much less frequently.
I highly recommend that families consider hiring a doula 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 see the difference that having doula support makes, even when you have a supportive partner and align well with your midwife.
Navigating 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 at Kensington Clinic. I was trained in supporting pregnancy loss in both home and hospital settings with and without medication. I believe in the value of reframing miscarriage as a birth process, and offer in person and phone support as requested by families going through pregnancy loss.
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 a 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 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, if desired. Labs can often be done during prenatal visits.
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:
- Normal 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 (no matter the chosen birthplace).
- 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 in either home, birth suite or hospital setting.
- 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.
- Compassionate use of pain medication.
- Navigating routine practices, interventions and recommendations.
- Making a postpartum support plan.
- Normal 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.
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 caregiver, 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.
- Option for self-directed prenatal care.
- 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.
Open communication around your needs, questions, concerns and decision making is highly encouraged. If an aspect of your prenatal care is not working for you, please let Lisa know.