What is a midwife?

Midwives are regulated health care professionals who provide primary care to women throughout their low-risk pregnancy, labour and birth, and provide care to both mother and baby during the first six weeks following the birth.


How are midwives trained and regulated?

Registered midwives complete a 4-year university degree in midwifery (Bachelors in Health Science, Midwifery). Once a midwife has completed her training, has attended a minimum of 60 births and has passed a qualifying examination (Canadian Registration Midwifery Examination), they are licensed by the College of Midwives of Ontario under the Midwifery Act, 1991, and the Regulated Health Care Professions Act (RHPA). 

As a requirement of registration, midwives must demonstrate ongoing competence in all birth settings (hospital and out-of-hospital), and maintain up-to-date certification in cardiopulmonary resuscitation (every 2 years), neonatal resuscitation (every year), and emergency obstetrical skills (every two years). 


Can I have a midwife and a doctor?

No. Midwives, obstetricians and family physicians are all considered primary caregivers. You can choose to have a midwife or a doctor, not both, as it would be considered double-billing the health care system. You don't need a referral from a doctor to have a midwife, just contact us directly.


Does it cost to have a midwife?

There are no out-of-pocket costs. Midwifery services are completely funded by the Ontario Ministry of Health and Long-Term Care. Ontario residents who are not currently covered by OHIP can still receive free midwifery care.


Are midwives the same as doulas?

No. A birth doula is a trained labour support person who provides emotional and physical support to those giving birth and their families. While not medical professionals, doulas can offer a wide range of comfort measures. Doula services are not covered by the Ministry of Health and Long-Term Care and you would be responsible for finding and paying for a doula yourself. If you are considering having a doula at your birth, talk about it with your midwife.


Can midwives order tests & ultrasounds like doctors can?

Yes. Midwives can arrange the same routine prenatal tests as family physicians and obstetricians, including blood tests, urine tests, genetic screening, and ultrasounds. During appointments, midwives will talk to you about what each test looks for, how it is performed, and possible advantages and disadvantages. She will also discuss your results and provide follow-up as necessary.  In addition to arranging tests, midwives can also prescribe certain drugs related to your care, like antibiotics to treat infections.


What happens if there is a problem with my pregnancy?

The majority of births are normal and low-risk. Midwives are experts in low-risk pregnancy and birth. If a health concern or complication arises in pregnancy, during birth or in the post-partum, your midwife will consult with the appropriate health care professional. This may be your family doctor, or a specialist as required. Occasionally, this may result in a transfer of care for you or your baby. If your care is transferred (for example, in the event of a cesarean section) your midwife will continue to provide support and resume primary care when possible.


Can I have a hospital birth with a midwife?

Yes. Choosing a midwife does not mean choosing a home birth, although this is an excellent and safe choice for the majority of women. In fact, 80% of all midwifery-attended births happen in hospital, and Tesmikaming Midwives have privileges at Temiskaming Hospital. Your midwife will talk to you about your options, answer your questions and provide you with the information you need to make an informed decision about where you choose to have your baby.


Can I have a waterbirth with a midwife?

Yes. Midwives are trained in water immersion and waterbirth, and this can be offered at Temiskaming Hospital or in an out-of-hospital setting. If you are considering this option, talk about it with your midwife. 


Can I have an epidural with a midwife?

Yes. If you choose to have an epidural or need an induction, your midwife can still care for you, as these skills are part of their scope of practice at Temiskaming Hospital. Midwives offer a range of natural and pharmaceutical pain relief options. Pharmaceutical pain relief including epidurals and ‘laughing gas’ can only be accessed at a hospital birth. Water immersion, massage and other non-pharmacological methods are also effective ways to relieve pain at home and in the hospital.


How often will I see my midwife prenatally and in the post-partum?

Prenatal visits are usually once a month for the first 28 weeks, every two weeks until 36 weeks and then once a week until your baby is born. Appointments are 30-45 minutes long. After your birth, midwives provide care to you and your baby for six weeks. You will have about six midwifery appointments during the six weeks following the birth, including several in the first few days and weeks to monitor the health of both you and your baby and provide breastfeeding support. Midwives remain available by phone 24 hours a day, seven days a week for emergencies. After six weeks, clients are discharged from midwifery care.