What is a Midwife?

A midwife is a health care professional who:

Sees pregnancy and childbirth as a normal physiological process
Respects and supports women so that they may give birth safely, with power and dignity
Is a trained professional who provides complete and comprehensive care to women through all stages of pregnancy and birth and continues to care for both mother and baby for six weeks postpartum.

During regularly scheduled visits midwives provide prenatal care, clinical care, counseling, education and postnatal care. Midwives have a regulated scope of practice that stipulates circumstances during pregnancy or birth when they are required to consult with an obstetrician. In some circumstances a midwife may be required to transfer care to an obstetrician. If your care is transferred, your midwife remains with you in a supportive role.

There are a limited number of midwives in Canada. If you wish to have midwifery care for your pregnancy and birth it is recommended that you contact the midwifery practice nearest you as soon as you are able to during your pregnancy.

The model of midwifery is based on three principles:

Continuity of Care - Midwifery care is available to women throughout their pregnancy, labour, birth, and the first six weeks after birth. Midwives spend time developing relationships with women and are available 24 hours a day, seven days a week.
Informed Choice - Women are active decision-makers in the care they receive; midwives provide information to enable women to make informed decisions.
Choice of Birthplace - Midwifery clients may choose to give birth at home or in hospital. Midwives maintain hospital privileges at many hospitals and work collaboratively with other health care practitioners.^[i]

Are midwifery services covered under provincial health insurance plans?

In some provinces and territories midwifery services have been regulated and are covered by provincial health insurance plans.

Province	Regulated Midwifery Services	Midwifery services covered by provincial health insurance
Alberta	Yes	No
British Columbia	Yes	Yes
Manitoba	Yes	Yes
Newfoundland and Labrador	No	No
New Brunswick	Yes	No
Northwest Territories	Yes	Yes
Nova Scotia	Yes	No
Nunavut	Yes	No
Ontario	Yes	Yes
Prince Edward Island	No	No
Quebec	Yes	Yes
Saskatchewan	Yes	Yes
Yukon	No	No

Questions to ask when interviewing a midwife:

Where did you receive your midwifery education? Are you certified or licensed?
How many women are due within a month of my due date?
Do you work with a partner? If so, what are her qualifications?
What is your plan if someone else is in labour when I am?
What methods/products do you recommend/use if clients are overdue?
What prenatal tests do you require?
Do you carry an oxygen tank to births?
What methods do you suggest to alleviate labour pain?
Is your certification in neonatal resuscitation up to date?
Do you maintain statistics from your practice? May I see them?
What physician collaboration or backup do you have?
To what hospital do you transport if this becomes necessary? Who will go with me?
How often do you make postpartum visits?

Additional questions for a hospital-based midwife:

Who will care for me if you aren't at work when I go into labour?
Are you open to my having a doula, in addition to my partner?
May I drink and eat during labor?
Can I have intermittent monitoring rather than EFM?
Are there tubs or showers at the hospital? Is it likely that I can use one?
Is there a time limit on labour?
Can you put my baby on my chest (skin-to-skin) after birth?
When do you clamp the umbilical cord?

For more information and resources visit:

Canadian Association of Midwives
The Canadian Women’s Health Network

Updated October 15, 2009

[i] Adapted from www.aom.on.ca