{Ottawa Doula} Midwifery: Fact and Myth

It's not shocking to me at all how often I come across regular folks who have no clue what a midwife does.

I was there, too.

Before becoming pregnant with my first child, I gave no thought to my care provider. I pictured myself visiting my family doctor and being referred to an obstetrician. It was the fortuitous meeting I had one day with a local midwife that changed the course of my life forever (I guess you could say my pregnancy changed the course of my life forever, but I'm going for dramatic effect here!)

I interviewed this student midwife for a short one-month placement at Hopewell (Ottawa's only eating disorder support centre - as a side note, all midwives are expected to do one community-based placement; women with eating disorders get pregnant too, hence this midwife was particularly interested in this issue) She opened my eyes to the possibility of having a midwife care for me during my pregnancy.

So I would like to share with you some of the things I've learned about midwives, which will dispel some of the myths floating around out there. These tidbits are designed to surreptitiously indoctrinate gently urge you to seek out more information about midwifery care.

• You cannot have an OB (or family doc.) and a midwife; you can  have one or the other. There are exceptions - some women advocate for "shared care." These are generally women who are higher-risk but would like a compassionate, caring midwife to support them in their medical decisions.
• Midwives are highly trained professionals. They have not stumbled out of the forest wearing birkenstocks, and they don't arrive at your birth with a dirty towel and piece of shoestring
• Their training program is 4 years long, most of which is hands-on clincial experience
• Midwives care for low-risk pregnant women - they will not take on women who clearly need the expertise of an obstetrician.
• Midwives DO deliver primarily in hospitals. Yes, they do homebirths as well, but only if you're a good candidate, and only if you actually want to!
• Midwives will call in an OB consult if something abnormal comes up during your pregnancy/birth. Often this is just a quick face-to-face with an OB, whereby they give some advice and then you are back in the care of your midwife. Sometimes, transfers of care happen, but most midwives will stay with you and support you throughout.
• Midwives are trained to view birth as normal, until proven otherwise (OBs are trained to view birth as abnormal, until proven otherwise)
• Midwives discharge you from hospital earlier - which means less time stuck in semi-private rooms with other crying babies (and maybe even crying mommies).
• Midwives visit you at home in the postpartum period. AT HOME....like, on your couch!! I can't stress enough how amazing this is.
• A midwifery appt is usually 30min long, and allows for lots of discussion time. It's casual, and you get to meet with both your primary midwife (many times) and your secondary midwife (several times). An OB appt is 15min long, and if you go to the Ottawa Hospital, you will most likely never see your OB. You'll see a different resident each time.
• A midwife catches your baby. An OB "delivers" your baby (like a pizza), and they will arrive in the room when the head is crowning.
• Midwives have signicantly better outcomes than OBs - lower rates of intervention (e.g. episiotomy) and lower c-section rates
• Midwives practice informed decision making and informed consent. That means, every single little thing that happens during your pregnancy/birth is discussed beforehand, and you always have the right to refuse. Hospitals claim they practice these things too, but it's variable.

There are probably many more points I could add, but I hope this dispels some of the myths you have been hearing about midwives here in Ontario. As you may have read from my last post, there is a big push for more midwifery care here in Ontario. A birth attended by a midwife costs less than one attended by a family doctor, and significantly less than one attended by an OB.

We are now headed in a direction where soon, most low-risk pregnancies will be followed by midwives. It may not happen next year, but certainly in the next ten years. It just makes sense.

If you've had the care of a midwife, please share your story below! What was your experience like?