Full Scope Practice

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We are a full scope practice, meaning you stay under our care for epidurals, Oxytocin Induction or Augmentation for labour

What to expect during the course of your care

Model of Care

Here we work in a shared care model where clients are assigned to a team of midwives. During the pregnancy, our goal is to provide clients with many opportunities to meet each midwife on their team. Your midwives work together to provide prenatal, labour and birth, and postpartum care. Teams rotate through a 6-week rotation to ensure there is one midwife on call and one conducting clinic appointments. With this schedule, clinic is rarely cancelled due births, and a is midwife on call 24/7 to answer any urgent pages, assess labour and attend deliveries. Normally there are two midwives present at each birth, whether the birth takes place at home or in the hospital. The backup Midwife that attends your birth will be a midwife from one of our 4 teams or a Hospitalist Midwife on the AMU. There is always a small chance that a known midwife from your team may not be your primary during labour and delivery because your Midwife is attending another birth or sleeping due to a prior delivery. In any case, we are all committed to practicing in a very similar way so that you can develop of relationship of trust with all of us.



Labour and Birth Care

Your midwife team is available by pager to answer questions and provide reassurance during early labour. When you think you may be in active labour, your midwife will either assess you at your home or meet you at the hospital, or have you meet a hospitalist Midwife for an assessment. If your labour is induced, your midwives will work together with the obstetrical staff to ensure you receive seamless care. Inductions involving oxytocin do not require a transfer of care to the obstetrician on-call. Midwives are trained to recognize and manage emergencies that can occasionally arise, and will involve hospital staff (obstetricians, family doctors, nurses, etc.) if needed, however at a normal birth, your midwife will catch the baby, provide you support during labour, preform a newborn exam after delivery and help with breastfeeding prior to being discharged from the hospital.



Prenatal Appointments

Regular visits with one of your team of midwives is an important aspect of pregnancy as each visit should be a time for you to ask questions and voice any concerns you may be having. It is also when the midwife will conduct an examination to ensure that you and your baby are well, to offer the appropriate tests, and discuss relevant topics for each stage of the pregnancy. First appointments are scheduled to take place when clients are roughly between 8-11 weeks and are an hour in length. Regular prenatal appointments, following the intake, are approximately 20-30 minutes in length, and usually are once a month for the first 28 weeks, every two weeks until 36 weeks, and then once a week until your baby is born.



Postpartum Care

Midwives provide care to both client and baby for six weeks after the birth. This is called postpartum care. Whether your baby is born at home or in the hospital, your midwife will provide care in your home within 24 hours of the birth. Clients will have several appointments at home during the first week to monitor their health and provide breastfeeding support. They ensure the client is recovering well, both physically and emotionally. Clients and their baby are then seen in the clinic several times between 2 and 6 weeks. Midwives provide physical examinations of the baby, which include checking: weight, length, heart, lungs, healing of umbilical stump, hearing, and overall physical development. After six weeks, clients are discharged from midwifery care and will begin to see their family doctor. The Durham clinic is now happy to provide group care classes!



WHERE WE DELIVER

The Alongside Midwifery Unit at Markham Stouffville hospital officially opened its doors on July 9th, 2018. The AMU is staffed by hospitalist midwives on the unit 24/7 who will facilitate and organize consultations and work as the liaison with obstetricians and community midwives. 23 midwives have privileges to deliver on the AMU, seven of whom are hospitalist midwives. The AMU has six specially equipped birthing rooms outfitted with upright birthing stools, and hanging slings allowing women to adopt upright positions.

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The rooms also have tubs suitable for water births and have double-sized Murphy beds for rest after giving birth. 80 per cent of women will go home within six hours after giving birth and are visited at home by a midwife within 24 hours. Midwives provide complete care from early pregnancy to six weeks after labour for mother and baby.

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©2019 by Midwifery Services of Durham.