Full Scope Practice
We are a full scope practice, meaning you stay under our care for epidurals, Oxytocin Induction or Augmentation for labour
What is the Definition of a Midwife in Ontario?Ontario, a midwife is a registered health-care professional who provides primary care to low-risk women throughout pregnancy, labour and birth. Midwives also provide care to both mother and baby during the six weeks following birth. They are available to clients 24 hours a day, seven days a week by pager. A woman receives care from a small number of midwives. You will know the midwife who attends your labour and birth. In Ontario, if you see a midwife you will not see a physician unless there are concerns or complications. If there are complications, midwives can consult or transfer care to a physician. Midwives provide safe and expert care to healthy women and newborns. - See more at: http://www.ontariomidwives.ca/midwife/
How can I access Midwifery Care?It is best to contact us as soon as you find out you're pregnant. Not only is demand for midwives high, but it is also beneficial to access prenatal care at the beginning of your pregnancy. First appointments are schedule when women are between 8-10 weeks gestation, and generally those who are interested in Midwifery care complete our online intake form between 4-6 weeks pregnant. Our practice books clients in based on estimated due dates and geographical location. We are limited to the number of clients we can care for each month. Sometimes we have openings for clients later in pregnancy, however this can be a rare occasion.
Do I need a Referral?You do not need a doctors referral to see a midwife. We accept and prefer clients to self referrals by completing the online application form. This form can be found here: https://www.durhammidwives.com/become-a-client
Can I have a Midwife and an OBGYN?You can choose to have a midwife or a doctor, but not both. Midwives are experts in low-risk pregnancy and birth, and midwifery clients will not see a physician unless there are concerns or complications. If complications arise, midwives can consult with physicians or, if necessary, transfer a client’s care to a physician. Midwives can order bloodwork, ultrasounds and test related to pregnancy. Clients will see their Midwives on a frequent schedule, where we will perform a wellness check on you and baby during each appointments.
What is the difference between a Midwife and OB?First of all, it’s not actually Midwife versus OB, we are team-mates not adversaries! Although you need to choose which type of provider will manage your care, we work together as a team to deliver the highest level of care to birthing people in our community. Obstetricians are skilled surgeons who specialize in high risk pregnancy. Midwives specialize in caring for healthy people from the beginning of pregnancy through to 6 weeks after the birth including the care of their newborns. We have great relationships with the OB team at Oak Valley Health (Markham Stouffville Hospital) so if complications arise, each client gets the type of care they need with no barriers to access. So to highlight the differences between Midwifery and Obstetric care, here are some reasons why Midwifery care may be right for you. You want a known care provider looking after you in labour - there is a greater than 90% chance that the midwife who will care for you in labour will be a midwife who cared for you in pregnancy. There are approximately 15 OBs that work at MSH and they all take turns covering the birthing unit, which means is not very likely that your doctor will be the on on-call the day you go into labour. You want someone whose only job is looking after you in labour - we provide one-to-one care in labour, which is something that sets midwifery care apart. The midwife who attends your birth will have no other responsibilities while they are looking after you. With the physician-led model, a team of nurses will provide most of the hands-on care, so that the doctor can oversee the management of everyone in labour on the floor. You want home visits after the birth - care for a new baby while your body is healing from the birth is tiring and emotional. Midwives provide all the healthcare you and your baby needs in the fist 10 days in the privacy and comfort of your home. You want longer appointments with more opportunities for questions, individualized care planning and support - Midwife appointments last between 20-60 minutes and we spend lots of time doing health teaching, discussing your plans and wishes, and answering your questions. A full-time OB cares for about 400 clients a year and a full-time midwife cares for about 40. You want want efficient care - Midwives' clinics are usually running on time. We are able to stay on schedule because of lower client volumes and longer apppointments, which gives us enough time to get everything done. With a midwife you will usually have a short wait and long visit and with an OB you'll often have a long wait for a short visit. In the hospital, you will spend less time waiting as well because the midwife is the making making the management decisions. Remember the OBs are often juggling all the patients on the ward, while your midwife will usually just have you in triage/labour. You want access to your care provider 24/7 - At Durham Midwives, we are available to you at all times if you encounter an emergency or urgent situation. All clients have access to the paging system and will use it in labour, emergencies with you or your baby or urgent concerns. OB patients are always welcome to present to the hospital is they have an urgent concern, but many times midwifery clients can save themselves a trip to the hospital on discussion with their midwife. You are interested in labouring at home or planning a home birth - With Midwifery care, clients have options when it comes to where they want to deliver.
Do I have to pay for a Midwife?Midwifery services are completely funded by the Ministry of Health and Long-Term Care, so women do not pay for care out-of-pocket if they have OHIP. Women who are not currently covered by OHIP can still receive midwifery care. Cost can be associated to those that do not hold an OHIP card. To find out more, please give our office a call
Where can I deliver my baby?Clients have options when it comes to where to deliver - either home or hospital. Should you choose to have a hospital delivery, We have privileges at Oak Valley Health - Markham Stouffville location, where we deliver on the Alongside Midwifery Unit (AMU). We also support the choice of having a homebirth - ask your midwife if you are a candidate for a home birth.
Where do prenatal appointments take place?Clients are seen at our clinic, 138 Old Kingston Rd, Ajax for the routine prenatal visits. After delivery and the first week of home visits, clients will bring their baby for their routine postnatal follow up between weeks 2-6. The final appointment is scheduled at 6 weeks postpartum.
Is a Midwife the same as a Doula?A midwife is not a doula! 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. You would find and pay your doula yourself, as doula services are not covered by the Ministry of Health and Long-Term Care. If you are considering having a doula at your birth, talk about it with your midwife.
What pain relief options are available?Midwives offer a range of natural and pharmaceutical pain relief options, including access to epidurals in hospital. Pharmaceutical pain relief can only be accessed at a hospital birth. Many women use water, massage and other methods as an effective way to relieve pain at home, birth centre and hospital. Midwives at Markham Stouffville Hospital have what we call "full scope of practice" which includes ordering epidurals and taking care of women with epidurals. Your care will not change if you request an epidural and the midwives will continue to take care of you throughout your labour and birth.
Will my care be transferred if I need Oxytocin for Induction or Augmentation?Your care will not be transferred should you need Oxytocin Induction or Augmentation for labour. Midwives provide this progressive and innovative continuity of care to all our clients who may need oxytocin in their labours, without the need for consultation in most situations.
If I have a Hospital Birth, how long do I need to Stay after I deliver?"If both you and the baby are fine, you will probably be ready to go home from hospital about 4-6 hours after the birth. The Midwives will visit your home within the first 24hrs to check on you and the baby, to answer any questions you may have, and to help you if needed with such things as feeding the baby. After the first home visit, the Midwives will provide two follow up home visits within the first week. The midwives are available both at the clinic and by pager for urgent questions if the need arises. If after a hospital birth there is any concerns about either your health or that of your baby, you may have a longer stay in the hospital as needed.
Can midwives run the same kinds of tests as doctors?Yes. Midwives can arrange all routine prenatal testing including ultrasound and genetic screening, as well as standard laboratory and diagnostic tests. Midwives discuss the results with clients and provide information and follow-up.
Our practice is running on our regular prenatal schedule. Clients will be seen in person on a regular basis.
Virtual appointments are optional, but in place for those who may be symptomatic/feeling unwell
We ask that you do not present to the clinic is you are feeling unwell or have any signs/symptoms of COVID-19, or if you have been in contact with someone who is positive.
To view our schedule of visits, please follow the link below:
For low risk healthy newborns:
1 in person assessment in the first 24 hours after birth to complete newborn screening for clients discharged early from hospital for you and baby only.
2 additional home visits around day 3 & 5 (these days could vary)
Weeks 2, 4 & 6 will be scheduled as an in clinic appointments.
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.
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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