Midwifery Information
General Information
All registered midwives in Ontario are governed by the College of Midwives of Ontario. We provide primary care to women during pregnancy, labour, and birth. We continue to care for mothers and babies during the first six weeks after the baby is born.
The St. Jacobs Midwives' practice was officially established in 1994, the year that Ontario became the first province in Canada to recognize midwifery as a regulated health profession. There is no direct cost to midwifery consumers for care at home or in the hospital. Women do not need a referral from their family physicians.
The St. Jacobs Midwives all maintain active privileges at Grand River Hospital in Kitchener. All midwives are certified in Adult CPR and Neonatal Resuscitation.
Women receiving midwifery care do not see a physician during the course of their care. However, if a medical concern either with the mother or with the baby, arises during pregnancy, labour or birth, or in the six weeks of post partum care, we consult with the appropriate specialist according to our guidelines. If it becomes necessary, we transfer primary care and then we continue to provide supportive care.
St. Jacobs Midwives are committed to ensuring the growth of midwifery care in Ontario by providing practical learning opportunities for students of the Ontario Midwifery Education Program. We encourage clients to welcome the involvement of midwifery students in their care.
Our Informed Choice Agreement outlines our philosophy, our role, protocols for practice, and client responsibilities. Feel free to discuss with us any questions you may have about this Agreement.
The St. Jacobs Midwives work within a defined geographical catchment area. If you live outside this area, we will be pleased to provide you with names of other midwifery practices.
What to Expect from Midwifery Care
The Midwifery Act of Ontario states that "the practice of midwifery is the assessment and monitoring of women during pregnancy, labour and the post-partum period, and of their newborn babies, the provision of care during normal pregnancy, labour and post-partum period, and the conducting of spontaneous normal vaginal deliveries."
We encourage first-time midwifery clients to attend one of our Midwifery Information Nights, usually held about once a month. This class is also open to anyone interested in midwifery, however we do encourage you to call ahead to pre-register.
Your prenatal visits will be held at our clinic in St. Jacobs. Your first visit takes about one hour and subsequent visits take about 30 minutes. We will record your blood pressure and weight, do urine tests, check for swelling, classify any risks, palpate baby's position, and listen to the fetal heart. Any questions, problems or anxieties you have may be discussed at this time. Fathers and siblings are welcome to attend as well. Towards the end of your pregnancy, we will do a home visit so that we know how to find you when you begin labour, and to meet other members of your family. At this time, we can also discuss your birthing plans and accommodation.
Most of our clients begin their labour at home, whether or not they are planning a home birth. You will be carefully monitored throughout labour and the birth to detect any complications that may occur, and we will discuss appropriate action with you. If perineal trauma (tearing) occurs, midwives are trained to repair tears either at home or hospital. Most mothers and babies are discharged from the hospital within a few hours of a normal birth. We encourage mothers to be at home and resting in this first week. For this reason, several post-partum visits are made to your home within the first week to check mother and baby. We continue with visits at two, four and six weeks at the office. You may be seen more often if necessary. Midwives provide breastfeeding support and well baby care for the first six weeks after the birth. We provide all necessary forms for birth registration. The midwives are available by pager 24 hours a day, seven days a week.
Frequently Asked Questions (FAQ)
When do I arrange for midwifery care?
Our practice is very busy and we often have a waiting list for care. You should call the office as soon as you have a confirmed pregnancy (home tests are fine). Occasionally we can accommodate late requests, depending on our schedules. Call the office to check for availability. You do not need a referral.
Is there any reason why I can't have a midwife?
A midwife is a specialist in normal, healthy pregnancy, labour, birth and post-partum care. Healthy low-risk women are generally suitable for midwifery care. An initial health history will allow the midwife to determine whether you can remain in midwifery care or whether you need obstetrical care.
Can I have a midwife and a doctor?
You can have either a midwife or a doctor. Midwives, obstetricians and family physicians are all considered primary caregivers. A primary caregiver takes sole responsibility for your care. To have two caregivers is viewed as a duplication of health care services.
How often do I see a midwife?
Prenatal care (before the baby is born). Midwives work collaboratively in group practices. A woman receives care from a small number of midwives. Visits to a midwifery practice occur on a regular basis during which time midwives provide clinical examinations, counseling and education. Appointments are 30 minutes. The appointment schedule follows the standard care model. Prenatal visits 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. Midwives are on-call for emergencies 24 hours a day.
What kind of testing can a midwife order?
There are several tests that a midwife can order. For example, a midwife can arrange for appropriate ultrasound and genetic screening, initial laboratory tests and urinalysis.
Is there a charge for midwifery care?
There is no fee charged for midwifery care for permanent Ontario residents. Midwifery care, including prenatal, birth and post-partum care, is paid for by the Ontario Ministry of Health. If you do not have a valid Ontario Health Card or for clarification of permanent residency, please call the office.
Where can I have my baby?
Midwives offer you the choice of a home or hospital birth. Whichever setting you choose, you and your baby will receive comprehensive and safe care.
Do you offer childbirth classes?
We encourage you to consider attending prenatal classes which are generally taken when you are about six months pregnant. However, you need to book early to reserve space. There is a fee for these classes. See the Events and Classes section of our website for contact information.