What is a midwife?
What does midwifery care entail in Canada?
Can any woman choose a midwife?
Why is midwifery recommended?
What training does a midwife have?
What is the difference between a midwife and a doula?
Do midwives only offer home births?
Are home births safe?
How do I contact a midwife?
Is midwifery legal in NB?
Where else is midwifery care provided?
How can I help to make legislated midwifery services available to women in NB?
How do I train as a midwife?
I am an internationally trained midwife, how can I start working here?

Appuyez ici pour les questions françaises

What is a midwife?
o Midwife means ‘with woman’
o A midwife is an independent, autonomous caregiver
o A midwife is a primary health care professional
o A midwife is the specialist in normal birth
o A midwife believes birth is a normal physiological process
o The World Health Organisation Definition:
“Midwives are able to give the necessary supervision, care and advice to women during pregnancy, labour and the postpartum period, to conduct deliveries on their own responsibility and to care for the newborn infant. This care includes preventive measures, the detection of abnormal conditions in mother and child, the procurement of medical assistance and the provision of emergency measures in the absence of medical help. Midwives have an important task in health counseling and education, not only for the women they serve, but also within the family and community. This work involves prenatal education and preparation for parenthood.”

What does midwifery care entail in Canada?
~Woman centred care, with the woman as the primary decision maker
~Time for questions, support for informed decision making
~Continuity of care in the community, from conception to six weeks post-partum
~Respect for choice of birthplace, hospital, birthing centre or home
~Individualised care responding to social, emotional and cultural as well as physical needs
~Health promotion focus on maintaining and improving health, thereby avoiding problems
~Home visits for postnatal care and breastfeeding support

Can any woman choose a midwife?
Midwives care for healthy women with normal pregnancies. If, for example, you have or develop any medical condition such as diabetes, or if you are expecting twins, you will be referred to an obstetrician.

Why is midwifery recommended?
~Low intervention rates - women are less likely to be induced, have an epidural or episiotomy
~Excellent health outcomes reported in the first ten year evaluation of midwifery care in Ontario
~Community access for all women, it is easier for the midwife to travel than a new mother
~Cost -effective
o interventions are reduced
o complications are prevented
o hospital time is reduced due to a shorter stay for the birth and a reduction in readmissions
o breastfeeding rates are very high (>90 %), which reduces childhood and maternal illness
o in comparison to 100% physician attended births

What training does a midwife have?
In Canada the majority of midwives have a ‘direct entry’ four year baccalaureate degree, including clinical placements, and emergency skills training.
Some midwives may have gained their education via an alternative route, for example an international training and then a prior learning assessment process Canada, but they have passed the same theoretical and clinical assessments in order to gain registration here.
All midwives registered in Canada have been assessed theoretically and clinically, and are required to maintain current certification in CPR, Emergency Skills and Neonatal Resuscitation.

What is the difference between a midwife and a doula?
~A midwife is a health professional who takes responsibility for the clinical care of the woman and her baby from conception through pregnancy and birth to six weeks post-partum.
~A doula has had training in providing emotional and physical labour support. Certain doulas will also have some training in postpartum care, and are able to provide breastfeeding support.
If you choose midwifery care, your midwife will be with you throughout active labour, and the first few hours postpartum.
Both midwives and doulas provide labour support. You may not be able to have both a midwife and a doula with you if you also have another support person with you in the hospital.
In a home situation you can choose to have whatever support you want.

Do midwives only offer home births?
In provinces where midwifery is legislated, midwives offer care at home, in birthing centres and in hospitals. In provinces like NB where midwifery is not yet legislated, midwives offer home births only, as they have no hospital privileges as yet, and there are no birthing centres..

Are home births safe?
Many women have never considered a home birth, thinking that a hospital is the safer place to have a baby. The research shows that planned home birth is as safe as hospital birth for healthy women with normal pregnancies when professional care is provided. In Holland over 30% of women birth at home. Some advantages for the woman include an enhanced feeling of control in her own home, the freedom of being able to have whatever support she chooses, of being close to her other children, in a familiar environment, where she can relax and labour as privately as she wishes. The mother will be able to recover from the birth in the comfort of her own bed and not be disturbed by other babies crying at night. There is also less risk of infection .
In addition to basic equipment , midwives always carry emergency equipment such as oxygen, medications, intravenous fluids and suction.
In a province where midwifery is legislated, if for some reason you need to be transferred to hospital during labour, your midwife will accompany you, managing your care if all returns to normal, or transferring care to an obstetrician if problems persist. In an unlegislated province, your midwife will stay with you for support but will be unable to take any further clinical responsibility for your care.

How do I contact a midwife?
In NB there are no registered midwives. Until there is legislation and regulation, it is the responsibility of an individual woman and her family to investigate any care options offered. This includes interviewing the potential caregiver as to her education, qualifications, clinical skills, emergency skills, equipment, transport, care plan and fees.

Is midwifery legal in NB?
Not yet. Midwifery is alegal, which means at present there are no laws governing the practice. It is up to an individual woman if she chooses midwifery care. In many provinces, such as Nova Scotia, midwives offered home births prior to legislation due to maternal demand . The Midwifery Act was passed in Nova Scotia in the fall of 2006.

Where else is midwifery care provided?
Midwives are the senior health care professionals at the majority of births in 72 countries, including Australia, New Zealand, the UK, France, and the Netherlands.
In Canada, midwifery care is legislated in BC, Alberta, Saskatchewan, Manitoba, Ontario, NWT, Quebec and Nova Scotia. In all but Alberta, midwifery services are publicly funded. Midwifery legislation will be passed soon in Nunavut, and midwifery services are available to most women in Nunavik. Women in the Atlantic provinces are losing out.

How can I help to make legislated midwifery services available to women in NB?
~Birth Matters -join our group working towards making midwifery services available to all women in NB, write to birthmatters @hotmail.com for more information
~Letters - write and tell the Health Minister what maternity care you feel should be available, address him as ‘Dear Minister Murphy’, and send the letter to:

Honourable Michael Murphy
Minister of Health
Government of New Brunswick
P. O. Box 5100
Fredericton, NB E3B 5G8

~Lobbying -visit your MLA! Let the government know what services women want!
Public and Professional Awareness -talk to your neighbours, your family physician, your friends
Further Information: Canadian Association of Midwives www.canadianmidwives.org

How do I train as a midwife?
~5 universities offering the four year degree.
UQTR (French, for Quebec residents only)
Ryerson U in Toronto
Laurentian U in
McMaster U in Hamilton
U British Columbia in Vancouver

~3 diploma programs available to Aboriginal candidates choosing a shorter program
Ontario -Six Nations
Manitoba - AMEP
NWT - Rankin Inlet
Distance Learning Program
WAM

I am an internationally trained midwife, how can I start working here?
The situation is complex but is gradually becoming easier. Unfortunately there are no assessment opportunities in the Atlantic provinces at this time. It is necessary to travel west. However a national exam will be available by 2008 and registration will eventually be reciprocal between the provinces.
Please read the info provided at these sites:
Canadian Midwifery Regulators’ Consortium CMRC www.cmrc
International Midwifery Preregistration Program (Ontario)IMPP www.ryerson.ca/ce/midwife
Manitoba PLEA
British Columbia PLEA
OSFQ PLEA