ABOUT PLUM MIDWIFERY
YOUR CARE AT PLUM
Your midwives are members in good standing with both the Midwives Association of BC and the College of Midwives of BC. We are a teaching practice and regularly host future midwives, doctors, nurses and nurse practitioners. This is optional but highly encouraged in order to help grow these important professions. We hold admitting privileges at the North Island Hospital - Comox Valley in Courtenay. We work collaboratively with other health professionals and will aid you in accessing community resources and support. Read about your full course of prenatal, birth and postpartum care below.
PRENATAL CARE
Prenatal appointments are scheduled every 4 to 5 weeks until you’re 28 weeks pregnant, then every 2-3 weeks until 36 weeks. At 36 weeks, your appointments will be weekly until the birth of your baby. Each visit is part discussion and part physical assessment. You can expect your visits to be 30-45 minutes long to both build a relationship with your care providers and allow sufficient time for informed choice.
The physical assessment at each clinic visit includes your blood pressure, measuring the growth and heart rate of your baby and can include weight checks as well. You can expect to be offered all routine screening including blood tests and ultrasounds along with a discussion about each. We are trained to recognize potential concerns and complications and will provide timely specialist referral as required. If required, your midwife can prescribe medications for pregnancy-related conditions. In addition, you can reach your midwife 24/7 for urgent concerns between appointments.
The discussion at each appointment is when we answer your questions and help address your concerns. We will also provide education about what to expect during your current stage of pregnancy. We view you and your family as the primary decision makers in your care and believe that it’s our job to facilitate that through our partnership with you. By sharing the most recent research with you, informing you of community and College standards and finally offering our clinical experience, we can help you make decisions that are both safe and meaningful to you.
We also offer prenatal group care as a complement to your individual appointments.
Midwives provide continuous care throughout labour and birth. Research shows this is not only the safest way to care for a labouring person but also leads to the most positive experience. You can expect us to provide care throughout your active labour, the birth and the immediate postpartum. Our role at your birth is two-fold: we provide information, emotional support and comfort as well as assessing you and your baby's well-being.
We offer labour and birth care in the home and hospital settings. We fully support your choice of birth place through ongoing discussions during your pregnancy. We follow provincial guidelines as well as the scope of practice required by our College and if any complications outside of that scope should arise, we will consult with the appropriate physician to access the care that you need. Your midwives are all frequently trained in obstetric emergency skills, neonatal resuscitation (NRP), CPR and fetal health surveillance. While we are trained to detect complications at an early stage as well as manage unexpected emergencies, we believe birth is a normal physiologic event in most cases. We consider ourselves to be guardians of normal birth and commit to supporting your birthing goals and honoring this powerful and precious experience in your life.
At a hospital birth, we care for you along with one of the perinatal nurses. If any complications arise or you request an epidural, we will consult with the appropriate physician to access the care that you need. In the hospital, you have access to pharmacologic pain relief and continuous fetal heart monitoring (if indicated).
Current research consistently concludes that planned home birth, attended by a qualified caregiver, is as safe as a hospital setting for healthy clients with healthy pregnancies. This means you have no pre-existing or pregnancy-related health complications, you are at term (37-42 weeks), you are pregnant with one baby and that baby is head down. We bring medications and equipment to manage all common emergencies (ie. postpartum hemorrhage, neonatal resuscitation) and will arrange timely transport in an emergency.
In both settings, you can expect us to listen to your baby’s heart rate, check your vital signs and assess the progress of your labour. We will support you with encouragement, position changes, massage or hydrotherapy as desired. We will safeguard you and your baby’s well-being and keep you informed on an ongoing basis. You can expect to have your baby on your chest immediately after birth (unless they need assistance to breathe) and to have uninterrupted time with them for breastfeeding and bonding.
LABOUR AND BIRTH
POSTPARTUM CARE
The birth is over and now the real adventure begins! We recognize the early postpartum to be a simultaneously beautiful and stressful and exciting time in a family’s life. Especially if this is your first child, every moment is full of learning for both parents and baby. You will likely have frequent questions and worries, therefore we are always available by pager for urgent concerns and see you frequently in the first week or two postpartum.
If you had your baby in the hospital, we will see you each day you are admitted to assess you and your baby's well-being and discharge you home when you are feeling recovered and ready. If you had a home birth, we come back to see you within 24 hours of the birth. We then continue to see you about every 2 days for the first week or two postpartum, and more often if there are challenges with feeding or your physical recovery. By 2-3 weeks postpartum, your care returns to the clinic and we see you biweekly until you are discharged at about 6-8 weeks postpartum to your family doctor or nurse practitioner. If you don't have a primary care provider, we will help you find and access care. During all of these visits, you can expect full assessments of the physical health of yourself and your baby as well as breastfeeding assistance, emotional support and screening for postpartum mood concerns, and opportunities to discuss your birth or address your parenting questions.
In addition to our routine postpartum care, you have access to our postpartum baby group located at our Cumberland clinic on Wednesday mornings from birth to three months postpartum. This is a comfortable place to not only access our clinical care, but to meet other new parents, have a cup of tea and a snack, seek support and learn more about available community resources with others who understand the stage you are in.
