FREQUENTLY ASKED QUESTIONS
WHAT IS A MIDWIFE?
Midwives are experts in healthy pregnancy and birth.
In BC, registered midwives offer primary maternity care to healthy pregnant clients and their newborn babies from early pregnancy, through labour and birth, until about six weeks following delivery. They practice evidence-based, client-centered maternity and newborn care and are an established part of the BC health care system.
Midwives listen, observe, educate, guide and care. They order and interpret tests and screen for physical, psychological, emotional and social health. They are with clients during pregnancy, labour and birth, normal and complicated. They catch babies. They do home visits after the baby is born. They help with breastfeeding and adjusting to life with a new baby. They work together and with other health professionals.
DO I NEED A REFERRAL FROM MY DOCTOR TO SEE A MIDWIFE?
No referral is required. You can book an appointment with a midwife as soon as you know you are pregnant.
HOW DO I FIND A MIDWIFE?
Finding a midwife is easy. Simply look up the contact details of your local midwifery practices and give them a call. To help you find a midwife in your area, use the searchable map on our website here.
ARE MIDWIFERY SERVICES REGULATED?
Yes. Midwives are registered with and regulated by the College of Midwives of British Columbia (CMBC) according to the BC Health Professions Act, the Midwives Regulation and the CMBC Bylaws. Midwives have been regulated and legally recognized as autonomous health care practitioners in BC since 1998.
ARE THE COSTS OF MIDWIFERY SERVICES COVERED IN BC?
Yes, the BC Ministry of Health covers the cost of midwifery services for all BC residents with a valid Carecard or BC Services Card through the BC Medical Services Plan (MSP). Military health plans also cover midwifery care. If you are not a BC resident, please contact our clinic to discuss private payment options.
CAN I HAVE A DOCTOR AND A MIDWIFE?
The BC Medical Services Plan covers only one primary care provider for the duration of your pregnancy and birth, to six weeks following delivery for healthy pregnancies. The choice of caregiver during your pregnancy is up to you.
Midwives are experts in healthy pregnancy and normal birth and consult with family doctors and other specialists such as obstetricians as the need arises. Six weeks after delivery, when your midwifery care is completed, you will be transferred back to your family doctor who will resume responsibility for the health of you and your new baby. Families who do not have a family doctor are responsible for making arrangements for their ongoing primary care. Your midwife can provide you with more information on finding a doctor for your family.
I AM NOT COVERED BY MSP. CAN I STILL HAVE A MIDWIFE?
If you are not covered by MSP, make contact with a midwifery clinic and speak with them about the option of paying for your care privately. You will not be charged more than the rates determined by the MSP, however certain tests including lab work and ultrasound will also need to be covered by the family.
If you are a refugee covered by the Interim Federal Health Program (IFHP) you can call the Midwives Association of BC (MABC) at 604-736-5976 to find a midwife registered with Medavie Blue Cross in your area.
WHEN SHOULD I CALL TO MAKE MY FIRST APPOINTMENT WITH A MIDWIFE?
You should contact us as soon as you are aware you are pregnant. However, you can call at any time as space may become available or a practice may not be full for any given month. If you started your pregnancy in the care of your family doctor and would like to transfer to a midwife, it is possible to do so.
HOW OFTEN DO I SEE A MIDWIFE?
Midwife visits happen according to provincial guidelines followed by most maternity care providers. Most visits in the first part of pregnancy are scheduled every four to five weeks and last between 30-45 minutes. In the third trimester, visits increase to every two weeks and are often every week or more often during the last month of pregnancy. These longer visits allow for physical, emotional and social health assessments and allow time for informed decision making and the development of a trusting relationship between clients and their care providers.
After your baby is born, visits usually take place wherever the new family resides. This may be in the hospital after a hospital birth or at home. After the first week or two, visits are scheduled in the clinic and continue for about six weeks when your care is transferred back to your family doctor or nurse practitioner. Between visits, midwives provide 24/7 call coverage for urgent care or concerns.
HOW MANY MIDWIVES WILL BE INVOLVED IN MY CARE?
Our practice works in a group of four midwives. We will ensure that you have the opportunity to meet each of the midwives prior to your birth. We also use locums to cover our practice occasionally due to unexpected events or leaves of absence (i.e maternity leave). You can learn more about our midwives and locums here. Continuity of care is one of the pillars of the midwifery model - the CMBC Midwifery Model of Practice highlights the concept of continuity of care in providing safe, individualized care.
WHAT IS THE WORKING RELATIONSHIP BETWEEN MIDWIVES AND OBSTETRICIANS?
Midwives consult with obstetricians, pediatricians and other specialists if the need arises during your pregnancy, birth or postpartum period. This may simply be an additional appointment or assessment, but a transfer of care could arise under urgent scenarios. Unless a significant complication arises early in pregnancy midwives remain involved in a supportive role, with care sometimes transferred back to the midwife once the complication has subsided.
WILL I HAVE ACCESS TO THE SAME TESTS AND PRESCRIPTIONS THAT I WOULD HAVE HAD WITH A DOCTOR?
Yes, registered midwives offer the complete panel of prenatal laboratory tests, genetic screening and diagnosis options, ultrasound imaging and many other tests and procedures for clients and newborns. A midwife's scope of practice includes the use of many medications that may be indicated in pregnancy, during labour — including emergency situations or pain medication — and following birth. If medication or testing is required outside of this scope of practice, midwives consult with and refer to doctors as indicated for more specialized care.
COULD COMPLICATIONS RULE OUT MIDWIFERY SERVICES?
Yes, this is possible depending on your personal circumstances. During your initial visit, your midwife should be able to give you an idea of whether the care you need is covered by their scope of practice. If you are unsure, you may also call or email our clinic to inquire prior to booking your first visit.
Should complications arise while in a midwife's care at any time, the midwife will follow provincial guidelines that will help inform the decision to consult with or transfer care to the appropriate doctor or other specialist. Individual hospitals also often have policies on when consultation or transfer may take place.
CAN I CHOOSE WHETHER I GIVE BIRTH AT HOME OR IN HOSPITAL?
Yes, midwives offer the choice of birthplace to healthy, low-risk clients based on the principles of informed decision making. On average, 70% of births attended by midwives occur in hospitals. This number varies by practice and community. For more information on home birth, you can read our Home Birth section as well as the CMBC Place of Birth Handbook.
WHAT PAIN RELIEF OPTIONS ARE AVAILABLE FOR ME?
Midwives offer a range of natural and pharmaceutical pain relief options. These include hydrotherapy (the use of water for pain relief), touch, suggestions for positions and breathing techniques, verbal support as well as access to medications such as narcotics, nitrous oxide (laughing gas) and access to epidurals. It is paramount in midwifery care that clients have access to the information necessary to make informed decisions about the use of pain relief options. These options are discussed during prenatal visits as well as extensively covered during our during prenatal group care classes.
WHAT HAPPENS IF I HAVE TO HAVE A C-SECTION?
Midwives have a 42% lower Caesarean section rate than the provincial average. However, in certain circumstances a Caesarean birth may be recommended as a safer option than a vaginal birth. In most situations, your midwives are involved in the decision making process, and will usually be present to receive the baby during your Caesarean birth and continue with our postpartum care the baby is born.
WHAT IF I HAVE A PROBLEM UNRELATED TO PREGNANCY?
During pregnancy, clients continue to see their family doctor or specialist physician for health issues unrelated to pregnancy.
WHAT IS THE DIFFERENCE BETWEEN A MIDWIFE AND A DOULA?
Doulas do not provide medical care and do not deliver babies. Midwives are trained to provide all the necessary medical care and to monitor the health and well-being of you and your baby.
Doulas work as a part of the team, with a midwife or doctor and nurse. Doulas provide continuous emotional and physical support and are a positive addition to the birth team for clients who want extra support. For more information about doulas, please visit the BC Doula Services Association. If you or your partner are Aboriginal, you qualify for a free doula through the BC Association of Aboriginal Friendship Centres.
(Excerpted from the Midwives' Association of British Columbia)