Midwives offer an alternative

from NiagaraLife Magazine   Nov 12, 2013 – 1:11 pm

3e58bbecc34a1ed14ba1d9bf70e52b4eBy Amanda Moore

When Julia Wilson arrived on Canadian soil two months pregnant, she didn’t realize the health system focused on medical treatment for prenatal and birth care. Having been pregnant once before in her native England, her care was immediately given over to midwives. In England, it’s the norm.

Wilson struggled over the idea of seeing a medical doctor or obstetrician throughout her pregnancy — after all, she was pregnant, not sick.

“Women have been doing it for many years. Bushmen did it without any help.”

After sharing her experience with some local moms, Wilson learned of a midwife practice in its first year in Beamsville. She instantly felt relieved and hoped she would be able to get into the practice.

“I firmly believe that birth is a natural occurrence,” says Wilson, who delivered a healthy daughter, Vivian, on Sept. 27, 2013 into the hands of midwife Pilar Chapman.

Lincoln Community Midwives is a sister practice to Niagara Midwifery Practice. The clinic opened its doors in October 2012 and delivered 160 babies in its first year. The clinic is home to six midwives — Pilar Chapman, Carrie Seguin, Rachel Pennings, Taryn Spiegelberg, Inge Roorda and Laura MacIntosh — and services the Grimsby, Lincoln and West Lincoln communities.

 

Chapman joined Niagara Midwifery Practice 14 years ago after completing a four-year bachelor of science with a major in midwifery. Her path to midwifery started in an unexpected place.

“I came into midwifery in a very indirect route,” says Chapman, who used to work in Toronto for the United Church delivering social programs to immigrant and refugee women. “Some of those women were pregnant and some of those women asked me to be their labour support person, to be a friend. Those were the first births that I went to and I was in awe and struck by the miracle of birth and what an amazing process it was. And at the same time I couldn’t help but think there had to be a better way to do this.”

Chapman can still recall the first time she witnessed that miracle. She remembers so vividly being awed by childbirth while wishing she could do more for the newcomer lying in a hospital bed before her.

“There are things I remember so distinctly about that birth,” says Chapman. “She had given birth before in another country and it was obvious she was allowed to birth in very different positions there. She wasn’t at all comfortable with what was being suggested to her, which was giving birth in a bed, lying on her back, feet up in stirrups on the bed. Here she was going through a very powerful process, and I was in awe of her strength and at same time I tho

ught how unfortunate that she obviously has the desire to do it a certain way and her caregivers aren’t comfortable with that way.”

In choosing a midwife, expectant mothers are taking back control of their birthing experience.

In Ontario, about seven to eight per cent of all births are overseen by a midwife.

Midwives provide care throughout pregnancy, birth process and post-partum up to six weeks for both mother and her baby.

“We provide clinical care in the same schedule as a physician would see patients,” explai

ns Chapman, noting because of funding differences, midwives are able to meet with patients for a longer period. An average appointment is about 30 minutes. “We can order lab work and ultrasounds, we can also order genetic testing and we have hospital privileges.”

Just like general practitioners and obstetricians, midwifery care is covered under Ontario’s Health Insurance Plan. Expectant mothers do not have to pay out of pocket for midwife care.

Where midwife care differs from that of a physician or obstetrician is in offering choices to an expectant mother. Something Chapman refers to as allowing mothers to make an informed choice.

“Women have the option now, if they’re low risk, to decide if they want to have midwife, family physician or obstetrician deliver their baby,” says Chapman. “That’s something called informed choice and it’s something we strongly believe in. It means a woman is fully informed of what her options are and is making a decision that makes sense for

her.”

Those choices range from where the birth will take place to what types of tests and scans will be done during pregnancy. A midwife will lay the options out on the table, make recommendations and support a mother no matter what her choice.

“You can have 10 women and they will all choose very different options,” says Chapman. “We all have different philosophical beliefs, religious beliefs and personal beliefs that determine those choices.”

Chapman says there are benefits to both home and hospital births.

 
 

The Lincoln Community Midwives work out of West Lincoln Memorial Hospital where they are given the full scope of responsibility in the delivery room. Only when there are complications will an obstetrician step in. Patients can also choose pain relief – an option they do not have at home. With the WLMH model of care, midwives can still remain as the primary caregiver should the mother choose an epidural. Chapman explains that is not the case across the province. In some hospitals, it is seen as transfer of care.

The key benefit of home birth, says Chapman, is comfort.

“Women tend to move around in their home setting more freely,” says Chapman. “There are no people in hallways or the busy world of a hospital going on outside the door. It’s easier for them to get into their own bathtub and labour there for a while, move into living room, move around their own space. That’s a good reason why pain relief is not needed in the home setting.”

Wilson chose a hospital birth. She was admitted to West Lincoln Memorial Hospital around 10 a.m. on Sept. 21. Vivian was born just before 3 p.m. All were on their way home by 6 p.m. Midwife patients have the option of early discharge, says Chapman, noting almost all patients opt to return home three hours after giving birth.

She received her first visit from her midwife the following day.

“I felt completely safe and secure in their hands. I never once felt like I needed a doctor around to make it safer.”

Wilson felt safe even though she had been previously warned she may need a C-section should she give birth again after her son, Ethan, was born with a hematoma on his head.

A recent study says the midwives could safely lead care in most pregnancies.

Jane Sandall of King’s College in London recommends more midwife-led births for low-risk, healthy women. Sandall and her colleagues compared midwife-led care to other models from 13 trials involving more than 16,000 women with low and increased risk of complications. Results, which were released in August in the Cochrane Database of Systematic Reviews, found that women being cared for by a midwife received fewer interventions such as epidurals and episiotomies, were less likely to experience pre-term birth and were less likely to lose their baby before 24 weeks gestation. Patient satisfaction rates were also higher among moms who were cared for by a midwife.

There are 900 registered midwives in Canada and there are 100 new graduates each year.

Many provinces and territories – with the exception of New Brunswick, Prince Edward Island, Newfoundland and Labrador, and Yukon – have licensed, practicing midwives.

After 800 births, Chapman is still amazed by the power of the body.

“Witnessing a birth is a miracle,” she says. “It’s an amazing event. You have this instant respect for a woman and the power of the body.”