The Midwives of Algoma are a small group of registered midwives who work both independently and in co-operation with other health care professionals to provide comprehensive prenatal, delivery and postpartum care to women in Sault Ste. Marie and the surrounding area.
As midwives we understand that pregnancy, birth and early parenting are normal, healthy life events, and we are committed to providing high quality, culturally sensitive, safe and effective care to women and their families.
The midwife is recognized as a responsible and accountable professional who works in partnership with women to give the necessary support, care and advice during pregnancy, labour and the postpartum period, to conduct births on the midwife’s own responsibility and to provide care for the newborn and the infant. This care includes preventative measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical care or other appropriate assistance and the carrying out of emergency measures.
The midwife has an important task in health counselling and education, not only for the woman, but also within the family and the community. This work should involve antenatal education and preparation for parenthood and may extend to women’s health, sexual or reproductive health and child care.
The midwifery scope of practice in Ontario is defined as the assessment and monitoring of women during pregnancy, labour and the postpartum 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.
Midwives in Ontario promote normal birth and provide client-focused care. The following statements provide a framework to the philosophy of midwifery care practiced in Ontario:
Midwives view pregnancy and childbirth as a healthy and normal physiologic process and a profound event in a woman’s life.
Midwives respect and support their clients so that they may give birth safely, with power and dignity.
Midwives respect the diversity of women’s needs and the variety of personal and cultural meanings that individuals, families and communities bring to the pregnancy, birth, and early parenting experience.
Midwives promote optimal health throughout the childbearing cycle and maintain a focus on preventive care.
Midwives encourage women to actively participate in their care throughout pregnancy, birth and postpartum period and make choices about the manner in which their care is provided.
Midwives provide education and counselling to support women making informed choices.
Midwives promote decision-making as a shared responsibility, between the client, her family (as defined by the woman) and her caregivers. The client is recognized as the primary decision maker.
Midwives provide care that is continuous, personalized and non-authoritarian.
Midwives provide care that is responsive to women’s social, emotional, cultural and physical needs.
Midwives respect women’s right to choice of caregiver and place of birth and attend births in a variety of settings, including home, hospital and birth centre.
Midwives support the appropriate use of technology as required in the provision of midwifery care.
Midwives regard the interests of the woman and the fetus as compatible.
Midwives make the time commitment necessary to develop a relationship of trust with the woman during pregnancy to be able to provide safe and individualized care, to fully support the woman during labour and birth, and to provide comprehensive care to mother and newborn throughout the postpartum period. Your care will be provided by the same midwife throughout your pregnancy, during your labour and delivery and through the post partum period, and you will be introduced to one or two other midwives during this time so that in the event that your primary midwife is unavailable for an appointment or during your labour, your attending midwife will be somebody known to you.
Midwives offer the choice of either a hospital or out-of-hospital location for birth. The choice of a planned out-of-hospital birth is available to women who have had an uncomplicated, low risk pregnancy and remain low risk during labour.
From the onset of your care, throughout your pregnancy, for your labour and birth and for the first 6 weeks post partum, midwives are available directly by pager 24 hours/day for urgent situations. If your midwife is on holidays or ill, an alternate midwife will care for you until her return. Non-urgent messages should be left at our office number 705-253-4158. After office hours, the pager service is available for important or urgent concerns that need to be dealt with prior to the next office day. You can expect that a midwife will respond to urgent calls within 15 minutes of paging.
Adequate prenatal care is required for all pregnant women. It is a safeguard for your health and the health of your baby and it will allow you the opportunity to learn about the changes your body experiences as pregnancy advances and you prepare for birth. When you come into midwifery care, time will be taken to discuss your medical and obstetrical health history. This may include details about your parents and extended family members. We also may draw bloodwork at this time. Prenatal visits occur once monthly until 28 weeks and then bi-weekly until 36 weeks and weekly after that. If there are concerns about you or your baby, you may need to be seen more frequently. During prenatal visits we will monitor your blood pressure, urine, fetal growth, fetal heart rate, fetal position and screen the general health of you and your baby. You will be offered various tests and routine ultrasounds during your pregnancy and are encouraged to ask your midwife any questions you may have. Midwives are the most appropriate care providers for low risk, healthy women. In the unlikely event that you develop certain pregnancy related complications, your care may have to be transferred to an Obstetrician.
Once active labour has been established, your midwife will attend you either at the hospital or at home, and will call a second attendant (either a midwife or a registered nurse) when labour is advanced and you are close to delivery. Following the delivery, we will continue to provide clinical monitoring, as well as support for your desired method of feeding. Your midwife will stay with you until she is reasonably certain that all is well with you and your infant. If you have a home birth, she will return in approximately 24 hours to assess you and baby and to do the Ontario Newborn Screen (link). If you give birth in hospital, it is standard to stay 24 hours (although an early discharge is possible and can be discussed with your midwife), at which point a bilirubin test and Ontario Newborn Screen will be done on your baby, following which your midwife will see you in the hospital and discharge you home. If you have a cesarean section, the recommended stay is approximately 48h.
In the postpartum, your midwife will see you for several visits in your home during the first weeks and then for at least one visit in the clinic. Visit schedules will vary according to need. At 6 weeks you will have your final visit and you and your baby will be examined and your care will be transferred to your doctor or other primary care provider.
Our practice respects each client’s right to complete confidentiality. You may have access to your file at any time. If records exist of previous pregnancies, births, or health concerns that you think are relevant to this pregnancy, we will ask you to sign a release of records form. This allows your midwife to access pertinent background information from other care providers thus enabling her to provide you with appropriate care and advice.
Only the midwives, student midwives and staff, have access to your file. Your records will only be shared with others if you consent to do so.
At your six-week follow up visit you may request a copy of your records and we will retain the originals for our files.
We are a teaching practice affiliated with Laurentian, Ryerson, and McMaster Universities. Students enrolled in the Midwifery Education Program may accompany midwives as they provide care. Our practice is committed to ensuring that our quality of care is improved and not diminished by the presence of students. Our teaching responsibilities are an important part of our practice and your feedback assists us in evaluating the service we provide. We encourage you to meet and get to know the student(s) who is/are working with your midwife. Many of our clients welcome and enjoy their involvement. Also, from time to time, we have requests from nurses, medical students and/or paramedics for opportunities to expand their knowledge in midwifery and obstetrical care. If you do not already have a midwifery student you may choose to invite one of them to participate in your care.
Ontario was the first province in Canada to regulate and legislate midwifery in 1994. The profession is now regulated in British Columbia, Alberta, Saskatchewan,Manitoba, Quebec and Nova Scotia.
Responsibility for well-being rests with both the health care providers and with each individual. We believe that the best midwifery care is attained when women and their families make informed decisions about their care and develop a comfortable and co-operative relationship with their of midwives.
A midwife is a registered health care professional who provides primary care to women during pregnancy, labour and birth, including conducting normal vaginal deliveries and providing care to mothers and babies during the first 6 weeks postpartum.
A registered midwife must follow the College of Midwives of Ontario philosophy of midwifery care, as well as a comprehensive set of guidelines, known as standards. For example, there are standards for consultation and transfer of care to physicians, place of birth, equipment and medication, record keeping, and a Code of Ethics.
According to the Ontario Midwifery Act, 1991, “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.”
As the demand for midwives is larger than the number of midwives available, it is best to contact a midwife as soon as you find out you’re pregnant.
Midwives qualify for registration either by graduating from the Ontario Midwifery Education Programme, which is a Bachelor of Health Science in Midwifery four-year university degree program, or by successfully completing the International Midwifery Pre-registration Program, offered through the continuing education division at Ryerson University.
A midwife is a trained primary caregiver who provides care to women throughout their pregnancy, labour and birth, and to both mother and baby during the first six weeks postpartum. Midwives manage the clinical needs of the labouring woman while prividing emotional and physical support.
A birth doula is a trained labour support person who provides emotional and physical support to a labouring woman and her partner. While she is not a medical professional, she can offer a wide range of comfort measures during labour – from massage to aromatherapy to continuous reassurance and coping techniques. For more information on doula care, please refer to www.doulacare.ca
There are a wide range of tests that a midwife can order. For example, a midwife can arrange for appropriate ultrasound and genetic screening, as well as standard initial laboratory and diagnostic tests.
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.
Midwives are primary care givers for women who are pregnant from conception to six weeks postpartum. It is not necessary to see a medical practitioner unless there is a medical concern with you or your baby during the course of your care with us.
There is no fee charged for midwifery care. Midwifery care, including prenatal, birth and postpartum care, is paid for by the Ontario Ministry of Health and Long-Term Care.
The midwife provides care for you and your baby until six weeks postpartum (after the baby is born). The midwife will visit you at home (or in hospital) within 24 hours of the baby’s birth and come for an additional three or more visits within the first two weeks postpartum, to support and assist you with infant feeding and newborn care, and to monitor your health and your baby’s health. Visits then continue at the clinic until the final visit at six weeks following birth.
• College of Midwives of Ontario: www.cmo.on.ca
• Association of Ontario Midwives: www.aom.on.ca
• Canadian Association of Midwives: www.canadianmidwives.org
• Society of Obstetricians and Gynaecologists of Canada (SOGC): www.sogc.org
• Canadian Paediatric Society: www.cps.ca
• Algoma Public Health Unit www.algomapublichealth.com
• Sexuality and You www.sexualityandu.ca
• Prenatal Classes www.ahu.on.ca
• Baby Centre: www.babycentre.com
• Motherisk: www.motherisk.org
• Find a Doula: www.doulacare.ca
• The Genetics Education Project www.mtsinai.on.ca/fammedgen
• Beststart http://beststart.org/
• Dr. Jack Newman: www.drjacknewman.com
• La Leche League: www.lalecheleaguecanada.ca
• Infant Feeding Action Coalition Canada: www.infactcanada.ca
• Algoma Public Health www.algomapublichealth.com
• Stanford http://newborns.stanford.edu/Breastfeeding/MaxProduction.html
• Kellymom http://kellymom.com/
• The Mother of All Pregnancy Books: An All-Canadian Guide to Conception, Birth and Everything in Between, Ann Douglas, 2000
• The Complete Book of Pregnancy & Childbirth, Sheila Kitzinger, 2003
• You Pregnancy Week by Week, Glade Curtis, 1997
• Rediscovering Birth, Sheila Kitzinger, 2001
• Homebirth, Sheila Kitzinger 1991
• Birthing from Within, Pam England & Rob Horowitz, 1998
• The Birth Partner, Third Edition, Penny Simkin, 2007
• Dr. Jack Newman’s Guide to Breastfeeding, Jack Newman & Teresa Pitman, 2003
• The Womanly art of Breastfeeding, LaLeche league International, 2004
• Bestfeeding, Mary Renfrew, Chloe Fisher, Suzanne Arms, 2004
• The Mother of All Baby Books: The Ultimate Guide to Your Baby’s First Year, Ann Douglas, 2002
Feeding Your Baby From Six Months To One Year, Best Start, 2011
A Parent’s Guide To Vaccination, Public Health Agency of Canada, 2012