What to Expect From Your Care
Adequate prenatal care is required for all women preparing for birth. It is a safeguard for your health and for that of your baby. Prenatal visits offer you the opportunity to learn about the changes your body goes through as your pregnancy advances.
Our care begins with an initial interview where your midwife will provide you with information about the model of midwifery care in Ontario. There will be no clinical activities during this initial visit. We will secure your booking for two weeks after this visit. Should you decide to become a midwifery client, you may call back anytime during this period to book another appointment with us. If we do not receive a call back from you within two weeks of your consultation visit, we will assume you have made other arrangements for your care and will no longer hold a spot for you.
Prenatal visits are booked approximately once a month until the 28th week, every second week until the 36th week, and once a week thereafter. During your prenatal visits, we monitor your blood pressure, urine, fetal growth, fetal heart rate, fetal position, and screen the general health of both you and your baby(ies).The number, timing, and length of prenatal visits will be scheduled according to need. These needs vary widely depending on the relative well-being of each client, her level of experience with pregnancy and birth, and a multitude of other health and/or social concerns. Appointment times generally vary from 30 to 45 minutes. Anyone planning to be with you at the time of birth is welcome to attend these visits with you.
During the third trimester, your midwife may do a prenatal home visit. Whether you are planning a home or hospital birth, this home visit allows your midwife to become familiar with the location of your home. With midwifery care, clients have the option of early labour assessments at home. Familiarity with the location of your home allows the midwife to arrive in a timely manner.
Labour and Birth
Your midwife will attend you once active labour has been established. One midwife is with you during active labour and a second midwife or birth attendant is called when labour is advanced. Midwives provide skilled physical and emotional support during labour, but it is not our intention to replace the important support of your chosen birth partner(s).
After the birth, your midwife will continue to provide clinical monitoring, emotional support, information, and guidance to you and your family. Your midwife will also assist you and provide information to support your feeding choices.
After the birth, your midwife will stay with you until she is assured that all is well with both you and your infant. Women who give birth in the hospital have the choice of early discharge the same day or staying in the hospital. Provided there are no complications, most women who give birth at the hospital choose to go home with their baby within hours of the birth, but some choose to stay in hospital for a day or two.
Following a birth at home, your midwives will help clean up and do laundry, make you a light meal, and ensure the well being of you and your baby prior to leaving your home.
Postnatal visits include assessment of both mother and baby’s well-being; i.e. breastfeeding support, weighing the baby, assessing your physical and emotional well being, and discussion of pertinent postnatal issues including family planning and feeding your baby in the first year of their life.
The number and timing of postnatal visits will be scheduled according to need. Just as during pregnancy, postnatal needs of individual clients vary. Some will be breastfeeding for the first time or may have a fussy baby, while others may have more experience and feel more comfortable caring for their newborn. All women and newborns will be seen in the first 24 hours after the birth and on day 3 either at home or in hospital. We plan a follow-up home or clinic visit between days 7-10. Additional visits are geared to need.
Your final discharge visit is planned around 6 weeks postpartum, after which you would arrange follow-up care with you family doctor, nurse practitioner, or other care providers as available in your community.
Availability of Midwives
One of the midwives from your team is available directly by pager 24 hours a day from the onset of your care, throughout your pregnancy, for your labour and birth, and for 6 weeks postpartum. Non-urgent messages should be left at our office number, 622-2229. After office hours, a paging service is available for important or urgent concerns. You can expect your midwife to respond to urgent calls within 15 minutes of being paged. In rare instances, clients will be seen by a midwife they have not met, as their team members may be unavailable due to a birth, emergency, or illness.
Second Birth Attendant
The model of midwifery care in Ontario requires that two midwives be present at a birth; one for the mother, and one for the baby. The second midwife is called when the birth is imminent. If a midwife from the practice is unavailable, births may be attended by a registered nurse who works in the hospital obstetric department.
Client Confidentiality and Records
Our practice respects our clients’ 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 and enables her to provide you with appropriate care and advice.
Only the midwives, student midwives, and administrative staff have access to your file. If you do not have a student involved in your care, you may request that students be excluded from having access to your records.
At your six-week follow up visit you may request a copy of your records and we will retain the originals for our files.
The Community Midwives of Thunder Bay is a teaching practice affiliated with Laurentian, Ryerson, and McMaster Universities. Students enrolled in the Midwifery Education Programme accompany registered midwives as they provide care. Our practice is committed to ensuring that our quality of care is improved 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 who is working with your midwives. Many of our clients welcome and enjoy their involvement. It is your choice whether to have students involved in your care. 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.
Our catchment area encompasses a radius of approximately a one-hour drive from the Thunder Bay city limits. Home visits are provided within this catchment area. Historically, we have provided care to women who live further than one hour away from Thunder Bay. However, these women, who come from all across North Western Ontario, are required to travel to Thunder Bay for their care.