Midwifery at Central Health
In 2016, Midwifery regulations were passed in Newfoundland and Labrador. Central Health is pleased to now offer midwifery services as another option for maternity care in this region. As essential members of the healthcare team, midwives will work within various inter-professional teams to provide the best care possible to their clients. There is no cost for this service as it is covered under your MCP.
What is a midwife?
Midwives are trained health care professionals providing primary care in the prenatal, intrapartum, and postpartum period for mothers and their newborns up to six weeks of age. Midwives specialize in low-risk pregnancies but are trained to recognize any complications that may arise requiring a specialist in high-risk. A midwife can order routine tests and lab work and can prescribe certain medications. A midwife's scope of care includes guidelines on when to consult, when to share care and when to transfer care to another health care provider.
From the World Health Organization, “Midwifery encompasses care of women during pregnancy, labour and the postpartum period, as well as care of the newborn. It includes measures aimed at preventing health problems in pregnancy, the detection of abnormal conditions, the procurement of medical assistance when necessary, and the execution of emergency measures in the absence of medical help.”
Midwives train and practice under a philosophy of informed choice, continuity of care, and choice of birthplace resulting in empowering, woman-centered care. They respect and support each woman’s right to make choices about her care, caregiver, and place of birth.
What qualifications does a midwife have?
As a minimum, a midwife has a four-year university degree in a Bachelor of Health Sciences in Midwifery, though it is common for midwives to have previous education and training prior to being accepted for midwifery training. This professional program includes both lecture components as well as clinical placements. Placements are done with different midwifery practices, as well as with obstetricians, labour and delivery nurses, postpartum nurses, NICU nurses, lactation consultants, and other healthcare practitioners providing a wealth of interprofessional experiences. Following graduation, the midwife writes the Canadian Midwifery Registration Exam. The first year of practice is known as the new registrant year and needs to be done in an established midwifery practice with other registered midwives.
All practicing midwives in Newfoundland must be registered with the Newfoundland and Labrador Council of Health Professionals. Midwifery practices must remain up to date with current research and evidence. The council ensures midwives are current in neonatal resuscitation training, CPR, emergency skills training, fetal health surveillance, as well as clinical practice experience.
What does midwifery care look like?
Midwifery care includes quality health care, education, counseling, and support for childbearing women. Midwifery views birth as another state of health and childbirth as a normal process. Midwives will work with each woman and her family to identify their unique physical, social and emotional needs.
Midwives provide care to women throughout pregnancy, labour, birth, and continue to care for both mother and baby for six weeks following the birth. You do not need to see a doctor unless there is a medical condition requiring a doctor’s care. Midwives consult and work together with other health professionals when necessary.
Appointments take place at the standard frequency for prenatal care; monthly appointments until 28 weeks, appointments every 2 to 3 weeks until 37 weeks, and then weekly until your baby arrives. You will meet the whole midwifery team over the course of your care, and appointments are generally 30-45 minutes long allowing time to get comfortable with each member. Central Health Midwifery is made up of a team of 4 registered midwives, one of whom is on call 24/7 for urgent concerns.
Once your baby arrives, your midwives will come to your home for visits during the first week. Your midwives will monitor the physical and emotional well-being of mom, as well as manage the clinical care of baby including weight gain, jaundice, and feeding. Typically, clients are seen day 1, 3, and 5 of your baby’s life. Mothers and babies return to the clinic for postpartum visits at 2, 4, and 6 weeks after birth. At six weeks, mom and baby are discharged from midwifery care.
Choice of Birthplace
The choice of where the baby is born is a fundamental philosophy of midwifery care. In the Gander area, the options will be homebirth or a hospital birth at the James Paton Memorial Regional Hospital.
For a low-risk pregnancy, with a registered midwife who is part of the healthcare system, studies have shown that a planned homebirth is as safe as a planned hospital birth for both mothers and babies. At any birth, whether in a hospital or homebirth setting, it is the standard to have two trained care providers present.
Talk to your midwife about the best option for you.
What services do midwives offer?
Comprehensive prenatal care and education
All necessary prenatal testing (blood work, ultrasounds, etc.)
During Labour and Birth
Choice of birthplace (James Paton Memorial or home)
Clinical care and physical/emotional support during labour and birth
Midwives conduct normal deliveries and would consult an obstetrician if there was a need for assisted delivery (vacuum, forceps, caesarean section)
After the Baby is Born
Breastfeeding support and education
Postpartum care for mother and baby in home and clinic for the first 6 weeks after birth
Early parenting education
Prescribe and administer certain medications
Ordering of certain tests
Admission and discharge of clients in hospital
Consult with physicians and other health care professionals as needed