As a resident of Ontario, I have benefited from a highly skilled and regulated midwifery program that strives to give women their best possible birth experience.
Nine weeks ago, I went into labour with my third child. After an uncomfortable night of increasingly intense contractions, I called the midwives in the morning. Three of them – Heather, Brianna, and Becky – arrived at my home within an hour. They set up their small hospital’s worth of supplies and equipment on the dining room table, as I cleared away the breakfast dishes and sent my oldest son off to school. The younger one went outside to play, supervised by his grandma, and I got down to the business of delivering my baby.
Assisted by these tremendously skilled women and my ever-patient husband, I worked on pushing that baby into the world. This incredible support team held me, massaged me, fed me, and whispered words of encouragement as I paced, stood, lay, and squatted. The midwives checked my dilation and the fetal heartbeat frequently, and, when it was time to push, helped me to find the most effective position. Four hours later, with my curious three-year-old perched on a pillow watching, our third son emerged into the world, wet and purple and already chubby.
"Reach down and grab your baby," Heather ordered me. I slid him onto my chest, where we lay skin-to-skin, staring at each other in amazement. Meanwhile, the midwives injected an anti-hemorrhagic drug, carefully checked the placenta, palpated my shrinking uterus, put in a couple stitches, and performed the infant examination. They stayed for three hours following delivery to make sure everything was stable, and then, by mid-afternoon, it was just me and my freshly expanded family, on our own once again.
A midwife came to my house the next day, then on the third, fifth, and tenth days for post-partum visits. They provided help with breastfeeding, checked the baby’s breathing, looked for any signs of jaundice, assessed his frequency of diaper changes, and answered all my endless questions.
I am very fortunate to have access to such high quality care. Twenty years ago, midwifery was regulated here in the province of Ontario, which means that all midwives have to complete a four-year Bachelor of Health Sciences program and attend a minimum of 60 births before they can graduate. All preceptors, too, must still practice as midwives.
Midwives in Ontario are closely integrated into the provincial health care system, working alongside doctors to deliver babies in hospitals, or else remaining in people’s homes, in certain midwifery clinics with available bedrooms, or in birthing centers. When I went into labour, I’d been pre-registered with the local ambulance in case of emergency transfer.
What many people don’t realize is how well-equipped and well-trained midwives are in Canada, where the practice of midwifery is provincially regulated. They carry equipment equivalent to that of a Level 1 hospital. They have IVs, oxygen tanks, and fetal heart monitors. They can administer antibiotics, prescribe medications, and suture. In addition, they provide six weeks of post-partum care.
Here in Ontario, the service is entirely free to all women, even those who have opted out of universal health care coverage, such as the old-order Amish families who live in my area. Some other provinces, despite being regulated, still require clients to pay out-of-pocket, which is a major discrepancy that needs to be addressed.
Opting for an out-of-hospital birth is desirable for many women not only because it’s more relaxing and comfortable, but also because there are fewer interventions and lower risk of infection. The infant’s gastrointestinal tract, too, immediately begins to be populated by the microflora of its family and home environment.
It is important to have a positive birth experience for both mother and baby. It decreases risk of post-partum depression and aids in breastfeeding by easing babies into the world in a less traumatic and more personalized way than hospitals are able to offer. There is excellent “continuity of care,” which ensures that mothers see the same midwives at appointments and, by the time they go into labour, have established a good relationship.
The presence of skilled midwives creates a safe space in which to incorporate one’s own cultural birthing traditions. The new birthing centre in Toronto, for example, allows Indigenous women to include smudging ceremonies, sacred songs, and drumming circles into their labours.
Whenever I stop to think about my three births – all with midwives and out-of-hospital – I feel so incredibly fortunate. I realize that midwifery care, whether in hospital or at home, might not appeal to everyone, but the option should be available to all women as a reasonable alternative to the overly medicalized approach to pregnancy and childbirth that currently prevails. Women must be allowed to choose what they want for themselves, particularly when it pertains to one of the most empowering events of their lives – giving life to another human being.