What is midwifery care?
What do midwives do?
Is a midwife the same as a doula?
Is midwifery care safe?
Is midwifery care legal?
Who chooses midwifery care?
Do I have to pay for a midwife?
When do I book to see a midwife? do I need a referral from a doctor?
What are my responsibilities as a midwifery client?
Where can I have my baby?
Is home birth safe?
Can I have a midwife and a doctor at the same time?
What if I develop complications during my pregnancy; or may baby has a problem?
Can I use pain medications during my my labour if I have a midwife?
Where do my prenatal and postpartum appointments happen?
How often do I see the midwife?
I had a C-section before. Can I still have a midwife for this pregnancy?
Do midwives ever take time off?
A Registered Midwife can offer you:
- Personal, individualized care that respects physical, emotional, and cultural diversity.
- Informed choices in pregnancy and birth, including a choice of birth place.
- Support and empowerment to discover your body’s own ability to give birth
- Family-centred care that welcomes spouses, family members, and siblings in the childbearing process.
- An opportunity to build a strong and trusting relationship with your caregiver.
- Non-interventive care based on the most recent medical research available.
- Sensitive, continuous, one-to-one care during labour and delivery.
- In-home postpartum visits the first week after delivery.
- Consultation and collaboration with physicians should the need arise.
Registered Midwives embrace the Philosophy of Care, Model of Midwifery Practice, Standards of Practice and Code of Ethics of the College of Midwives of BC (CMBC).
Registered Midwives in BC are primary care providers for low-risk pregnant, labouring, and postpartum women and their healthy newborn. This includes assessment, monitoring, counselling, support, and medical care. Apart from ‘catching’ the baby, midwives order and interpret the results and reports of routine screening and diagnostic tests (like bloodwork and ultrasounds). Midwives can also prescribe, order and administer some drugs commonly used in maternity and newborn care. Midwives work closely with other health care professionals, like nurses, obstetricians and pediatricians, to ensure that a woman’s individual needs are being met.
Midwifery care is governed by the College of Midwives of BC (CMBC), according to the Midwives Regulation of the Health Professions Act. To be registered with the CMBC, midwives must meet the requirements of the Competencies of Registered Midwives and maintain emergency skills such as CPR, and neonatal resuscitation.
Is a midwife the same as a doula?
Doulas do not provide medical care, and do not deliver babies. Doulas provide continuous emotional, informational and physical support to the labouring woman and her support people. A doula can be a really positive addition to the birth team for those women who desire extra support. For more information about doulas, contact the Doula Services Association of BC.
Yes. There is a large body of evidence that supports midwifery care as a safe choice for low-risk healthy women. Data was gathered from New Zealand, Australia, the UK, and Holland where regulated midwifery is widely practiced in order to justify its regulation in BC. In fact, researchers found that women and babies did better on average in countries where midwifery was the normal care. (
FACT: Midwifery clients experienced lower rates of forceps, vacuum extractions, cesarean sections, episiotomies, infections and babies born requiring resuscitation, in studies where midwifery was compared to physician led care. (
Yes. Since 1998 midwifery has been regulated in BC through the Health Professions Act by the College of Midwives of British Columbia (CMBC). The goal of the College is to register qualified, competent midwives to provide safe, high quality care to women and their families in the province of British Columbia. People wanting to practice midwifery must be registered with the CMBC.
Registered Midwives must also be members of the Midwives Association of BC (MABC). This professional association oversees general liability insurance for its members.
With midwifery now registered, and fully funded by Medical Services Plan, midwifery clients come from all cultural and social backgrounds. Clients are encouraged to be informed and involved decision-makers in their health care.
Do I have to pay for a midwife?
No. In BC, the Ministry of Health pays for the services of Registered Midwives, whether you choose a hospital or a home birth. If you are covered under the BC Medical Services Plan (MSP), all you have to do is show your BC Care Card when you come into care.
If you do not have MSP coverage, please ask us about private pay options.
When do I book to see a midwife? Do I need a referral from a doctor?
You can call the office as soon as you know you are pregnant, or anytime during the pregnancy. You do not need a doctor’s referral. We encourage you to call early in the pregnancy because our practice limits the number of clients we take each month.
What are my responsibilities as a midwifery client?
In keeping with the College of Midwives of BC Philosophy of Care, clients are encouraged to embrace their role as primary decision makers in their own healthcare. Harmony Midwives will work with you to ensure that you have the information you need to make the decisions that are right for you and your family.
Midwives respect a woman’s right to choose the place of birth (home or hospital) in accordance with the Standards of Practice of the College of Midwives of BC. Midwives are trained, experienced, and equipped for home or hospital births. Harmony Midwives utilize Royal Columbian Hospital as our primary hospital site, so that we can provide comprehensive care in both the hospital and home setting. Clients considering a home birth are encouraged to discuss this option with their midwives.
Yes: Home birth is internationally recognized as being as safe as hospital birth, for well-screened, healthy women, with normal pregnancies, when attended by qualified caregivers. (References are available on the Hospital or Home Birth page.)
Your midwives will assist you in deciding where to birth, by discussing the risks and benefits of each birth setting. Although most normal births require little or no intervention, midwives are trained in emergency skills and carry emergency equipment such as oxygen and resuscitation equipment, and anti-hemorrhagic drugs to all births. It is important to recognize that in rare situations, the technology available only in a hospital setting may make a difference to the well being of the newborn or mother.
Can I have a midwife and a doctor at the same time?
Not usually. The Medical Services Plan will cover one primary care provider for the duration of your pregnancy and birth, to six weeks postpartum. The choice of caregiver during your pregnancy is up to you (midwife, family doctor, or obstetrician).
Midwives are experts in healthy pregnancy, normal births and well babies, and are trained to recognize when situations deviate from normal. If your situation (whether routine or urgent) requires specialized care, your midwives will consult with the appropriate professional.
If you are in midwifery care, and require medical attention for something that is not pregnancy-related, you can certainly see your family doctor.
About six weeks postpartum, your care is transferred back to your family doctor who will resume responsibility for the health of you and your new baby.
What if I develop complications during my pregnancy, or my baby has a problem?
The College of Midwives of BC has produced clear guidelines on when midwives need to consult or transfer care during pregnancy, birth and postpartum, called Indications for Discussion, Consultation, and Transfer of Care.
If a situation comes up that falls outside the midwife’s scope of practice, a consultation can be arranged with an appropriate specialist (obstetrician, pediatrician, anesthesiologist, etc.). Midwives recognize women as the primary decision makers in their care, and always endeavour to keep women informed and involved in any care decisions. In most situations, you would remain in midwifery care, but may require special tests or follow-up (with the consultant). If your care is transferred to another care provider, your midwife may be able to stay involved in your care in a supportive manner. Often, your care can be transferred back to the midwife for postpartum care.
Can I use pain medications during my labour if I have a midwife?
Every birth is unique and will have unique needs. Fundamental to midwifery care is the understanding that a woman’s caregivers respect and support her so that she may give birth safely, with power and dignity.
Harmony Midwives help women (and their support people) to be informed before labour of potential comfort measures and available pain management strategies (including medications and epidurals). These discussions include the risks, limitations, and benefits of both non-pharmacological and pharmacological options. In the hospital, you will have access to all of these pain management options. If you’re planning to birth at home, you will not have access to pain medications like nitrous oxide (“laughing gas”), narcotics (like morphine), or an epidural.
Harmony Midwives work with a labouring woman, and her support people, to find comfort measures and coping strategies that will work specifically for her. These measures can include (but are certainly not limited to): massage, changing positions, distraction, hotpacks/hot water bottles, moving around, showering or having a bath, visualization, counterpressure, encouragement, reassurance, and rhythmic behaviours (like tapping or counting). Clients can also use Transcutaneous Electrical Nerve Stimulation (TENS) machines for pain relief. Harmony Midwives encourage the continued use of complementary therapies like acupressure/acupuncture, homeopathy, herbs, aromatherapy, hypnotherapy, chiropractic and naturopathy for women who utilize these modalities.
Where do my prenatal and postpartum appointments happen?
Your prenatal appointments will be at the Harmony Midwives office. During the first week postpartum, your midwives will come to you, whether you’re in the hospital or at home, usually 3 or 4 times. We are firm believers in women nurturing themselves and their baby in the early postpartum period. After the first week postpartum, your appointments will be at the office.
How often do I see the midwife?
(Keeping in mind that a normal pregnancy “due date” is the equivalent of 40 weeks gestation…)
Up to 30 weeks gestation, you will come to the office an average of every 4 to 5 weeks. From 30-36 weeks gestation, appointments are about every 2-3 weeks. Then, after 36 weeks, appointments are every week until the birth.
Office appointments last 30 minutes, allowing time to assess your emotional and physical well-being, the baby’s well-being, family preparedness, and to have informed choice discussions related to your care. You are welcome to bring whomever you like to any of your appointments.
Between appointments, clients can leave a message at the office with non-urgent questions. For urgent concerns or labour, clients of Harmony Midwives can call the urgent line to reach the midwife on call 24 hours a day, 7 days a week. Clients are given the urgent line phone number when they come into care.
In the postpartum period, the midwife will visit you 3 or 4 times during the first week, at home or in hospital. After that, you will have office appointments at about 2, 4, and 6 weeks after the birth.
After 6 weeks postpartum, care is transferred back to your family doctor.
I had a C-section before. Can I still have a midwife for this pregnancy?
Yes. Registered Midwives regularly care for women who have had a previous C-Section. Depending on why and how you had your C-Section, you may be a candidate for a Vaginal Birth After C-Section (VBAC).
Do midwives ever take time off?
Yes! Harmony Midwives believe that to give clients the best possible care, midwives need to lead well-rested and well-balanced lives. We usually plan our extended holidays at least nine months in advance, and limit the number of women we take into care during holiday time.