(905) 527-8919 -- 189 Hughson Street South, Hamilton, ON L8N 2B6 -- info@hamiltonmidwives.ca
(905) 527-8919 -- 189 Hughson Street South, Hamilton, ON L8N 2B6 -- info@hamiltonmidwives.ca
This document provides information about the services you can expect from us. It is provided to help you make an informed decision about whether midwifery care is appropriate for you. We believe that the best care is provided when women and their families have a complete understanding of the philosophy and extent of midwifery services and wish to develop a collaborative relationship with their midwives.
The Hamilton Midwives are a teaching practice that includes midwifery students from affiliated universities. We attend births in the home and in hospitals in Hamilton. More detailed information about each of these aspects of our practice appears in later sections of this document.
The following definition was developed by the World Health Organization and has been endorsed by health planning groups in Ontario:
“A midwife is a person who, having been regularly admitted to a midwifery education program, duly recognized in a country in which it is located, has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery. She must be able to give the necessary supervision, care and advice to women during pregnancy, labour and the postpartum period, to conduct deliveries on her own responsibility and to care for the newborn infant. This care includes preventive measures, the detection of abnormal conditions in mother and child, the procurement of medical assistance and the execution of emergency measures in the absence of medical help. She has an important task in health counseling and education, not only for the patients, but also within the family and community. The work should involve antenatal education and preparation for parenthood and extends to certain areas of gynecology, family planning and childcare. She may practice in hospitals, clinics, health units, domiciliary conditions, or in an any other service.”
Midwives qualify for registration either by graduating from the Ontario Midwifery Education Programme (a four-year university degree program offered at three Ontario Universities) or the International Midwifery Pre-registration Program, offered through Ryerson University’s continuing education division.
Midwifery practice is specifically covered in legislation that sets out the provisions for many health professionals in Ontario. Midwives must be registered by the College of Midwives of Ontario, which sets standards and educations requirements. All midwives in The Hamilton Midwives are registered and follow the standards set forth by the College of Midwives. These standards include specific conditions of mother and infant for which midwives must seek a medical referral. The written list of these conditions is available at your request. All aspects of midwifery care are publicly funded health care services under the Ontario Ministry of Health.
Adequate prenatal care is required for all women preparing for birth and is a safeguard for your health and your unborn baby. It offers you the possibility of learning about the changes in your body as pregnancy advances.
In general, our care begins with an extensive interview so that we get to know you, your plans and concerns and your health history. During the next few visits, we will do a general physical assessment and obtain needed lab assessments such as blood values. At ongoing visits, we will monitor blood pressure, weight gain, nutritional status, fetal growth, fetal heart rate and fetal position.
We expect to see pregnant women approximately once a month until the 28th week, every second week until the 36th week and weekly from then until the baby is born. Most appointments are 30 to 45 minutes in length. Extra appointments or longer visits can be scheduled as needed.
If you have seen a family physician or another midwife for part of your prenatal care, it is very important that we receive copies of your health records. This includes all the blood work, urine tests, Pap smear results, etc., that were done and the results of any ultrasound exams. We will request that you sign a release of information to obtain any prenatal results.
Midwives provide total care to women who experience healthy, normal pregnancies. If you develop obstetric problems or have a medical condition, you and your midwife will determine the appropriate source for ongoing care.
We suggest that sometime in the last month or two of pregnancy, you telephone or visit your family physician to discuss arrangement for postpartum care. This planning visit ensures that there is ongoing communication and coordination of visits during the early weeks after baby arrives. In addition, we encourage you to enroll in the prenatal classes of your choice in your community.
We can attend births at St. Joseph’s Health Care (SJH) and the Hamilton Health Sciences (HHS). However, due to our clinic proximity to SJH, The Hamilton Midwives primarily do their hospital deliveries at St. Joseph's Health Care. If you plan to use the hospital, we recommend that you register for a tour of labour and delivery unit to become familiar with the facility. We will provide you with a pre-registration package for the hospital and a number to call to arrange for your tour. If you are planning a homebirth, we will supply you with some items and you will be given a list of supplies to have on hand. As well, we will discuss the indications and arrangements for transport to hospital.
During early labour, a midwife will be in contact with you over the phone and will attend you once active labour is established. During labour, the midwife will monitor labour contractions, check the dilation of your cervix, blood pressure and the fetal heart rate, assist with breathing techniques and positioning, delivery of the baby and placenta, examine the newborn infant, and check all aspects of the mother’s condition after the birth.
One midwife is with you during active labour and a second midwife will be called as the labour advances. Midwives provide skilled support during labour and suggestions for pain relief. However, we cannot replace the important support provided by your partner, close friends or other family members.
After the birth, whether in a hospital or at home, we will monitor the condition of both you and your baby for the first hours. We will help you breastfeed, have a bath or shower and provide information and guidance for your care during the early days after the birth. If you give birth in the hospital and all is well, you may leave to go home within 3-4 hours or stay for longer, depending on your needs. The arrangements are flexible and will be organized to meet your needs as best as possible.
We will visit you during the postpartum period to check on you and the baby, answer questions and assist with breastfeeding and other aspects of infant and self care. The usual postpartum visit schedule is on days 1, 3, 5, and between 7-10 at your home, and weeks 2, 4 and 6 at the clinic.
The final visit usually takes place at 6 weeks and is booked in the clinic so that a complete physical assessment can be provided. A summary of the pregnancy, birth and postpartum period will be sent to to your family doctor at the conclusion of our services.
Because we are a large group of midwives, we organize ourselves to work in smaller groups of 2 or 3 midwives. You will meet the small group and have several visits with each of them. Two midwives will attend your birth, both of whom are almost always known to you. Only in the event of several labours occurring at the same time, or if one of your midwives is off call, will a midwife from another group be called.
The individual midwives within the practice bring many years of experience in different settings to the practice. We share a respect for childbearing women and the variety of meanings that childbirth has for families. Your midwives will be pleased to discuss their individual education and background with you.
Midwives are available by pager at all times for urgent problems and for labour and birth. All of the midwives and our students use a common answering service that is staffed 24 hours a day. Occasionally pagers don’t work and if you have not had a reply in 15 minutes to an urgent request, please call the paging service again. When individual midwives have their off-call time, we will forward their pages to a partner midwife so you will always reach one of us.
If your question is non-urgent or concerns a clinic appointment, please call the office during business hours, or leave a message on the voice mail. Our phone numbers are listed on our Directions and Contact Us page.
Because our model of practice includes home visits and the possibility of attending your labour at home, we restrict the geographic area that we can serve. The general boundaries of our area are central Oakville on the east, Highway 401 to the north, Grimsby in the Niagara peninsula and Brantford to the west.
We are a teaching practice affiliated with the Midwifery Education Programs of McMaster, Laurentian and Ryerson Polytechnic Universities. Students are present throughout the year and must participate in all aspects of client care. Students at the second and third year level conduct births as well as provide prenatal and postnatal care.
We are committed to ensuring that the quality of care we provide is improved and not diminished by the presence of students. We encourage clients to be teachers of our students by giving them and us feedback at all times.
We believe that women and their families should be active participants in their care and we expect that clients will be responsible for the health of themselves and their babies.
Women should eat a balanced diet, participate in prenatal care and get adequate rest and exercise. We believe that parents should acquire knowledge about pregnancy, birth and child care. We are available to answer questions, but cannot be the only source of your learning about the many aspects of childbearing that are of importance.
You are welcome to borrow books, articles, videos and pamphlets from our shelves. We also welcome contributions of resources that you find particularly useful. We encourage you to bring your questions or concerns to your visits; making a written list is often helpful. In order for us to be effective caregivers, it is important that you keep us informed of problems or situations that may affect your care.
One of the most important decision that parents must make is the location of birth. Parents are responsible for becoming as informed as possible, for weighing the various risks and benefits and making a decision that is appropriate for themselves. If your pregnancy is low risk, you may choose to have your baby either in the hospital or at home, and we will provide full midwifery care in either setting. We support the choice of planned home birth as an option for healthy mothers.
Comprehensive prenatal care and careful monitoring in labour by a known caregiver are important factors in preventing, detecting and managing any complications which might arise. Even with the best of prenatal screening, however, difficulties can occur during labour and birth. Most often these are not life threatening and can be dealt with at home. For more serious concerns, transport to hospital will help ensure the safety of mom and baby.
There are circumstances when planned hospital care is essential for the safety of mother and/or baby. Giving birth, whether at home or in hospital, means the acceptance of certain risks which may be life threatening. We can provide you with information about some of the complications which may arise and our ability to manage them. We encourage you to have a full and complete discussion with us about these issues if you are planning a birth at home.
You are free to review your midwifery records at any time. If you go out of town for a vacation or on business, we will supply a copy of your records to carry with you. Often, we will ask you to carry a copy of your records during the last month of pregnancy so that if you require a hospital visit you will have readily accessible information. At your final postpartum visit, you may request a copy of your records to keep. We will retain the original in our files. Your records are kept in a locked area and are only accessible to members of the practice. We respect each client’s right to complete confidentiality.
We hope that this information has helped you to understand our care and to think of additional questions you may have. We urge you to consider this information carefully before making your final decision about choosing midwifery care.