Frequently Asked Questions

WHAT IS A MIDWIFE?

Midwives are experts in healthy pregnancy and birth.

In BC, registered midwives offer primary maternity care to healthy pregnant clients and their newborn babies from early pregnancy, through labour and birth, until about six weeks following delivery. They practice evidence-based, client-centred maternity and newborn care and are an established part of the BC health care system.

DO I NEED A REFERRAL FROM MY DOCTOR TO SEE A MIDWIFE?

No referral is required.

HOW DO I FIND A MIDWIFE?

To help you find a midwife in your area, use the searchable map on our website here.

ARE MIDWIFERY SERVICES REGULATED?

Yes. Midwives are registered with and regulated by the College of Midwives of British Columbia (CMBC) according to the BC Health Professions Act, the Midwives Regulation and the CMBC Bylaws. Midwives have been regulated and legally recognized as autonomous health care practitioners in BC since 1998.

ARE THE COSTS OF MIDWIFERY SERVICES COVERED IN BC?

Yes, the BC Ministry of Health covers the cost of midwifery services for all BC residents with a valid CareCard or BC Services Card through the BC Medical Services Plan (MSP).

CAN I HAVE A DOCTOR AND A MIDWIFE?

The BC Medical Services Plan covers only one primary care provider for the duration of your pregnancy and birth, to six weeks following delivery for healthy pregnancies. The choice of caregiver during your pregnancy is up to you.

Midwives are experts in healthy pregnancy and normal birth and consult with family doctors and other specialists such as obstetricians as the need arises. Six weeks after delivery, when your midwifery care is completed, you will be transferred back to your family doctor who will resume responsibility for the health of you and your new baby. Families who do not have a family doctor are responsible for making arrangements for their ongoing primary care. Your midwife can provide you with more information on finding a doctor for your family.

I AM NOT COVERED BY MSP. CAN I STILL HAVE A MIDWIFE?

If you are not covered by MSP, make contact with a midwifery clinic and speak with them about the option of paying for your care privately.

If you are a refugee covered by the Interim Federal Health Program (IFHP) you can call the Midwives Association of BC (MABC) at 604-736-5976 to find a midwife registered with Medavie Blue Cross in your area.

WHEN SHOULD I CALL TO MAKE MY FIRST APPOINTMENT WITH A MIDWIFE?

Contact a midwife as soon as you know you are pregnant. Midwifery practices may be full depending on the community and their practice volume. However, you can call at any time as space may become available or a practice may not be full for any given month. If you started your pregnancy in the care of a doctor and would like to transfer to a midwife, it is possible to do so but it may be difficult to find an available practice.

HOW OFTEN DO I SEE A MIDWIFE?

Midwife visits happen slightly more often than visits with doctors. Most visits in the first part of pregnancy are scheduled every three to six weeks and last between 30-60 minutes. In the third trimester visits are scheduled more frequently and are often every week during the last month of pregnancy. Longer visits allow for physical, emotional and social health assessments and allow time for informed decision making and the development of a trusting relationship between clients and their care providers.

After your baby is born, visits usually take place wherever the new family resides. This may be in the hospital after a hospital birth or at home. After the first week or two, visits are scheduled in the clinic and continue for about six weeks when your care is transferred back to your family doctor. Between visits, midwives provide 24/7 call coverage for urgent care or concerns.

HOW MANY MIDWIVES WILL BE INVOLVED IN MY CARE?

Midwives often work in groups of two or three, but may also work as solo providers or in interdisciplinary teams with other care providers such as doctors or nurses. In small group practices most clients will have met all of the midwives in the group by the time their labour begins. The CMBC Midwifery Model of Practice highlights the concept of continuity of care in providing safe, individualized care.

WHAT IS THE WORKING RELATIONSHIP BETWEEN MIDWIVES AND OBSTETRICIANS?

Midwives consult with family doctors, obstetricians, paediatricians and other specialists as the need arises. A transfer of care could arise under urgent scenarios. Unless a complication arises early in pregnancy midwives often remain involved in a supportive role, with care sometimes transferred back to the midwife once the complication has subsided. In these cases midwives nearly always remain involved in the care provided.

WILL I HAVE ACCESS TO THE SAME TESTS AND PRESCRIPTIONS THAT I WOULD HAVE HAD WITH A DOCTOR?

Yes, registered midwives offer a complete panel of prenatal laboratory tests, genetic screening and diagnosis options, ultrasound imaging and many other tests and procedures for clients and newborns. A midwife's scope of practice includes the use of many medications that may be indicated in pregnancy, during labour—including emergency situations or pain medication—and following birth. If medication or testing is required outside of this scope of practice, midwives consult with and refer to doctors as indicated for more specialized care.

COULD COMPLICATIONS RULE OUT MIDWIFERY SERVICES?

Yes, this is possible depending on your personal circumstances. During your initial visit, your midwife should be able to give you an idea of whether the care you need is covered by their scope of practice.

Should complications arise while in a midwife's care at any time, the midwife will follow provincial guidelines that will help inform the decision to consult with or transfer care to the appropriate doctor or other specialist. Individual hospitals also often have policies on when consultation or transfer may take place.

CAN I CHOOSE WHETHER I GIVE BIRTH AT HOME OR IN HOSPITAL?

Yes, midwives offer the choice of birthplace to healthy, low-risk clients based on the principles of informed decision making. On average, 70% of births attended by midwives occur in hospitals. This number varies by practice and community.

For more information on home birth in BC, you can read the CMBC Place of Birth Handbook.

WHAT PAIN RELIEF OPTIONS ARE AVAILABLE FOR ME?

Midwives offer a range of natural and pharmaceutical pain relief options, including access to epidurals. It is paramount in midwifery care that clients have access to the information necessary to make informed decisions about the use of pain relief options. These options are discussed during prenatal visits as well as during prenatal classes.

WHAT HAPPENS IF I HAVE TO HAVE A C-SECTION?

Midwives have a 42% lower caesarean section rate than the provincial average. However, in certain circumstances a caesarean birth may be recommended as a safer option than a vaginal birth. In most situations midwives are involved in the decision making process, and will usually be present during a caesarean birth and for healthy baby care afterwards.

WHAT IF I HAVE A PROBLEM UNRELATED TO PREGNANCY?

During pregnancy, clients continue to see their family doctor or specialist physician for health issues unrelated to pregnancy.

WHAT IS THE DIFFERENCE BETWEEN A MIDWIFE AND A DOULA?

Doulas do not provide medical care and do not deliver babies. Midwives are trained to provide all the necessary medical care and to monitor the health and well-being of you and your baby.

Doulas work as a part of the team, with a midwife or doctor and nurse. Doulas provide continuous emotional and physical support and are a positive addition to the birth team for clients who want extra support. For more information about doulas, please visit the BC Doula Services Association. If you or your partner are Aboriginal, you qualify for a free doula through the BC Association of Aboriginal Friendship Centres.
List of Doulas in the Nanaimo area.

taken from https://www.bcmidwives.com/faq.html 

Reasons to Call Your Midwife During Office Hours

  • rashes of any kind except the ones you often get (like eczema)

  • sudden, unusual thirst

  • fever

  • a feeling of being tired all the time

  • sudden or continuing swelling of your hands or face

  • frequent vomiting, when you are unable to keep fluids down

  • a burning sensation when peeing

  • coloured, frothy and/or bad-smelling vaginal discharge, or vaginal discharge causing itchiness or irritation

  • constant negative feelings or anxiety about your pregnancy and care of the baby

  • depression or periods of weeping that don’t go away

  • any violence or threatening behaviour towards you in your home or workplace

  • contact with anyone who has rubella (German measles) / Varicella (Chicken Pox) and you are not immune

Reasons to Page Your Midwife

  • Please page day or night if you think you are in labour and have regular strong contractions:
    First baby: 3-1-1 rule - consistent strong contractions every 3 minutes or less for over 1 hour and during this hour contractions are lasting 45-60 seconds long.
    Second (or more) baby: 5-1-1 rule - regular strong contractions that are 5 minutes apart or less for 1 hour and lasting 45-60 seconds.

  • signs of preterm labour (preterm is before 37 weeks gestational age)

  • bleeding from the vagina (fill a pad in less than an hour)

  • a trickle of fluid from your vagina that continues or a gush of fluid

  • stomach pains or bad cramps that don’t go away

  • lower back pain or pressure or a change in lower backache that does not go away after taking a 30 min warm bath.

  • pressure in the pelvis, feeling that the baby is pushing down

  • contractions – they feel regular and don’t go away after taking a 30 min warm bath.

  • feeling that something is just not right

  • feel that your baby has moved a lot less – first sit quietly in a chair for 2 hours and rest your hand on your tummy and count each time the baby moves. If you count six movements in less than 2 hours then all is well, less than 6 movements then page immediately no matter what time of day or night.

  • Spontaneous rupture of the membranes (‘bag of water breaking’) and GBS positive. If GBS negative please wait until the morning if it is the middle of the night and then call.

  • Spontaneous rupture of the membranes and the fluid has a strong odor, OR if the fluid is any colour other than clear, OR if you do not feel baby moving normally afterwards.

  • fever (38 degrees or higher)

  • dizziness, dimming and/or blurring of vision

  • Severe persistent headache that does not go away

  • severe abdominal pain or if your abdomen feels hard

  • Large amount of vaginal bleeding other than bloody show/mucous. (Large amount means you put on a pad and it is full in 15 – 30 min).

After your baby is born:

  • If you or your baby have a temp over 37.5 C: If the baby is over-bundled or dressed too warmly, undress your baby, check temperature again in 20-30 minutes

  • Bleeding: it is normal to continue bleeding even up to 6 weeks postpartum, but if at any time you are soaking a large menstrual pad in one hour or less, or experience continued gushing after you pass a clot, please page right away. It is normal to pass clots even up to the size of an orange, especially when you have been lying down, but bleeding should not continue after a clot has passed

  • Breathing: Babies breathe very irregularly. However, if your baby is breathing very quickly (over 60 breaths per minute – please count for a whole minute as normal newborn breathing is very irregular), or is moaning with out-breaths, please page

  • Breastfeeding: breastfeeding is a learned skill and sometimes very challenging, and we want to help! If you are having problems latching your baby, or your baby is not feeding 8-10 times in a 24 hr period, please page

How to Page your Midwife

  • Dial the pager number.

  • Listen to the message.

  • After the beep, carefully enter your 10-digit phone number that you want your midwife to call you back on.

  • Hang up.

This is a numeric pager, please key in your number carefully after the beep. Please do not leave a voicemail. If you do not hear back from us within 15 minutes of placing your page, please call the Perinatal unit at the hospital at: 250-755-7691 ext 52021.