Your Pregnancy & Birth Team: Choosing a Midwife, Location, and more

What to consider before you choose your birth team

Where do you want to give birth? It’s probably not the first thing that comes to mind when you envision your perfect birthing experience – but location will affect many of the decisions you make when planning who will attend your birth. Your prenatal educator is a great person to ask about the services and professionals available in your region.

Which province or territory do you live in? If you choose to have a midwife as part of your birthing team and you live in British Columbia, Alberta, Saskatchewan, Manitoba, Northwest Territories, Ontario, Quebec or Nunavut, your province or territory will cover the cost. Nova Scotia will cover the cost of midwives in their province. However, there are only limited regions where they can act as the primary healthcare provider. That doesn’t mean if you live outside of these provinces or territories you won’t be able to find a midwife. It only means your provincial healthcare plan may not cover the full cost.

Do you live in an urban or a rural setting? Urban centres have more hospitals and birthing centres to choose from. For example, if you live in or near Toronto, there will be more hospitals than if you live in Red River. On the other hand, if you live in a rural setting, it may be easier to access a nurse practitioner during your pregnancy. In rural areas, there are a greater number of nurse practitioners available to help compensate for the fewer number of hospitals. So, be sure to talk to your prenatal educator or doctor about the services available where you live.  

It is important to trust and feel comfortable with the person who will be providing you with care throughout your pregnancy. Whoever you choose, they should be happy to answer your questions and encourage your input. Here are a few things to consider before settling on a primary care provider for your pregnancy:

• Ask about their views on pain medication, natural births, and breastfeeding.
• Would you like someone that is aware of/accommodating to certain cultural or religious practices?
• Do you need a healthcare provider that speaks a certain language?
• Where does the healthcare provider typically deliver? Do you have your mind set on a specific delivery site (hospital, birthing centre, home)?
• When booking prenatal visits, is it important to have an office that takes evening or weekend appointments?

Getting to know your pregnancy & birth team

Birth Partner You probably feel that you know just about all there is to know about your birth partner. This is the person that you couldn’t imagine experiencing pregnancy without. This may be your husband or partner your mother or your best friend. It is that special person you can count on to give you the support you need throughout your pregnancy, labour, delivery and after baby arrives.

Prenatal Educator They most likely won’t be there with you in the delivery room, but they are a pretty important resource in the months leading up to your birth. Your prenatal educator is anyone who provides you with support or advice about your pregnancy (e.g.your Lamaze coach or a parenting instructor). They will answer your questions and provide you with the information and support you need. They will focus on pregnancy, birth and early parenting. Most importantly, they will be able to tell you about the hospitals and maternity services available in your region.

Family Physicians Your family physician may provide some prenatal care, but fewer family doctors are delivering babies than in the past. After week 32 your doctor may transfer you to another family physician, obstetrician or midwife for the duration of your pregnancy and delivery.

Obstetrician-Gynaecologists Not every obstetrician-gynaecologist (Ob-Gyn) provides prenatal care, but more are delivering Canadian babies than ever before. If your pregnancy is deemed high risk (women with diabetes, those who develop preeclampsia or women expecting twins or multiple births), expect an Ob-Gyn to be a part of your birth team. If you’re scheduled for a caesarean, the same applies.

Midwife Your midwife is an expert in women’s healthcare – especially prenatal care. Midwives are trained to provide complete care for low-risk women during pregnancy, childbirth and the first few weeks after childbirth. Your midwife will help to ensure you have a healthy pregnancy and natural birth experience. Midwives are present during childbirth, and while they are licensed to prescribe certain drugs and order required tests during your pregnancy, your midwife will not intervene with any medications unless necessary.

Doula You may choose to have a Doula as part of your birth team. This is someone who will provide you with non-medical prenatal, childbirth and postpartum support. Sometimes referred to as a birth assistant, she is trained to provide emotional and physical support during your labour. Your doula may use massage, aromatherapy and positioning suggestions to help you during labour. After birth, your doula is there to provide reassurance and support as you navigate the world of parenting.  

If you choose to have a doula or a midwife as part of your team, be sure to ask a few questions about their training, certification, the number of births they’ve attended and their philosophies on labour.

Maternal/Newborn Nurses Your nurse is a trained medical professional and - just like doctors - specializes in certain areas of care. So expect to receive care from a variety of nurses before and after your baby is born. Throughout your pregnancy a nurse practitioner may also be available to you. She will offer you prenatal care and advice similar to a physician. Once your labour starts and you are admitted to the hospital, you will meet your labour and delivery nurse. Ask her questions, be honest about your fears, and look to her for support throughout your labour – she’s there to help. After your baby is born, you will meet your nurse lactation consultant who will provide breastfeeding help and support to you and your baby. Finally, you will meet your public health nurse. She will provide you with continued follow-up care, advice and support after you leave the hospital.

With everything else you’ll be thinking about, you can rest easy knowing you have your very own team of experts to help support you during your first introduction to motherhood.

This is intended for information purposes only. Please note that this may vary depending on your location.