The Association of Ontario Midwives

The Association of Ontario Midwives

Midwifery Q & A

In Ontario, a midwife is a registered health care professional who provides primary care to low-risk women throughout pregnancy, labour and birth. Midwives also provide care to both mother and baby during the six weeks following birth. They are available to clients 24 hours a day, seven days a week by pager. 

A woman receives care from a small number of midwives. You will know the midwife who attends your labour and birth. 

In Ontario, if you see a midwife you will not see a physician unless there are concerns or complications. Most births are normal and there are no complications. If there are complications, midwives can consult or transfer care to a physician. Midwives provide safe and expert care to healthy women and newborns. 

What does it cost to use a midwife?

Midwifery services are completely funded by the Ministry of Health and Long-Term Care, so women do not pay for care out-of-pocket. Women who are not currently covered by OHIP can still receive free midwifery care. 

When should I contact a midwife?

It is best to contact a midwife as soon as you find out you're pregnant. Not only is demand for midwives high, but it is also beneficial to access prenatal care at the beginning of your pregnancy. Some clinics do have openings for clients later in pregnancy. Call anytime. You do not need a referral to see a midwife. 

How do I find a midwife?

Locate a clinic in your community or call the Association of Ontario Midwives at 416-425-9974 or toll free at 1-866-418-3773. 

How many midwives are there in Ontario?

There are close to 700 registered midwives practicing in 100 clinics throughout the province. In 1994, Ontario became the first province in Canada to regulate midwifery. Since that time, Ontario midwives have attended more than 180,000 births, including 35,000 home births.

What is the philosophy of midwifery?

Ontario midwifery is based on three principles: 

Continuity of Care

Midwives provide care throughout pregnancy, labour, birth, and the first six weeks following birth. Midwives develop relationships with women and are available to clients 24 hours a day, seven days a week by pager. 

Informed Choice

Women are active decision-makers in the care they receive; midwives give information to help women make informed decisions. 

Choice of Birthplace

Women may choose to give birth safely at home or in hospital. Midwives have hospital privileges in Ontario hospitals. This means that they can admit and discharge clients at hospitals and access hospital resources needed by clients, including a consultation from a doctor if there is a concern or complication. Midwives are the only health care professionals specifically trained in out of hospital birth. Starting in late 2013, clients in Ottawa and Toronto will also be able to access new birth centres.

How are midwives trained and regulated?

Registered midwives complete a four-year university degree through the Ontario Midwifery Education Program (offered at three Ontario universities). If a midwife has been trained outside of Canada, she completes the International Midwifery Pre-Registration Program, offered through Ryerson University. Once a midwife has completed her training, she is licensed by the College of Midwives of Ontario.  Newly registered midwives are required to complete a mentorship year with an experienced midwife.  

Another option available to Aboriginal midwives in Ontario is the four-year Aboriginal Midwifery Training Program at Tsi Non:we Ionnakeratstha Ona:grahsta’ Maternal and Child Centre on Six Nations of the Grand River territory.

What happens at a prenatal appointment?

During regularly scheduled visits to the midwifery clinic, midwives provide physical examinations and assessments, support and information. Appointments are on average 30-45 minutes long. Prenatal visits are usually once a month for the first 28 weeks, every two weeks until 36 weeks and then once a week until your baby is born. Most women will see their midwife 11-12 times before they go into labour. 

What happens at appointments once my baby is born?

Midwives provide care for both mothers and babies for six weeks after the birth. Whether your baby is born at home or in the hospital, your midwife will provide care in your home within 24 hours of the birth. Clients will have about six midwifery appointments during the six weeks following the birth, including several in the first few days and weeks. Midwives monitor the health of mother and baby and provide breastfeeding support. Midwives remain available by pager 24 hours a day, every day. After six weeks, clients are discharged from midwifery care and will see their family doctor for care. 

Can I have a home birth with a midwife?

Yes. Midwives provide the option of a home or hospital birth. About one in four women in midwifery care chooses a home birth. In some communities, birth centres are also available as a third option to support normal birth.

What pain relief options are available?

Midwives offer a range of natural and pharmaceutical pain relief options, including access to epidurals in hospital. Pharmaceutical pain relief can only be accessed at a hospital birth. Many women use water, massage and other methods as an effective way to relieve pain at home, birth centre and hospital. 

Can midwives run the same kinds of tests as doctors?

Yes. Midwives can arrange all routine prenatal testing including ultrasound and genetic screening, as well as standard laboratory and diagnostic tests. Midwives discuss the results with clients and provide information and follow-up. 

Am I too old or too young to have a midwife?

There are no age restrictions for accessing midwifery care. Anyone with a normal and low-risk pregnancy is eligible for a midwife. The majority of births are normal and low risk. 

What happens if there is a problem with my pregnancy?

Midwives are experts in normal pregnancy and birth and provide safe care for both mother and baby. If a health concern or a complication arises, your midwife may consult with a physician. Situations that require consultation with, or transfer to, a physician are set by the College of Midwives of Ontario. If needed, your care is transferred to a physician (for example, in the case of a caesarean section). Your midwife will continue to provide support and resume primary care when possible. 

Can I have a midwife and a doctor?

No. Women can have either a midwife or a doctor for pregnancy, birth and newborn care. Midwives, obstetricians and family physicians are all considered primary caregivers. A primary caregiver takes responsibility for your care. 

What is the difference between a doula and a midwife?

A birth doula is a trained labour support person who provides emotional and physical support to a labouring woman and her partner. While she is not a medical professional, she can offer a wide range of comfort measures. You would find and pay your doula yourself. Doula services are not covered by the Ministry of Health and Long-Term Care. If you are considering having a doula at your birth, talk about it with your midwife. 

What is an Aboriginal midwife?
In 1994, following regulation of midwifery in Ontario, the title “midwife” became protected through legislation, i.e. those who practice as midwives in Ontario must be registered with the College of Midwives of Ontario. At the same time, this legislation recognized Aboriginal midwives and states they may continue to practice autonomously.

According to the National Aboriginal Council of Midwives, an Aboriginal midwife is a primary health care provider who cares for pregnant women, babies and their families throughout pregnancy and for the first weeks in the postpartum. She is also a person who is knowledgeable in all aspects of women’s medicine and she provides education that helps keep the family and the community healthy. Midwives promote breastfeeding, nutrition and parenting skills. A midwife is the keeper of ceremonies for young people like puberty rites. She is a leader and mentor, someone who passes on important values about health to the next generation.

I am an Aboriginal woman, where should I look for a midwife?
Women can access midwifery care from any midwifery practice in Ontario with registered midwives. Seventh Generation Midwives Toronto is a practice located in downtown Toronto that provides care to all women, but with a special focus on women in the Aboriginal community. Women who live on or within driving distance of Six Nations reserve can receive care from Aboriginal midwives at the maternal and child centre.

I am a midwifery student from another country and I'd like to do a placement at a clinic in Ontario. How do I arrange this?
International students or students from jurisdictions outside of Ontario seeking placements in Ontario midwifery practices are encouraged to contact practices directly regarding placement availability. Ontario Midwifery Education Program students are prioritized for placement, and practice availability may vary. Each practice oversees its own schedule and staffing.

All student midwives doing placements in Ontario are required to have liability insurance, which is typically provided through your educational institution. It is recommended that you have a copy of the insurance policy before approaching practice groups.

This information is also available in these languages: Arabic, Farsi, French, Korean, Russian, Simplified Chinese, Spanish, Urdu.