Who will look after me?
In Ontario, you can choose to have a midwife or a doctor look after you when you’re pregnant, but not both. Midwives are primary care providers who specialize in low risk pregnancy and birth. This means that unless there is a complication, your midwife will provide all the care you need at your hospital birth.
What hospital will I give birth at?
Midwives provide care in the hospital where they have hospital privileges.
Hospital privileges mean:
- the hospital has reviewed and approved the midwife’s credentials and licensure
- midwives are members of the hospital’s professional staff
- midwives can access all the hospital resources they need to do their jobs
- midwives have quick access to specialist care (e.g. obstetrician, pediatrician) in the hospital if complications arise
If you are interested in giving birth at a specific hospital, you can find out here which midwifery practice(s) have privileges there.
How can I find out what it’s like to give birth at the hospital in my community?
Some people find it helpful to visit the space where they plan to have their baby. Many hospitals provide in-person or virtual tours of their labour and birthing unit. Every hospital is different, but most people in Ontario will have their baby in a private labour and birthing room. Depending on the hospital, you may or may not have access to your own private bathroom.
What about visitors?
Every hospital has its own visitor policy. A visitor policy helps the hospital manage the number of people in the labour and birth unit at any given time, protect patient privacy and prevent and control the spread of germs or illnesses like the flu.
Most hospitals allow two illness-free support people to be with you during labour and birth. Talk to your midwife about the visitor policy at the hospital(s) where they work.
What do I need to bring to the hospital for the birth?
Hospitals are equipped with all the necessary equipment, medications and disposable items needed for your birth. You may still want, or need, to bring other items with you. Use our handy Packing for the hospital checklist to help you plan. You can also talk to your midwife about how to best prepare for birthing at the hospital in your community.
What about germs and infection control?
All hospitals in Ontario have strict cleaning and disinfection protocols. They follow standards set by the Provincial Infectious Diseases Committee of Public Health Ontario.
It is still hard sometimes for hospitals to control infection risks because of the large number of sick people they take care of every day, that doesn’t mean that you or your baby will get sick if you go to the hospital. Healthy people, like most birthing parents and their babies, have a lower risk of getting an infection in hospital than people who are there because they are sick.
See how your hospitalHealth Quality Ontario is the province’s authority on the quality of health services being provided to Ontarians. Here you can search for your hospital to see how well they are doing at managing infections to keep their patients safe. measures up with their infection prevention measures!
What are my options for comfort measures and pain relief?
Comfort measures and pain relief options available to you at the hospital may include:
- relaxation and breathing techniques
- transcutaneous electrical nerve stimulation (TENS)
- nitrous oxide (laughing gas)
- epidural or spinal analgesia
- opioid analgesia
Not all hospitals or midwives offer all of these options. Talk to your midwife about the comfort and pain relief options available at the hospital(s) where they work.
Can my midwife still care for me if I want or need an epidural?
Yes, most midwives remain the primary care provider if their clients have an epidural, but it depends on the hospital.
Most, but not all, hospitals offer epidural services and some hospitals have policies that require midwives to transfer care to a doctor for epidurals. If this is the policy at the hospital where you give birth, your midwife will continue to provide supportive care, comfort and information. They will resume clinical care, after the birth.
You can speak to your midwife about whether your hospital has any restrictions on the care they can provide.
What happens if things don’t go as planned?
Most healthy people have healthy pregnancies and healthy births. However, sometimes birth does not go as planned. Midwives are prepared for this.
Midwives have the training and skills to:
- identify when a complication is developing early on
- correct many developing complications
- follow standards The College of Midwives of Ontario sets out standards to ensure midwives are providing the safest care possible. This includes outlining contexts where midwives are required to consult with, or transfer care to, another healthcare provider because the clinical situation is beyond their scope of expertise.about when to involve doctors (e.g. obstetrician, pediatrician) to achieve the best possible health outcomes for you and your baby
If a complication arises and you are no longer considered low risk, your midwife will consult a doctor. Midwives and doctors work together in a variety of ways. Depending on the situation, a doctor will do an assessment and:
- provide advice, information or make recommendations for a plan of care that the midwife carries out and your care remains with the midwife (called consultation),
- may recommend that a doctor take over your clinical care (called a transfer of care).
When a transfer of care occurs, your midwife will continue to provide supportive care, comfort and information. Your midwife will resume clinical care once your or your baby’s condition has improved.