Nishta Saxena had heard of midwives before she was pregnant, but remembers inundating her friends with questions as soon as she found out she was expecting.

At 36, Saxena wanted care from a midwife because she knew she would be treated as normal. She says she didn’t want to have her pregnancy categorized as high-risk based only on her age.

“I thought they would treat pregnancy more as a life experience rather than a medical procedure,” says Saxena, a Registered Dietitian.

“At every appointment, I could spend sometimes 40 minutes conversing. My midwife would take the time to answer any question I had,” she says. “I could sit there and get into the nitty-gritty details, not just the physical side but also emotional changes and impending life-alterations that will occur in the process of having a baby. It’s a holistic approach to care.”

Canadian midwives

There are over 1,000 midwives providing care across Canada. The only provinces and territories without regulated midwifery care are New Brunswick, Newfoundland and Labrador, Prince Edward Island, and the Yukon. In some provinces, regulated midwifery care is relatively new, and is not available in all regions.

Last year, midwives attended the births of more than 30,000 Canadian babies. Midwives provide care from early pregnancy through labour and birth, and provide care to both mother and baby for six weeks after the baby is born.

Lisa M. Weston is a midwife in Scarborough and the president of the Association of Ontario Midwives. She says women over 35 have a higher risk of having gestational diabetes and having high blood pressure.

Guidelines and consultations

“As with all women in midwifery care, those things are monitored,” she says. “There are lots of guidelines for women having their babies later in life and midwives are well-versed in the research. With the appropriate consultations when needed, almost any woman can receive care from a midwife.”

Exceptions would be women with high-order multiples (more than twins), or women with chronic health conditions such as heart disease or diabetes.

Weston says she also has clients who have undergone fertility treatments.

“The issue causing the infertility challenge may be completely unrelated to having a healthy pregnancy,” she says. “Midwives can help women increase their confidence in their body’s ability to give birth. Clients find the one-on-one support and information very valuable.”

Midwives see pregnancy and birth as a healthy time in a woman’s life and midwifery care increases the chance of a woman having a normal birth. Midwifery clients have fewer c-sections and other interventions such as inductions, epidurals and episiotomies.

Trained and educated

Midwives are experts in normal pregnancy and birth, and trained to recognize health situations that fall outside of normal.

They work alongside other health care professionals such as nurses and physicians, and will consult with doctors when necessary. In some cases, a client’s care will be transferred to a physician.

In Canada, midwives attend university for four years to study normal pregnancy, labour and newborn care, as well as emergency skills. They are experts in providing safe, research-based care for pregnant women and new babies. Midwives trained outside of Canada qualify here through a one-year university program.

Pregnant women have appointments with their midwives on about the same schedule as they would with a physician except the appointments last longer, allowing for in-depth conversations and relationship-building. Research shows high quality prenatal care leads to high quality outcomes for mothers and babies. Midwives provide clinical exams and information at each visit and can order tests and ultrasounds as needed. Clients can page their midwife at any time, 24 hours a day, seven days a week.

Saxena is now mother to Cardin, two-and-a-half, and his sister Eadha, 10 weeks. She says she’s happy to share her experience with other families.

“I’m approaching 40 now so that’s a lot of experience with health care,” she says. “And of any time I’ve gone through the system, from dealing with an injury to just regular health issues, midwifery is the best medical care I’ve ever received.”

By: Association of Ontario Midwives