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frequently asked questions

do i need a referral from my doctor to see a midwife?

No. While midwives do accept referrals from other care providers, clients who are interested in midwifery care can self-refer.

are midwifery services regulated?

Yes. Midwives are registered with and regulated by the College of Midwives of Newfoundland and Labrador (CMNL) and the Newfoundland and Labrador Council of Health Professionals (NLCHP) according to the Midwives Regulation under the Health Professions Act. Midwives have been regulated and legally recognized as autonomous health care practitioners in NL since 2016.

are the costs of midwifery services covered in nl?

Yes. The cost of midwifery services are covered for all NL residents with a valid Medical Care Plan (MCP) card.

can i have a midwife and a doctor?

Your MCP 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 your decision.

Midwives are experts in healthy pregnancy and normal birth and consult with family doctors and other specialists such as obstetricians and pediatricians as the need arises.

when should i call to make my first appointment with a midwife?

You can contact a midwife as soon as you know you are pregnant. Depending on availability, you can start midwifery care in your first trimester.

how often do i see a midwife?

Midwives typically welcome clients into care between 8-10 weeks gestation when they have an initial appointment. They are then seen every 4 weeks until 28 weeks of pregnancy, every 2 weeks until 36 weeks of pregnancy, and weekly until labour/delivery. The client has access to their midwife (or midwifery team) 24 hours/7 days a week throughout their care. Visits are typically longer in duration, between 30-60 minutes, to allow time for informed decision making and the development of a trusting relationship between clients and their midwife.

Once labour is progressing, the midwife will assess progress and often remain with the client once they are in active labour, through delivery and until 3 to 4 hours after the birth.

After your baby is born, visits usually take place on days 1, 3 and 5. 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. Between visits, midwives provide 24/7 call coverage for urgent care or concerns.

how many midwives will be involved in my care?

Midwives can work in groups of two to four but may also work as solo providers. In small group practices most clients will have met all of the midwives in the group by the time their labour begins.

what is the working relationship between midwives and other physicians?

Midwives consult with family doctors, obstetricians, pediatricians and other specialists as the need arises. In urgent situations, a transfer of care could arise. 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.

can i choose whether i give birth at home or in hospital?

Yes, midwives offer choice of birthplace to healthy, low-risk clients based on the principles of informed decision making. All Registered Midwives maintain hospital privileges so they can provide comprehensive care in all settings.

what pain relief options are available for me?

Midwives offer a range of natural and pharmaceutical pain relief options, including access to epidurals. These options are discussed during prenatal visits as well as during prenatal classes to ensure a client can make an informed choice decision that suits them.

what happens if i have to have a c-section?

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 can 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?

A Registered Midwife, like a physician, is a primary care provider. Midwives are trained to provide all the necessary medical care and to monitor the health and well-being of you and your baby.

Doulas do not receive medical training, and as such do not provide medical care or deliver babies. However, doulas provide continuous emotional and physical support and are a positive addition to the birth team for clients who want extra support.

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