May 5 is the International Day of Midwives. Who better than the President of the Order of Midwives to clarify certain aspects of the profession? She answered our questions!
Who are the midwives today?
“They are he alth professionals to whom pregnant women can contact for their pregnancy follow-up. Since 1999, the profession has been legalized, so it is since then that our professional order has been established. The midwives who are members of the Order all have their license which is in fact the recognition of aptitude to practice. »
International definition of midwife
"A midwife is a person who has completed a midwifery training program recognized in his or her country, has successfully completed the relevant studies and has acquired the necessary qualifications to be recognized or licensed as a midwife. She must be able to ensure the supervision and to give the necessary care and advice, to the pregnant woman, in labor and in the postpartum period, to help during a delivery under her own responsibility. and providing newborn and infant care. This care includes preventive measures,screening for abnormal conditions in mother and child, obtaining medical assistance when needed and carrying out certain emergency measures in the absence of a doctor. The midwife plays an important role in he alth education, not only for women, but also for the family and the community. Its work should include prenatal education and preparation for parenting, and should extend into certain areas of gynecology, family planning and child care. Midwives can practice in hospitals, clinics, at home or in any other place where their presence is required."
What do midwives advocate?
Midwives view pregnancy and birth as events in a woman's life. We perceive them as “normal”. We don't hide our heads in the sand saying that there is no risk or that no complications can occur, but the fact remains that we do everything possible in the follow-up to allow the event to continue "normally".
Some Aspects of Midwifery Practice
The practice of midwifery is based on respect for pregnancy and childbirth as normal physiological processes that hold deep meaning in the lives of women.
Midwives recognize that labor and childbirth belong to women and their families. The responsibility of he alth professionals is to provide women with respectand the support they need to deliver with power, safety and dignity.
Midwives encourage women to make choices about the care and services they receive and how they are delivered. They conceive of decisions as resulting from a process where responsibilities are shared between the woman, her family (as defined by the woman) and he alth professionals. They recognize that the final decision rests with the woman.
midwivesrespect a woman's right to choose her he alth care provider and place of birth, in accordance with the College's Standards of Practice Quebec midwives. Midwives are ready to assist women in the birthing place of their choice (birthing centre, hospital center and at home). Source:
What are the challenges of midwifery practice?
“The accessibility of services for clients is one of the issues for midwives. Currently, we can say that the demand is greater than the supply. There are graduates of the baccalaureate in midwifery practice in Trois-Rivières who finish, but who do not have a job. Midwives do not practice in private, so they are at the mercy of positions offered in institutions to meet the needs of the growing clientele.
Also, when the law was approved in 1999, it mentioned that women could have a choice of birthplace. Home birth is now possible and two hospitals, Hôtel-Dieu de Lévis and LaSalle Hospital, allow midwives to perform deliveries. It’s a long process to get into hospital settings. An agreement must be established with the center so that the midwives can go there. Increasingly, midwives will have access to different spaces. »
How is a follow-up with a midwife?
“A woman can be monitored from the start of her pregnancy. At the beginning, the meetings of 45 minutes on average take place once a month. From 32 weeks, the midwife and the couple meet every two weeks, then, at the 37th week, every week. The follow-up by a midwife is a service of the he alth network, so there is no cost as long as you are covered by the Quebec he alth insurance plan.
The midwives carry out the obstetrical follow-up, take the normal parameters (fundal height, weight, etc.), do the examinations and order an ultrasound if necessary or according to the parents' wishes. During the meetings, the midwife talks a lot with the woman and the couple about their needs and concerns, helps them to live the pregnancy well and prepares them for the arrival of a child in their family. The midwife takes pregnancy and birth into account more generally as an experience to be lived. Then, follow-up continues 6 weeks after birth. »
Is there a conflict between midwives anddoctors?
“No, not really. The opposition is less and less tangible. The professions get to know each other better. We have a different vision of birth. Our way of perceiving risks is also different. Basically, the end of the telescope through which we see the birth which is not the same. Are we thinking of the 85% of pregnancies that proceed normally or the 15% that present risks? It looks a bit like the glass of water, half empty or half full”
What are the limits of midwifery practice?
“If by monitoring and taking growth parameters, the midwife notices, for example, that there is a risk of premature delivery, she can refer her patient to another specialist. But as soon as everything is back to normal, she continues the follow-up. If the patient has to give birth in the hospital, the midwife can also accompany her without being the main speaker. On the other hand, it must be said that there is enough equipment in the birth centers to carry out certain interventions (such as placing a solute if there is bleeding after childbirth), but not too much either. »
Why do women turn to midwives?
“Many realize that they need to be supported in all the stages leading up to birth. The midwife then becomes the best-placed professional to monitor them during their pregnancy. It goes without saying, even if everything is going normally, that does not mean that we do not need to take care of it. Some women have already given birth in a hospital setting with a doctor and there they want to have a new experience where they can become more involved. Half of our customers are pregnant for the first time. For them, being pregnant is not a disease, so they do not want to go to the hospital. Often a friend or acquaintance has told them about follow-up with a midwife.
I also think that the midwife's approach, the continuity of care and the more personalized relationship that is established with the practitioner have a lot to do with the choice of women who turn to the midwives -women. »
If a woman wants to be seen by a midwife, what should she do?
“There are 11 birth centers. Women who wish to obtain the services of a midwife can contact birth centers directly. If there are no birth centers in her area, she can still make a request to her regional agencyto request access to this service. »
Resources
Regroupement des sages-femmes du Québec514-738-8090Ordre des sages-femmes du QuébecCanadian Association of MidwivesBachelor of Midwifery Practice
