WHAT IS A MIDWIFE?
WHAT IS A REGISTERED MIDWIFE?
A midwife is a skilled, regulated, and insured health professional who provides primary medical care through pregnancy, birth, and the postpartum period, as well as other sexual and reproductive health care services.
WHAT IS AN INDIGENOUS MIDWIFE?
An Indigenous midwife is a an Indigenous person who understands the spiritual, cultural, mental and emotional significance of childbirth, and provides holistic and comprehensive clinical care for pregnant people, newborns, and families. Indigenous midwives view birth as a ceremony and the place from which healthy communities grow. They blend the modern skills and training of a registered midwife with traditional and ancestral ways of knowing to support families and improve maternal health outcomes.
Indigenous midwives have been providing care for their communities since time immemorial
THE CANADIAN MODEL OF MIDWIFERY CARE
In Canada, a Registered Midwife (RM) is an autonomous, publicly-funded healthcare professional who provides skilled medical care throughout pregnancy, birth, and up to six weeks postpartum. Being an autonomous primary care provider means that a midwife can provide regulated and insured medical care without a referral or supervision from a doctor. This includes ordering ultrasounds and lab work, making medical decisions in low-risk pregnancy and managing deliveries in various settings, including outside of the hospital.
Registered midwives are experts in low-risk pregnancy and birth and complete at least one four-year bachelor degree program, including years of hands-on apprenticeship. Midwives carry medical liability insurance and are trained to attend low-risk births at hospitals, birthing centres, or at home. High-quality studies have demonstrated the safety and excellent outcomes of registered midwifery care in Canada in all birth settings. Midwives are also trained to identify risk factors and collaborate with obstetricians and doctors when pregnancy or birth becomes high-risk. They also are trained to facilitate and manage transport to hospital when necessary, and manage unexpected obstetrical emergencies in all birth settings.
CORE PRINCIPLES OF MIDWIFERY CARE
Partnership | Midwives view those they care for as the experts of their bodies and primary decision-makers in their health care. Midwives work in partnership with those they care for to provide personalized care plans and options. Indigenous midwives view partnership as an extension of Indigenous ways of knowing and being, rooted in models of matriarchal and collective (as opposed to hierarchal) leadership.
Evidence-based Care | Midwives are knowledge keepers who share their clinical and medical knowledge, grounded in years of hands-on experience, to support informed decision-making and safe and healthy outcomes. Evidence-based care in Canadian midwifery is a foundational principle of the national care model. It requires practitioners to blend current clinical research with their own expertise and the unique values, needs, and preferences of the pregnant person, ultimately prioritizing safety and informed decision-making. Indigenous midwives blend evidence rooted in Indigenous and ancestral knowledge systems that predate modern science to provide culturally nourishing care.
Informed Decision-Making | Midwives support informed decision-making by taking extra time to provide unbiased culturally-relevant information and evidence so that personalized medical choices can be made confidently by the person receiving care. Informed decision-making is a collaborative and empowering process where treatment plans are decided upon once an individual understands all their options, including risks, benefits, and alternatives. Indigenous midwives view informed decision-making as a practice to empower Indigenous women and parents as our communities' first leaders, promoting self-determination and sovereignty.
Continuity of Care | Midwives believe that good birth outcomes happen best in trusting relationship and partnership. Continuity of care is when a pregnant person receives care from one provider, or a small group of providers across their entire maternity care journey. Studies demonstrate that continuity of care and cultural continuity help improve birth satisfaction and outcomes. Continuity of care is enhanced at the IMP by our Innu student midwives who are a consistent presence throughout the maternity care journey and work to promote cultural and relational care as our locum midwives rotate through the program. To learn more about our locum midwifery program, please click here.
Choice of Birthplace | Midwives are the only maternity care providers in Canada with the medical skills, training, and expertise to safely offer choice of birthplace in hospital or out-of-hospital. Midwives partner with the families they serve to support informed decision-making about choice of birthplace. Midwives take into account individualized risks and benefits of all birth settings to ensure that birth can take place safely, wherever a birthing person feels the safest delivering their baby. Indigenous midwives aim to uphold choice of birthplace as an act of sovereignty, strengthening our relationships to the Land, since time immemorial.
Person-Centered Care | The midwifery model is designed to promote personalized care that meets the unique needs of each individual or family in care. Person-centered care is enhanced through Informed choice, continuity of care, and the 24/7 on-call nature of midwifery which ensures that individuals have access to their midwife outside of clinical hours in the case of emergencies, onset of labour, or urgent medical questions and concerns. Indigenous midwives recognize that barriers to ideal perinatal health outcomes are rooted in colonialism and the disruption of traditional birthing systems, not Indigeneity. Indigenous midwives build bridges between community and health systems to reduce systemic barriers and facilitate person-centered care.
Collaborative Care | Midwives are integrated into the larger health system, which allows them to provide care in collaboration with other health professionals when necessary. The continuity of care midwives provide enhances a sense of safety and trust even when shared or collaborative care with other health professionals is needed. Indigenous midwives recognize that respectful interprofessional relationships are integral to the healthy outcomes and positive experiences of those they care for.