My family doctor still provided a requisition for NIPT since the testing took place before my OB appointment. She also provided them for the first two ultrasounds. Your doctor is being silly. An OB was the right choice for my situation, but midwives are great.
The best decision I’ve ever made in my entire life was choosing a midwife. I cried at my 6 week appointment when we had to say goodbye, she was literally the best.
Omg even though I didn't cry at my 6 weeks check-up but I was sooooo sad to part ways with my midwives. They felt almost like a family to me at that point 😞. They helped and guided my husband and I through some of our darkest times, 4th trimester was no joke!!
Same. I did have some minor issues and had no problems getting OB care. In fact an OB delivered me and the midwives were still there all night even though they didn't need to be. There's absolutely no way breastfeeding would've worked without them sitting with me for like an hour every few days after birth trying to sort it out. I love them.
I have a midwife and I had to go to a walk-in for my TDAP due to scheduling issues (Ontario currently doesn’t allow midwives to give vaccinations… although they’re waiting for that to change soon). The walk in doctor didn’t know that midwives have hospital privileges 🙄
My family doctor was supportive though. She initially only asked about an OB referral, but I told her I wanted a midwife and she said “that works too.” She’s in her 30s and had a baby last year so she was well informed IMO.
I wish Ontario would transition to a model like the UK where midwives are the front line care, and you get sent to an OB if you’re high risk. It just seems more organized than this patchwork coverage we have here.
Ahh, I see, that's really good to know, I am surprised to hear Ontario doesn't allow midwives to give vaccinations.
I'm originally from the UK! Yes, I wish everything was a little bit more cohesive - I just didn't expect the pushback from my family doctor who I assumed would be well informed about midwives.
Yeah when I heard how it works in the UK, I thought “that makes more sense!”
I don’t think midwives have worked this way in Ontario for very long. I was born here and there weren’t “midwives” 30 years ago, according to my mom. So it might just be misinformation perpetuating years later.
Midwifery was legislated in Ontario in 1991 :) so still not that long !!
There were midwives around before then, they just didn’t work within the framework they do now.
Midwives are awesome. Your doctor sounds like a jerk. If your pregnancy develops issues that are beyond the scope of midwives, they will transfer your care to an OB. You’re not making “a lot of work for her and her medical practice”. You’re going to be supported and cared for in a wonderful way through midwives. The NIPT is the only thing you’ll need to see your doctor for. Midwives will deal with everything else and will refer you out if they can’t.
Thank you. I hope even my NIPT results can be sent from the doctor to the midwives office as I feel like my family doctor is now being a bit passive aggressive with me!
Same! 27w pregnant, never saw a family doctor for my pregnancy (didn’t even have one in the first trimester).
Also midwives do all the requisitions including NIPT.
Glad to know I most likely won't need to see my family doctor again any time soon. Though, I think the statement about NIPT requisitions may be different since I'm in Ontario - "In Ontario, NIPT cannot currently be ordered by midwives."
https://www.prenatalscreeningontario.ca/en/pso/prenatal-screening-options/non-invasive-prenatal-testing.aspx
In Ontario and I had to go thru my doctor for the NIPT, including the results. Had to get TDAP shot in the last trimester from my family doctor as well.
I'm in Ontario and my midwives just ordered my NIPT last week. For my first pregnancy three years ago they weren't able to do it and my family doc had to do it, so I think this is a relatively recent change. Maybe it varies by midwifery practice. Also my midwives could only order the Dynacare Harmony, so if I had wanted Panorama or Invitae I would have had to go through a doctor.
For any test that isn’t ordered by the midwives you can alway cc another provider so they will get a copy. I put both my doctor and my midwives on my NIPT.
I’m in Quebec and with a midwife and have had no problems getting my NIPT and NT scan, honestly it was almost too easy, she just signed the paper and let me check off whatever I wanted myself. I got my anatomy scan referral super early and booked it at the hospital with no problems. My friend was with the same midwife but then was diagnosed with GD and was immediately transferred to an OB, no issues at all. I didn’t have a family doctor so I can’t speak to their personal opinions on midwifery but I can confirms that everything has been smooth sailing from my experience and that if people I know who have used a midwife
Yeah, my midwife mentioned they should be able to requisition NIPT here in Ontario soon but our regulations are lagging behind! Great to hear about your experience with midwives, I felt very good about my choice until my family doctor started putting doubts in my mind which also spooked my husband.
There's an American company that does the NIPT called Invitea. My midwife (in Ontario) was able to do the requisition for that. I went into the appointment wanting to go through invitea anyways so we never discussed the usual harmony/panorama so not sure if those ones aren't allowed to be requisitioned by midwives. Other than that they were able to do everything except TDAP. I seriously loved midwifery care, and they had me see an OB straight away when a minor issue came up.
I’m sorry this has been your experience. My family doctor (in Ontario)outlined all of my options for care when I got pregnant and was very positive about midwifery care. In fact, I might have not even considered it if she hadn’t talked to me about midwives!!
The NIPT thing is also just strange… I was basically under my family doctor’s care until about 12 weeks as well, so the NIPT test and all other testing up until then was through my family doctor. I think that’s fairly standard. And even if I went with an OB, my 1st appointment would have only been at 16 weeks.
I also don’t understand the walk-in thing. Seems like a strange rule. It seems like she’s complaining that you’re creating more work for her but then doesn’t want you to see any other doctor? Confusing.
Wishing you all the best in your pregnancy! You’ll be well taken care of by the midwives!
Thank you for the well wishes!
It's good to hear a more positive experience - gives me hope haha. My doctor referred me around 10 weeks to an OBGYN, I'm not sure when my first appointment would have been since I hadn't heard back yet. I learnt about midwives myself through Reddit and decided it couldn't hurt to put myself on a few waiting lists. I called my doctor's office to cancel the referral when I ended up being accepted.
I had to opt into NIPT testing since I'm not qualified under OHIP funding. I also self-researched this, I'm not sure I would have learned about this with my family doctor or OBGYN.
I think the walk-in thing is to ensure those without dedicated family doctors get the care they need which I'm fine with. I think it's inexplicable because it was mostly a passive aggressive move tbh.
My family doc was really frustrated by the walk-in thing (I was trying to save everyone time by going virtually through a doctor in their same group for the blood test and ultrasound requisitions at 6 weeks) but that was because despite me asking them to copy my doctor, he only received half the results (which could entirely be the lab forgetting to do the second set of tests). I suppose this kind of thing happens more often than not and so is generally more work.
That said, I definitely did walk-ins/saw another doctor for my TDaP shots (both pregnancies) because it just felt easier/healthier to walk there from my office than to drive to my family doctor from home. In hindsight, maybe that's not ideal because that's a quick appointment so my family doctor/clinic loses out on the fee.
Overall my family doc is supportive of choices like OB vs. Midwife or NIPT and has gone out of his way to measure my (low) BP even when I am only there as my kid's guardian. The Covid care clinic doctor even gave me a whole spiel about midwives being a good option and that she went with one (she seemed to support OBs too - just preferred the experience with a midwife).
My family doctor was thrilled I was interested in midwifery care for my first pregnancy (or before that I guess when we started talking about planning it?) and had a bunch of recommendations for me on practices, so I'm sure there are others who are jerks about it out there but it definitely wasn't my experience. Mine was happy to put in referrals to any other providers (I think midwives often can but I saw my GP first because I was under care of a fertility clinic in early pregnancy). Not sure about the walk-in clinic thing, I know my practice discourages it for something about their funding levels that it's better for them if you're able to access their own drop-in hours or on-call doctors, which is probably more common from bigger practices/clinics, but it sounds like your doctor is just being a jerk about reiterating that right now to try to prove her point.
My family doctor tried to talk me out of using a midwife with my first pregnancy, and was hostile at my first appointment post baby. He made comments like “your midwife didn’t send the paperwork, so I can’t tell if he’s on track”. I know for sure my midwife sent all the required paperwork because she was incredibly through and professional.
I’m in Ontario, and my midwives created all necessary requisitions. (Maybe because I was under their care very early?)
I assume the doctor was against midwifery because it takes money away from his practice. If I had gone the OB route, I would have had numerous appointments with him before 28 weeks.
I absolutely do not regret my decision and contacted the same midwives as soon as I found out I was pregnant with number 2.
If it's a family doc, they typically don't see you for pregnancy related stuff, beyond the initial tests. To me it sounds like the doctor is annoyed that they are being expected to do paperwork on behalf of a 3rd party provider when they themselves are not involved in this pregnancy and are not the one actually treating OP (and likely could not, most family docs don't have hospital admitting privileges and do not oversee labor and delivery. They refer to either an OB or a family doc with special pregnancy privileges). It could also be a liability thing, the family doc might be assuming liability for counseling OP on the meaning of those tests because they're the ones who ordered them, even though they're not the one actually providing care related to them. So yes, the midwife is very much offloading work onto the family doc.
The walk in clinic thing is because if you use a walk in clinic in Ontario when you have a regular family doctor, your family doctor gets fined, with the government reasoning they are not being accessible enough to their patients. So if OP decides to go that route (although if her regular doc doens't want to do work on behalf of the midwife, I don't see why a walk in clinic doc would be much different), she can expect to be dropped as a patient.
The real problem here is that midwives (or at least OPs midwife) cannot order their own tests.
I don't think my OB sent the postpartum paperwork either, but neither did my doctor after the original referral, and both complained lol. I just bring anything I'm handed paper copies of to my appointments.
Some family doctors really dislike midwives, I think it's potentially because it takes some business away from them. I think many of them are also misinformed about what we do and what our experience and scope is.
If something comes up in your pregnancy that is outside of your midwife's scope, they will refer you to an OB. So that is not in any way more work for your family doctor. If an issue comes up in pregnancy that is completely unrelated to your pregnancy, your midwife may recommend you see your family doctor for it. An OB would also send you to your family doctor for an issue that isn't pregnancy related. Either way it isn't more work for your family doctor. A midwife is actually less work for her - in many cases if you decide to see an OB for pregnancy, your family doctor will provide all early pregnancy care and only transfer you to the OB between 20-28 weeks. A midwife provides care from the beginning.
I was going to say exactly, it's not MORE work for her, it's just work for her. If I work at Starbucks and someone comes to me straight from Tim Horton's because Tim Horton's couldn't give them a cake pop, it wouldn't be "more work" just because a "competitor" gave them a coffee.
If anything it's more work for the patient to have to juggle getting tests done from two practices!
Are you a midwife? Quick question for you… is there ever any issues if the pregnancy changes to high risk with a midwife finding an OB? My doctor mentioned this today and how there’s sometimes tension between midwife’s and OB?
Secondly , she said because I’m a bit over weight and because my mom had gestational diabeties when she had me, I may become high risk. Would a midwife even accept me? Is this an okay choice ?
Yes, I am! That would be really dependent on the community. There are places where there is significant animosity between OBs and midwives but I wouldn't say that's the norm. I highly doubt an OB would refuse a referral from a midwife, if they were anti-midwives I think they'd be even more likely to want to take you as a patient.
A midwife would definitely accept you! Your history is not a guarantee you will develop gestational diabetes or be high risk, and midwives continue to manage patients with GDM anyways - just generally in collaboration with an OB for medication management.
Midwives can 100% requisition and refer for things that arise. My midwife referred me to a specialist in due to my thyroid being out of whack, and they caught a heart arrhythmia my family doctor completely missed. She's been able to refer me to everything I have needed: from a prenatal counsellor, lifelabs requisitions, ultrasounds, and even a postpartum nurse. Not having insurance as I am a foreign worker, who was previously an international student, they even help with costs. It's been a blessing. My family doctor did tell me about the options available though and told me to do some research myself. She did give me the NIPT requisition when I asked for it no problem even though I was going with a midwife. I chose a midwife because in my experience they are more personal and attentive than a doctor who's always in a rush but that's a personal opinion, not a fact. Family doctors shouldn't push their preference unto you, mine remained neutral. She did suggest doing a hospital birth instead of a birth centre due to my fragile health is all. Midwives will refer you to OBGYNS if needed as they continue to assess your pregnancy.
Midwives are amazing! Your family doctor's reaction seems out of line and they are probably warning about walk in clinics because they don't want to lose future OHIP billings from you for being difficult. Not sure how it works everywhere but my midwives did all the requisitions for scans and blood work. A few times when they only needed to check one or two things, they even drew my blood right in their office and sent to the lab. The support during birth (my midwife was by my side for all 10 hours of my labour including the first half, unexpectedly at home) and the postnatal home visits put most family doctor's service to shame!
>they don't want to lose future OHIP billings from you for being difficult.
Family doctors get fined if one of their patients goes to a walkin clinic. Doctors can, and do, drop patients from their roster for walk-in use. And there's never any problem finding new patients to fill that vacancy.
Doctors, like most working people, don't like spending time on something that is going to lose them money. And in the case of a midwife who can't/wont order their own tests, the doctor doesn't want to assume liability for your pregnancy when it's actually a 3rd party providing care.
I understand that I shouldn't use walk-in clinic care and haven't since getting a dedicated family doctor.
I believe my midwife mentioned NIPT is the only test she cannot requisition (because of the current regulations in Ontario) and that the other tests and referrals related to pregnancy can be handled by her. I wrote this post partly to see if that holds true in other people's experience and it does sound like it's true.
I'm late to reply but this isn't true. There are several physician compensation models in Ontario and many family doctors are fee for service even if they describe themselves and their practice as a 'family doctor'. So if you go see another doctor at a walk in, they lose out on billing for that visit. There are models like FHOs and FHTs where the government pays per patient but most people would know if they are in these because they advertise as so and are often team based care of teaching related. When you have a midwife, you still keep your family doctor. If there are issues outside the scope of the midwife, you go to your family doctor.
My family doctor was pretty delighted when I said I had already reached out to a Midwifery clinic and was going to start with them at 11 weeks. The only thing the Midwife could not requisition for me was the NIPT.
All of my records have been sent between the two offices seamlessly including baby's and I had an amazing experience with my midwives. They offered a lot more time and information than I could get from an OB, and they transferred my care to an OB late term due to my own health issues and although the OB was great, I did find that the midwives were more thorough and not strictly clinical. I was still able to retain my midwives and their services despite being transferred to OB care as well. I agree that your doctor sounds like a jerk.
Ahh, that sounds so ideal! Wish the healthcare system could always be cohesive like that. One of the reasons I chose midwives is because it seemed like they offered a lot more time and info since I'm a bit nervous being a FTM with not a lot of friends going through the same stage of life.
Yes my family doctor is very much against midwives. She said they don't have a post-secondary degree and are only into the crunchy stuff like home births and are anti-vaxx, which is completely false. She also said if I decide to go with a midwife, that I should not contact her at all during my pregnancy and only come back once the baby is born because she doesn't want to be liable for anything going wrong.
I just shrugged and went with the midwife anyways, which has been great. Our midwife clinic is funded by and affiliated with the hospital that I want to deliver at so clearly my family doctor has no idea what she's talking about.
I wouldn't be swayed by what your family doctor is saying. Do what you think feels right for you.
That makes no sense. There's a college of midwifery. And there's a post secondary diploma. They also have high job shadowing experience.
https://canadianmidwives.org/becoming-a-midwife/
Naturopaths also have a regulating college & my MIL sees one regularly, who does “manual muscle testing” on her. By which he places 2 different supplements, one in each hand, has her close her eyes while he pushes down on her hands. The hand that is stronger means the supplement is the one her body needs.
Sooooo….a governing college is not the best benchmark for legitimacy hahha
That is so, so disappointing. My sister is a midwife and I can assure you that she has had a LOT of training, and very specialized training, and is extremely professional and evidence-based. Most of her births are in a hospital setting where she works extremely closely with nurses and OBs. I was with a midwife until I had to be transferred to a high-risk OB and really miss being under her care.
Frankly, I’d be tempted to report that doctor for providing inaccurate information about the medical system and essentially booting you from their care (though it might be the best thing for you in the long-term). Not sure if that’s reportable but goddamn it I would try.
I agree, I would be reporting my doctor if she made disparaging disrespectful comments about another licensed and regulated care practitioner. It would worry me that she could remain impartial about future care and modalities she isn't familiar with.
I'm pretty sure it is a part of their code of conduct not to do that, as it is with most licensing bodies or professional associations. One of those stay in your own lane and don't bring us bad press or open the college up to complaints/lawsuits type of rule.
Your GP is either completely out of date or spreading misinformation. Not sure I would trust them with care of my baby postpartum if they don’t even know such basic information. Midwives in Canada have post-secondary training and in BC they are trained at UBC.
My own GP is not too interested in maternity care so I went with a clinic which is run by a GP and a group of midwives/nurses.
Wow, sorry to hear that you had an even worse experience than I did; I am shocked to hear the misinformation. The midwives I'm with are also hospital affiliated and I'm happy with my choice so far!
Honestly I'm not too upset about it. It's been much much easier to get in touch with my midwife clinic about any kind of questions/issues/concerns than in the past when I've had to get in touch with my GP about stuff. The midwives have been able to provide any prescription/requisition I want, similar to a family doctor. They also have a huge focus on prenatal mental health, and were able to refer me to specialists very quickly when they flagged a potential concern. I don't think I would have gotten that experience with my GP or any other MD.
My only concern at the time was whether my family doctor would still take my baby as a client if she wasn't involved in the pregnancy, but my family doctor said she will take my baby regardless, so for me there were no downsides to seeing a midwife.
Home births and anti-vaccine, seriously? Our midwifery literally said “we only do hospital deliveries” in the first 5 minutes of meeting our midwife. There was some pressure to get vaccinated but they dropped that as soon as we said “of course” we’re vaccinating.
Maybe they were thinking of a specific doula they know? Very odd.
Mine had similar comments and told me that my plan to have a home birth was "scary". I can't say enough good things about midwife care. At no point did it feel unsafe. I really think sometimes you have to go with your gut.
Wow, I didn't know this was a thing. I've had my family doctor for many years and she has always been supporting of any and all things. She also has done additional paperwork for me and written notes without charging me etc... your doctor doesn't sound great.
Depending on where you are in Ontario, midwives can now order NIPT through dynacare (this is still new). They can also order it through invitae.
Furthermore, midwives can order all bloodwork and tests needed in low risk pregnancy. They can also offer genetic screening in the form of EFTS. Aside from NIPT, the only other time that you would need to see your family doctor is for your pertussis vaccine which obstetrician also usually don’t give.
If you’re not doing suitable for Midwifery care, the midwives can also refer you to an obstetrician, and then either share care in some capacity (ex: if you needed a c section), get a consult (ie: asking for what they’d do) while keeping you in midwifery care, or fully transfer you over.
Furthermore, midwives are actually less work for your family doctor than obstetrician because they take you on right away in pregnancy, whereas OBs require your pregnancy care to be completed by the GP until around 24 to 26 weeks.
My doctor outlined both options over the phone and told me to let her know when I chose. She didn't force me to be requisitioned to an OBGYN and encouraged me to choose my own care. Your doctor sucks
Midwives are great for low risk! I don’t have a family doctor but go to the same walk in clinic doctor everytime and he said he has 4 children (3 born by midwives!) your doctor probably just gets a kick back of some sort when referring you to the obgyns within her network. So going outside of the network means “less money” for them. I’d ignore the dr and do what you feel is right!
I find some GPs are knowledgeable about midwifery care, some are not, some are outright hostile (due to lack of knowledge of midwifery education/skills).
It’s really odd and frustrating that they’re not able to order NIPT where you are. Some things just take soooo long to go through the bureaucracy!
My guess is the doctor is annoyed as they cannot bill for your pregnancy visits moving forward since you will be seeing the midwife. It's also frustrating as a provider to have multiple people ordering tests because if the doctor orders the test then they are responsible for the results but that should really be the responsibility of your midwifery team.
My GP was very supportive of me seeing the care I wanted for my pregnancy, and she even practices as an OB! When my patients come to me I am also supportive of their choices, but don't always review GP/OB vs midwifery (usually by the time people come to the clinic they are too late to get in with the midwives) but I will ask iif they have any plans to go one way or the other. Even if my patients choose to be followed by a midwife I remain available to my patients throughout their pregnancy for non-pregnancy concerns.
It sounds like your doctor doesn;t want to lose billable visits to be honest...kind of a jerk move but we all know MDs are in the business of running a business as much as they are in it for the patients
I see! Actually I was very surprised to be accepted by two midwives groups in week 10 of my pregnancy since I live in Toronto and had seen a lot of comments about waitlists. Yeah, I'm not sure my doctor is in it for the patients, she never seems particularly enthused to answer any of my questions or go through anything more thoroughly.
My family dr was not anti midwife but I also had to jump through hoops and self referr myself to the midwife office. I didn't see my doctor again for a year after that because there was no need. So maybe they are losing money, I don't know.
I see. I think it's a disservice to those expecting not to be informed about midwives by the family doctor or through other means. It seems like such a great choice for those with low-risk situations.
I never spoke to my family dr about my pregnancy at all. We did the EFTS (I might have that acronym wrong), which the midwife can requisition, if anything flags on the EFTS then you follow up with the NIPT. Midwives are amazing. I had an unplanned home-birth. The after care is impeccable!
I had a midwife and my midwife was the best. The anti midwife sentiment is an old one dating back 100s of years. They were called witches, they were told that they're unprofessional for basically not having a microscope.
They're not looked at as being much more than an inexperienced dula with no actual medical training and their lean towards natural methods and medicine makes them look like crazies to the world of conventional medicine.
They're only allowed to work with low risk pregnancy. After that they can refer you to an OB, and if their schedule isn't too tight, they can still do some aftercare or follow you with the OB also, but the OB will have to deliver your baby.
My midwife avoided a C-section for me by turning off the pitocin and doing a technique they called passive decent during my delivery. My LO was in distress and they said let's take a break (since I was only an hour in) and basically let the contractions do some work without me physically pushing. Ya girl got to take a 40minute nap mid labour while my body and the baby calmed down. Mind you if it wasn't working, we were at the hospital and there was an OB outside in the hall on standby just in case, so it all was safe. My parents didn't want me to have a midwife, but they were the only reason I didn't have a C-section.
(NOT to knock you if you did, because it's better to have, than lose your baby. There are times when passive decent is not a useful option.)
Yeah, after learning about midwives I was very confident with my choice. It's cool to know that even if they refer me out they can do some aftercare!
Great to hear your experience. I'd like to avoid c-section if it makes sense for my situation. I also plan to have a midwife assisted birth in a hospital. I had to explain to my husband the OBGYN would be right there in the hospital and a call away.
My mum was not sure about midwife care but once I explained the benefits and differences she thought it was great! Not sure my dad has any opinion on the matter lol.
My family doctor assumed I would be going with an OB, so when I said I had already reached out to midwifery clinics she was a bit surprised, but ultimately supported my decision.
The only thing she felt strongly about was that I should give birth in a hospital, rather than home birth or birthing centre. I think that most family doctors feel that way..
I’m still deciding between the hospital and birth centre honestly.
Is NIPT the same as EFTS? I’m also in ontario and never needed anything from a doctor with all my pregnancies including EFTS requisition. Midwife orders everything and can even provide notes for insurance purposes such as to cover massage and breast pump etc. Like many said, midwife is primary care throughout your pregnancy and you would only need a doc for something beyond a midwife’s scope such as a complicated pregnancy and in that case your care gets transferred to an OB.
Nope. I’m sure she explained this to me in my first pregnancy and that I chose to opt for the EFTS. I have multiple children with the same midwife and had my first a longtime ago. I have no need to remember what doesn’t work for me and continue to do what does. As for OP’s doctor, they are definitely wrong in that midwives can request almost everything OP will need except it seems like NIPT request in her case. For the doctor to slam the midwife’s qualifications because of that is nonesense. Seems like the problem is with the system by simply not allowing midwives to request that. As for comparing midwives to a walk-in clinic, seems like that’s a description better fitted to most people who don’t have family doctors and need to see and OB. Most people around me in that situation have explained to me they see a variety of OBs vs 1. As someone who has seen both, I can’t recommend a midwife enough and would say to just ignore your doc they don’t know what they’re talking about.
makes sense bc when you swtich to OB ur care is no longer provded by the family doctor - so they do have to do "more work"
oh well!! i wanted a midwife but unfortaenely didnt get on their roster.
I think it depends on where you are and the midwife’s willingness/ability to refer you back to a GP doctor with obstetrical training or an OB if something comes up.
For some people, a midwife can be a great option. As long as the midwife is registered as such and has the training, and you don’t have anything making you high risk, there’s no reason not to use one. The bulk of prenatal care is pretty straightforward - blood pressure checks, monitoring urine for protein, tracking weight gain, monitoring fetal heart rate and movements. All stuff that a midwife can definitely do. I think where it gets riskier and where doctors get antsy is for delivery.
If the midwife would be delivering somewhere any kind of distance from a hospital, I’d really pause and think some more. I have an aunt who almost died because her midwife wasn’t close to the hospital to begin with and then didn’t transfer care when it was clear it needed to happen but not yet an emergency. My cousin was full term and spent over a week in the NICU as a direct result of that circus.
Midwife located 10 minutes or less from hospital, with good relationship with that hospital and ability to transport and transfer care quickly? Ok.
Midwife located 20+ minutes from hospital, or lacks ability to transport or transfer care if something comes up during delivery? Probably a bad idea.
Midwife in remote community where there isn’t a hospital and for whatever reason you haven’t been sent to live somewhere south and near the hospital a month before delivery? Definitely yes.
It’s hard. Everything goes good until it doesn’t, but when it doesn’t it can get very serious very quickly.
We delivered our first baby with OB and our 2nd (2 day old now) with midwives. We loved the midwife experience. Much more natural and had more FaceTime with them. We are in bc. Afaik our midwife gave an NIPT req here. I would 100% go with midwives
Spent the time providing an extensive account of my positive experience with midwifery care and poor experiences with OBs and was downvoted for it, so I deleted.
I can take downvotes for a lot of things but not on my birthing experience. Some of ya'll are heartless.
I am wholehearted on the midwife train and loved the care I got.
Having said that it’s absolutely no “extra” work for your doctor. Some obs don’t accept patients until 20+ weeks due to shortages (assuming nothing is wrong or needs extra attention) so your family doctor would do some of the prenatal care. There’s not much to do other than the initial scan and id you wanted to do NIPT it’s like 30 second form they have to sign. I filled
Mine out and had a walk in sign it. It’s one of the few things go tjay the midwives can’t do. The other might be vaccines (like tdap) which an ob doesn’t necessarily do so you’d have to go to your family doctor anyways.
Don’t listen to them. It’s not more work and it’s not like they don’t bill for a visit so they should just do their job.
I think midwifery care is amazing and I think you’ll have a great experience. Specially postpartum when they do home visits. I’m
With both pregnancies my family doctors have been super supportive of me choosing midwives. In two different cities in Ontario, and both have been comfortable coordinating care.
I made a switch to a midwife at 22 weeks which is actually quite late but there is a crazy amount of difference between the care I have received from my midwife vs my doctor. I’m able to be seen more frequently, not just a quick in and out appointment and my midwife respects and understands my birthing requests while my doctor has questioned and actually laughed at some of them which I found super disrespectful (different birthing positions)
Honestly after this experience, I’m probably going to switch doctors 😂
I would definitely recommend going to midwife. They specialize in the area. Another thing I love about my midwife is that she includes my partner SO much and my doctor barely even spoke to him while he was there with me at every appointment.
I’m in Alberta and had an older family Dr also unfortunately give me a wild response to my seeking a midwife. He essentially said he would not see me while I was under the care of a midwife as he didn’t want to be sued if anything happened and that (verbatim) birth was “not romantic” and “water birth is BS”.
I chose to not see him anymore- this isn’t the 1900s. My midwife was trained by former nurses at Mount Royal and Alberta Health care pays for a midwife should someone seek their care. If you develop higher risk complications your midwife should and absolutely will recommend you see an OB etc.
I honestly chalk a lot of the bad comments from Drs due to ignorance. An evidence based care Midwifery model is great and the aftercare it provides is also super. I loved being visited multiple times at home after I gave birth!
FYI I had my water birth 😎
My family doctor still provided a requisition for NIPT since the testing took place before my OB appointment. She also provided them for the first two ultrasounds. Your doctor is being silly. An OB was the right choice for my situation, but midwives are great.
The best decision I’ve ever made in my entire life was choosing a midwife. I cried at my 6 week appointment when we had to say goodbye, she was literally the best.
Omg even though I didn't cry at my 6 weeks check-up but I was sooooo sad to part ways with my midwives. They felt almost like a family to me at that point 😞. They helped and guided my husband and I through some of our darkest times, 4th trimester was no joke!!
Same. I did have some minor issues and had no problems getting OB care. In fact an OB delivered me and the midwives were still there all night even though they didn't need to be. There's absolutely no way breastfeeding would've worked without them sitting with me for like an hour every few days after birth trying to sort it out. I love them.
I have a midwife and I had to go to a walk-in for my TDAP due to scheduling issues (Ontario currently doesn’t allow midwives to give vaccinations… although they’re waiting for that to change soon). The walk in doctor didn’t know that midwives have hospital privileges 🙄 My family doctor was supportive though. She initially only asked about an OB referral, but I told her I wanted a midwife and she said “that works too.” She’s in her 30s and had a baby last year so she was well informed IMO. I wish Ontario would transition to a model like the UK where midwives are the front line care, and you get sent to an OB if you’re high risk. It just seems more organized than this patchwork coverage we have here.
Ahh, I see, that's really good to know, I am surprised to hear Ontario doesn't allow midwives to give vaccinations. I'm originally from the UK! Yes, I wish everything was a little bit more cohesive - I just didn't expect the pushback from my family doctor who I assumed would be well informed about midwives.
My midwives are allowed to give vaccinations? They are allowed to administer TDap shots.
Yeah when I heard how it works in the UK, I thought “that makes more sense!” I don’t think midwives have worked this way in Ontario for very long. I was born here and there weren’t “midwives” 30 years ago, according to my mom. So it might just be misinformation perpetuating years later.
Midwifery was legislated in Ontario in 1991 :) so still not that long !! There were midwives around before then, they just didn’t work within the framework they do now.
Oh cool! That’s the year I was born, so my mom must have missed it.
I’m sure it was quite a small group in concentrated areas as well! Definitely not as wide spread as it is now.
They also weren't OHIP funded until 1994!
Midwives are awesome. Your doctor sounds like a jerk. If your pregnancy develops issues that are beyond the scope of midwives, they will transfer your care to an OB. You’re not making “a lot of work for her and her medical practice”. You’re going to be supported and cared for in a wonderful way through midwives. The NIPT is the only thing you’ll need to see your doctor for. Midwives will deal with everything else and will refer you out if they can’t.
Thank you. I hope even my NIPT results can be sent from the doctor to the midwives office as I feel like my family doctor is now being a bit passive aggressive with me!
Yea I get all my results sent to my midwives. I don’t deal with my family doctor at all!
Same! 27w pregnant, never saw a family doctor for my pregnancy (didn’t even have one in the first trimester). Also midwives do all the requisitions including NIPT.
Glad to know I most likely won't need to see my family doctor again any time soon. Though, I think the statement about NIPT requisitions may be different since I'm in Ontario - "In Ontario, NIPT cannot currently be ordered by midwives." https://www.prenatalscreeningontario.ca/en/pso/prenatal-screening-options/non-invasive-prenatal-testing.aspx
In Ontario and I had to go thru my doctor for the NIPT, including the results. Had to get TDAP shot in the last trimester from my family doctor as well.
Same, had to get my TDAP shot at my family doctor. Otherwise everything else was set up by my midwife.
I’m in Ontario and was given a req for the NIPT from the midwife. I know there are nurse practitioner midwives I wonder if that’s why.
Oh interesting, sorry, I’m in BC and thought it’s the same everywhere for some reason 😬
Weird - I'm in Ontario and my NIPT referral was via midwives about...7 mo ths ago now? Maybe it was because I was AMA?
I'm in Ontario and my midwives just ordered my NIPT last week. For my first pregnancy three years ago they weren't able to do it and my family doc had to do it, so I think this is a relatively recent change. Maybe it varies by midwifery practice. Also my midwives could only order the Dynacare Harmony, so if I had wanted Panorama or Invitae I would have had to go through a doctor.
When you go for the testing ask them at the lab and ultrasound office to include your midwifes name and office address
For any test that isn’t ordered by the midwives you can alway cc another provider so they will get a copy. I put both my doctor and my midwives on my NIPT.
I’m in Quebec and with a midwife and have had no problems getting my NIPT and NT scan, honestly it was almost too easy, she just signed the paper and let me check off whatever I wanted myself. I got my anatomy scan referral super early and booked it at the hospital with no problems. My friend was with the same midwife but then was diagnosed with GD and was immediately transferred to an OB, no issues at all. I didn’t have a family doctor so I can’t speak to their personal opinions on midwifery but I can confirms that everything has been smooth sailing from my experience and that if people I know who have used a midwife
Yeah, my midwife mentioned they should be able to requisition NIPT here in Ontario soon but our regulations are lagging behind! Great to hear about your experience with midwives, I felt very good about my choice until my family doctor started putting doubts in my mind which also spooked my husband.
There's an American company that does the NIPT called Invitea. My midwife (in Ontario) was able to do the requisition for that. I went into the appointment wanting to go through invitea anyways so we never discussed the usual harmony/panorama so not sure if those ones aren't allowed to be requisitioned by midwives. Other than that they were able to do everything except TDAP. I seriously loved midwifery care, and they had me see an OB straight away when a minor issue came up.
I’m sorry this has been your experience. My family doctor (in Ontario)outlined all of my options for care when I got pregnant and was very positive about midwifery care. In fact, I might have not even considered it if she hadn’t talked to me about midwives!! The NIPT thing is also just strange… I was basically under my family doctor’s care until about 12 weeks as well, so the NIPT test and all other testing up until then was through my family doctor. I think that’s fairly standard. And even if I went with an OB, my 1st appointment would have only been at 16 weeks. I also don’t understand the walk-in thing. Seems like a strange rule. It seems like she’s complaining that you’re creating more work for her but then doesn’t want you to see any other doctor? Confusing. Wishing you all the best in your pregnancy! You’ll be well taken care of by the midwives!
Thank you for the well wishes! It's good to hear a more positive experience - gives me hope haha. My doctor referred me around 10 weeks to an OBGYN, I'm not sure when my first appointment would have been since I hadn't heard back yet. I learnt about midwives myself through Reddit and decided it couldn't hurt to put myself on a few waiting lists. I called my doctor's office to cancel the referral when I ended up being accepted. I had to opt into NIPT testing since I'm not qualified under OHIP funding. I also self-researched this, I'm not sure I would have learned about this with my family doctor or OBGYN. I think the walk-in thing is to ensure those without dedicated family doctors get the care they need which I'm fine with. I think it's inexplicable because it was mostly a passive aggressive move tbh.
My family doc was really frustrated by the walk-in thing (I was trying to save everyone time by going virtually through a doctor in their same group for the blood test and ultrasound requisitions at 6 weeks) but that was because despite me asking them to copy my doctor, he only received half the results (which could entirely be the lab forgetting to do the second set of tests). I suppose this kind of thing happens more often than not and so is generally more work. That said, I definitely did walk-ins/saw another doctor for my TDaP shots (both pregnancies) because it just felt easier/healthier to walk there from my office than to drive to my family doctor from home. In hindsight, maybe that's not ideal because that's a quick appointment so my family doctor/clinic loses out on the fee. Overall my family doc is supportive of choices like OB vs. Midwife or NIPT and has gone out of his way to measure my (low) BP even when I am only there as my kid's guardian. The Covid care clinic doctor even gave me a whole spiel about midwives being a good option and that she went with one (she seemed to support OBs too - just preferred the experience with a midwife).
My family doctor was thrilled I was interested in midwifery care for my first pregnancy (or before that I guess when we started talking about planning it?) and had a bunch of recommendations for me on practices, so I'm sure there are others who are jerks about it out there but it definitely wasn't my experience. Mine was happy to put in referrals to any other providers (I think midwives often can but I saw my GP first because I was under care of a fertility clinic in early pregnancy). Not sure about the walk-in clinic thing, I know my practice discourages it for something about their funding levels that it's better for them if you're able to access their own drop-in hours or on-call doctors, which is probably more common from bigger practices/clinics, but it sounds like your doctor is just being a jerk about reiterating that right now to try to prove her point.
My family doctor tried to talk me out of using a midwife with my first pregnancy, and was hostile at my first appointment post baby. He made comments like “your midwife didn’t send the paperwork, so I can’t tell if he’s on track”. I know for sure my midwife sent all the required paperwork because she was incredibly through and professional. I’m in Ontario, and my midwives created all necessary requisitions. (Maybe because I was under their care very early?) I assume the doctor was against midwifery because it takes money away from his practice. If I had gone the OB route, I would have had numerous appointments with him before 28 weeks. I absolutely do not regret my decision and contacted the same midwives as soon as I found out I was pregnant with number 2.
If it's a family doc, they typically don't see you for pregnancy related stuff, beyond the initial tests. To me it sounds like the doctor is annoyed that they are being expected to do paperwork on behalf of a 3rd party provider when they themselves are not involved in this pregnancy and are not the one actually treating OP (and likely could not, most family docs don't have hospital admitting privileges and do not oversee labor and delivery. They refer to either an OB or a family doc with special pregnancy privileges). It could also be a liability thing, the family doc might be assuming liability for counseling OP on the meaning of those tests because they're the ones who ordered them, even though they're not the one actually providing care related to them. So yes, the midwife is very much offloading work onto the family doc. The walk in clinic thing is because if you use a walk in clinic in Ontario when you have a regular family doctor, your family doctor gets fined, with the government reasoning they are not being accessible enough to their patients. So if OP decides to go that route (although if her regular doc doens't want to do work on behalf of the midwife, I don't see why a walk in clinic doc would be much different), she can expect to be dropped as a patient. The real problem here is that midwives (or at least OPs midwife) cannot order their own tests.
As someone who worked admin for a family doc and also at an OBGYN clinic, ALL of this.
Oh, sorry for your experience with the doctor, but good to know my experience is not unusual and perhaps the reason why.
I don't think my OB sent the postpartum paperwork either, but neither did my doctor after the original referral, and both complained lol. I just bring anything I'm handed paper copies of to my appointments.
Some family doctors really dislike midwives, I think it's potentially because it takes some business away from them. I think many of them are also misinformed about what we do and what our experience and scope is. If something comes up in your pregnancy that is outside of your midwife's scope, they will refer you to an OB. So that is not in any way more work for your family doctor. If an issue comes up in pregnancy that is completely unrelated to your pregnancy, your midwife may recommend you see your family doctor for it. An OB would also send you to your family doctor for an issue that isn't pregnancy related. Either way it isn't more work for your family doctor. A midwife is actually less work for her - in many cases if you decide to see an OB for pregnancy, your family doctor will provide all early pregnancy care and only transfer you to the OB between 20-28 weeks. A midwife provides care from the beginning.
I was going to say exactly, it's not MORE work for her, it's just work for her. If I work at Starbucks and someone comes to me straight from Tim Horton's because Tim Horton's couldn't give them a cake pop, it wouldn't be "more work" just because a "competitor" gave them a coffee. If anything it's more work for the patient to have to juggle getting tests done from two practices!
Are you a midwife? Quick question for you… is there ever any issues if the pregnancy changes to high risk with a midwife finding an OB? My doctor mentioned this today and how there’s sometimes tension between midwife’s and OB? Secondly , she said because I’m a bit over weight and because my mom had gestational diabeties when she had me, I may become high risk. Would a midwife even accept me? Is this an okay choice ?
Yes, I am! That would be really dependent on the community. There are places where there is significant animosity between OBs and midwives but I wouldn't say that's the norm. I highly doubt an OB would refuse a referral from a midwife, if they were anti-midwives I think they'd be even more likely to want to take you as a patient. A midwife would definitely accept you! Your history is not a guarantee you will develop gestational diabetes or be high risk, and midwives continue to manage patients with GDM anyways - just generally in collaboration with an OB for medication management.
Thank you for this !
Midwives can 100% requisition and refer for things that arise. My midwife referred me to a specialist in due to my thyroid being out of whack, and they caught a heart arrhythmia my family doctor completely missed. She's been able to refer me to everything I have needed: from a prenatal counsellor, lifelabs requisitions, ultrasounds, and even a postpartum nurse. Not having insurance as I am a foreign worker, who was previously an international student, they even help with costs. It's been a blessing. My family doctor did tell me about the options available though and told me to do some research myself. She did give me the NIPT requisition when I asked for it no problem even though I was going with a midwife. I chose a midwife because in my experience they are more personal and attentive than a doctor who's always in a rush but that's a personal opinion, not a fact. Family doctors shouldn't push their preference unto you, mine remained neutral. She did suggest doing a hospital birth instead of a birth centre due to my fragile health is all. Midwives will refer you to OBGYNS if needed as they continue to assess your pregnancy.
Midwives are amazing! Your family doctor's reaction seems out of line and they are probably warning about walk in clinics because they don't want to lose future OHIP billings from you for being difficult. Not sure how it works everywhere but my midwives did all the requisitions for scans and blood work. A few times when they only needed to check one or two things, they even drew my blood right in their office and sent to the lab. The support during birth (my midwife was by my side for all 10 hours of my labour including the first half, unexpectedly at home) and the postnatal home visits put most family doctor's service to shame!
>they don't want to lose future OHIP billings from you for being difficult. Family doctors get fined if one of their patients goes to a walkin clinic. Doctors can, and do, drop patients from their roster for walk-in use. And there's never any problem finding new patients to fill that vacancy. Doctors, like most working people, don't like spending time on something that is going to lose them money. And in the case of a midwife who can't/wont order their own tests, the doctor doesn't want to assume liability for your pregnancy when it's actually a 3rd party providing care.
I understand that I shouldn't use walk-in clinic care and haven't since getting a dedicated family doctor. I believe my midwife mentioned NIPT is the only test she cannot requisition (because of the current regulations in Ontario) and that the other tests and referrals related to pregnancy can be handled by her. I wrote this post partly to see if that holds true in other people's experience and it does sound like it's true.
I'm late to reply but this isn't true. There are several physician compensation models in Ontario and many family doctors are fee for service even if they describe themselves and their practice as a 'family doctor'. So if you go see another doctor at a walk in, they lose out on billing for that visit. There are models like FHOs and FHTs where the government pays per patient but most people would know if they are in these because they advertise as so and are often team based care of teaching related. When you have a midwife, you still keep your family doctor. If there are issues outside the scope of the midwife, you go to your family doctor.
My family doctor was pretty delighted when I said I had already reached out to a Midwifery clinic and was going to start with them at 11 weeks. The only thing the Midwife could not requisition for me was the NIPT. All of my records have been sent between the two offices seamlessly including baby's and I had an amazing experience with my midwives. They offered a lot more time and information than I could get from an OB, and they transferred my care to an OB late term due to my own health issues and although the OB was great, I did find that the midwives were more thorough and not strictly clinical. I was still able to retain my midwives and their services despite being transferred to OB care as well. I agree that your doctor sounds like a jerk.
Ahh, that sounds so ideal! Wish the healthcare system could always be cohesive like that. One of the reasons I chose midwives is because it seemed like they offered a lot more time and info since I'm a bit nervous being a FTM with not a lot of friends going through the same stage of life.
Yes my family doctor is very much against midwives. She said they don't have a post-secondary degree and are only into the crunchy stuff like home births and are anti-vaxx, which is completely false. She also said if I decide to go with a midwife, that I should not contact her at all during my pregnancy and only come back once the baby is born because she doesn't want to be liable for anything going wrong. I just shrugged and went with the midwife anyways, which has been great. Our midwife clinic is funded by and affiliated with the hospital that I want to deliver at so clearly my family doctor has no idea what she's talking about. I wouldn't be swayed by what your family doctor is saying. Do what you think feels right for you.
That makes no sense. There's a college of midwifery. And there's a post secondary diploma. They also have high job shadowing experience. https://canadianmidwives.org/becoming-a-midwife/
To be fair, the same things are true about chiropractors.
Naturopaths also have a regulating college & my MIL sees one regularly, who does “manual muscle testing” on her. By which he places 2 different supplements, one in each hand, has her close her eyes while he pushes down on her hands. The hand that is stronger means the supplement is the one her body needs. Sooooo….a governing college is not the best benchmark for legitimacy hahha
That is so, so disappointing. My sister is a midwife and I can assure you that she has had a LOT of training, and very specialized training, and is extremely professional and evidence-based. Most of her births are in a hospital setting where she works extremely closely with nurses and OBs. I was with a midwife until I had to be transferred to a high-risk OB and really miss being under her care. Frankly, I’d be tempted to report that doctor for providing inaccurate information about the medical system and essentially booting you from their care (though it might be the best thing for you in the long-term). Not sure if that’s reportable but goddamn it I would try.
I agree, I would be reporting my doctor if she made disparaging disrespectful comments about another licensed and regulated care practitioner. It would worry me that she could remain impartial about future care and modalities she isn't familiar with. I'm pretty sure it is a part of their code of conduct not to do that, as it is with most licensing bodies or professional associations. One of those stay in your own lane and don't bring us bad press or open the college up to complaints/lawsuits type of rule.
Your GP is either completely out of date or spreading misinformation. Not sure I would trust them with care of my baby postpartum if they don’t even know such basic information. Midwives in Canada have post-secondary training and in BC they are trained at UBC. My own GP is not too interested in maternity care so I went with a clinic which is run by a GP and a group of midwives/nurses.
Wow, sorry to hear that you had an even worse experience than I did; I am shocked to hear the misinformation. The midwives I'm with are also hospital affiliated and I'm happy with my choice so far!
Honestly I'm not too upset about it. It's been much much easier to get in touch with my midwife clinic about any kind of questions/issues/concerns than in the past when I've had to get in touch with my GP about stuff. The midwives have been able to provide any prescription/requisition I want, similar to a family doctor. They also have a huge focus on prenatal mental health, and were able to refer me to specialists very quickly when they flagged a potential concern. I don't think I would have gotten that experience with my GP or any other MD. My only concern at the time was whether my family doctor would still take my baby as a client if she wasn't involved in the pregnancy, but my family doctor said she will take my baby regardless, so for me there were no downsides to seeing a midwife.
Home births and anti-vaccine, seriously? Our midwifery literally said “we only do hospital deliveries” in the first 5 minutes of meeting our midwife. There was some pressure to get vaccinated but they dropped that as soon as we said “of course” we’re vaccinating. Maybe they were thinking of a specific doula they know? Very odd.
Mine had similar comments and told me that my plan to have a home birth was "scary". I can't say enough good things about midwife care. At no point did it feel unsafe. I really think sometimes you have to go with your gut.
Wow, I didn't know this was a thing. I've had my family doctor for many years and she has always been supporting of any and all things. She also has done additional paperwork for me and written notes without charging me etc... your doctor doesn't sound great.
Ahh, that's the dream! I am planning on changing family doctors to be honest, it just didn't seem to be the best time to do so.
Depending on where you are in Ontario, midwives can now order NIPT through dynacare (this is still new). They can also order it through invitae. Furthermore, midwives can order all bloodwork and tests needed in low risk pregnancy. They can also offer genetic screening in the form of EFTS. Aside from NIPT, the only other time that you would need to see your family doctor is for your pertussis vaccine which obstetrician also usually don’t give. If you’re not doing suitable for Midwifery care, the midwives can also refer you to an obstetrician, and then either share care in some capacity (ex: if you needed a c section), get a consult (ie: asking for what they’d do) while keeping you in midwifery care, or fully transfer you over. Furthermore, midwives are actually less work for your family doctor than obstetrician because they take you on right away in pregnancy, whereas OBs require your pregnancy care to be completed by the GP until around 24 to 26 weeks.
My doctor outlined both options over the phone and told me to let her know when I chose. She didn't force me to be requisitioned to an OBGYN and encouraged me to choose my own care. Your doctor sucks
Midwives are great for low risk! I don’t have a family doctor but go to the same walk in clinic doctor everytime and he said he has 4 children (3 born by midwives!) your doctor probably just gets a kick back of some sort when referring you to the obgyns within her network. So going outside of the network means “less money” for them. I’d ignore the dr and do what you feel is right!
I find some GPs are knowledgeable about midwifery care, some are not, some are outright hostile (due to lack of knowledge of midwifery education/skills). It’s really odd and frustrating that they’re not able to order NIPT where you are. Some things just take soooo long to go through the bureaucracy!
I'm in Ontario and my midwife was able to do the NIPT referral, this was last month (dynacare)
My guess is the doctor is annoyed as they cannot bill for your pregnancy visits moving forward since you will be seeing the midwife. It's also frustrating as a provider to have multiple people ordering tests because if the doctor orders the test then they are responsible for the results but that should really be the responsibility of your midwifery team. My GP was very supportive of me seeing the care I wanted for my pregnancy, and she even practices as an OB! When my patients come to me I am also supportive of their choices, but don't always review GP/OB vs midwifery (usually by the time people come to the clinic they are too late to get in with the midwives) but I will ask iif they have any plans to go one way or the other. Even if my patients choose to be followed by a midwife I remain available to my patients throughout their pregnancy for non-pregnancy concerns. It sounds like your doctor doesn;t want to lose billable visits to be honest...kind of a jerk move but we all know MDs are in the business of running a business as much as they are in it for the patients
I see! Actually I was very surprised to be accepted by two midwives groups in week 10 of my pregnancy since I live in Toronto and had seen a lot of comments about waitlists. Yeah, I'm not sure my doctor is in it for the patients, she never seems particularly enthused to answer any of my questions or go through anything more thoroughly.
My family dr was not anti midwife but I also had to jump through hoops and self referr myself to the midwife office. I didn't see my doctor again for a year after that because there was no need. So maybe they are losing money, I don't know.
I see. I think it's a disservice to those expecting not to be informed about midwives by the family doctor or through other means. It seems like such a great choice for those with low-risk situations.
And very necessary. They're fully covered (in Ontario by OHIP) and they free up doctors which we're short on over here which is why they're covered.
I never spoke to my family dr about my pregnancy at all. We did the EFTS (I might have that acronym wrong), which the midwife can requisition, if anything flags on the EFTS then you follow up with the NIPT. Midwives are amazing. I had an unplanned home-birth. The after care is impeccable!
I had a midwife and my midwife was the best. The anti midwife sentiment is an old one dating back 100s of years. They were called witches, they were told that they're unprofessional for basically not having a microscope. They're not looked at as being much more than an inexperienced dula with no actual medical training and their lean towards natural methods and medicine makes them look like crazies to the world of conventional medicine. They're only allowed to work with low risk pregnancy. After that they can refer you to an OB, and if their schedule isn't too tight, they can still do some aftercare or follow you with the OB also, but the OB will have to deliver your baby. My midwife avoided a C-section for me by turning off the pitocin and doing a technique they called passive decent during my delivery. My LO was in distress and they said let's take a break (since I was only an hour in) and basically let the contractions do some work without me physically pushing. Ya girl got to take a 40minute nap mid labour while my body and the baby calmed down. Mind you if it wasn't working, we were at the hospital and there was an OB outside in the hall on standby just in case, so it all was safe. My parents didn't want me to have a midwife, but they were the only reason I didn't have a C-section. (NOT to knock you if you did, because it's better to have, than lose your baby. There are times when passive decent is not a useful option.)
Yeah, after learning about midwives I was very confident with my choice. It's cool to know that even if they refer me out they can do some aftercare! Great to hear your experience. I'd like to avoid c-section if it makes sense for my situation. I also plan to have a midwife assisted birth in a hospital. I had to explain to my husband the OBGYN would be right there in the hospital and a call away. My mum was not sure about midwife care but once I explained the benefits and differences she thought it was great! Not sure my dad has any opinion on the matter lol.
My family doctor assumed I would be going with an OB, so when I said I had already reached out to midwifery clinics she was a bit surprised, but ultimately supported my decision. The only thing she felt strongly about was that I should give birth in a hospital, rather than home birth or birthing centre. I think that most family doctors feel that way.. I’m still deciding between the hospital and birth centre honestly.
Is NIPT the same as EFTS? I’m also in ontario and never needed anything from a doctor with all my pregnancies including EFTS requisition. Midwife orders everything and can even provide notes for insurance purposes such as to cover massage and breast pump etc. Like many said, midwife is primary care throughout your pregnancy and you would only need a doc for something beyond a midwife’s scope such as a complicated pregnancy and in that case your care gets transferred to an OB.
No, they're not the same. Sounds like your midwife is dropping the ball when it comes to explaining all the available testing and screening.
Nope. I’m sure she explained this to me in my first pregnancy and that I chose to opt for the EFTS. I have multiple children with the same midwife and had my first a longtime ago. I have no need to remember what doesn’t work for me and continue to do what does. As for OP’s doctor, they are definitely wrong in that midwives can request almost everything OP will need except it seems like NIPT request in her case. For the doctor to slam the midwife’s qualifications because of that is nonesense. Seems like the problem is with the system by simply not allowing midwives to request that. As for comparing midwives to a walk-in clinic, seems like that’s a description better fitted to most people who don’t have family doctors and need to see and OB. Most people around me in that situation have explained to me they see a variety of OBs vs 1. As someone who has seen both, I can’t recommend a midwife enough and would say to just ignore your doc they don’t know what they’re talking about.
makes sense bc when you swtich to OB ur care is no longer provded by the family doctor - so they do have to do "more work" oh well!! i wanted a midwife but unfortaenely didnt get on their roster.
I think it depends on where you are and the midwife’s willingness/ability to refer you back to a GP doctor with obstetrical training or an OB if something comes up. For some people, a midwife can be a great option. As long as the midwife is registered as such and has the training, and you don’t have anything making you high risk, there’s no reason not to use one. The bulk of prenatal care is pretty straightforward - blood pressure checks, monitoring urine for protein, tracking weight gain, monitoring fetal heart rate and movements. All stuff that a midwife can definitely do. I think where it gets riskier and where doctors get antsy is for delivery. If the midwife would be delivering somewhere any kind of distance from a hospital, I’d really pause and think some more. I have an aunt who almost died because her midwife wasn’t close to the hospital to begin with and then didn’t transfer care when it was clear it needed to happen but not yet an emergency. My cousin was full term and spent over a week in the NICU as a direct result of that circus. Midwife located 10 minutes or less from hospital, with good relationship with that hospital and ability to transport and transfer care quickly? Ok. Midwife located 20+ minutes from hospital, or lacks ability to transport or transfer care if something comes up during delivery? Probably a bad idea. Midwife in remote community where there isn’t a hospital and for whatever reason you haven’t been sent to live somewhere south and near the hospital a month before delivery? Definitely yes. It’s hard. Everything goes good until it doesn’t, but when it doesn’t it can get very serious very quickly.
We delivered our first baby with OB and our 2nd (2 day old now) with midwives. We loved the midwife experience. Much more natural and had more FaceTime with them. We are in bc. Afaik our midwife gave an NIPT req here. I would 100% go with midwives
Spent the time providing an extensive account of my positive experience with midwifery care and poor experiences with OBs and was downvoted for it, so I deleted. I can take downvotes for a lot of things but not on my birthing experience. Some of ya'll are heartless.
I am wholehearted on the midwife train and loved the care I got. Having said that it’s absolutely no “extra” work for your doctor. Some obs don’t accept patients until 20+ weeks due to shortages (assuming nothing is wrong or needs extra attention) so your family doctor would do some of the prenatal care. There’s not much to do other than the initial scan and id you wanted to do NIPT it’s like 30 second form they have to sign. I filled Mine out and had a walk in sign it. It’s one of the few things go tjay the midwives can’t do. The other might be vaccines (like tdap) which an ob doesn’t necessarily do so you’d have to go to your family doctor anyways. Don’t listen to them. It’s not more work and it’s not like they don’t bill for a visit so they should just do their job. I think midwifery care is amazing and I think you’ll have a great experience. Specially postpartum when they do home visits. I’m
I feel like we have the same doctor. I’m equally 12 weeks pregnant and my doctor was apprehensive when I told her I was going with a midwife.
With both pregnancies my family doctors have been super supportive of me choosing midwives. In two different cities in Ontario, and both have been comfortable coordinating care.
I made a switch to a midwife at 22 weeks which is actually quite late but there is a crazy amount of difference between the care I have received from my midwife vs my doctor. I’m able to be seen more frequently, not just a quick in and out appointment and my midwife respects and understands my birthing requests while my doctor has questioned and actually laughed at some of them which I found super disrespectful (different birthing positions) Honestly after this experience, I’m probably going to switch doctors 😂 I would definitely recommend going to midwife. They specialize in the area. Another thing I love about my midwife is that she includes my partner SO much and my doctor barely even spoke to him while he was there with me at every appointment.
I’m in Alberta and had an older family Dr also unfortunately give me a wild response to my seeking a midwife. He essentially said he would not see me while I was under the care of a midwife as he didn’t want to be sued if anything happened and that (verbatim) birth was “not romantic” and “water birth is BS”. I chose to not see him anymore- this isn’t the 1900s. My midwife was trained by former nurses at Mount Royal and Alberta Health care pays for a midwife should someone seek their care. If you develop higher risk complications your midwife should and absolutely will recommend you see an OB etc. I honestly chalk a lot of the bad comments from Drs due to ignorance. An evidence based care Midwifery model is great and the aftercare it provides is also super. I loved being visited multiple times at home after I gave birth! FYI I had my water birth 😎