The questions you ask potential clients, as a Doula at the first consult, evolve as you grow in experience as a Doula. As I near my sixth year I've made an interesting discovery at these consults. Soon to be parents often have no idea who is going to be catching their babies. Living in Calgary (Alberta) we are exposed to American TV and media all the time, but our medical system varies greatly when in comes to maternity care. Knowing who will be taking care of your body and your baby is VERY important. Parents also, are unaware that they can pick or switch care providers (or place of birth) at any point in their pregnancy. Knowledge is power... Women who empower themselves by making informed choices often have better birthing outcomes, thus lowering their chances of having postpartum depression. So what are the choices available to women birthing in the city of Calgary? Where does one start after finding those two little lines on a pregnancy test?
The majority of women will start with a visit to their regular family physician. After pregnancy conformation a family doctor will often care for a soon to be mom until sometime after she is past week 20. She will than be referred on to a predetermined clinic specializing in maternity care, where she will be seen until 6 weeks after birth. These clinics are either made up of low risk maternity doctors, OR obstetricians.
Alternatively a handful of women who apply for midwifery care at the first signs of a positive pregnancy will be accepted into one of the city's midwifery practices. Once accepted these women will see their midwives for every regular prenatal appointment until 6 weeks after the birth of their baby. Barring to no complications throughout pregnancy, of course.
Now let's explore what each option has to offer our birthing families...
Risk Maternity Doctor: The majority of women in Calgary will be referred or can self-refer to a low-risk maternity clinic. These clinics are run by a group of family physicians who practice low-risk obstetrics. Typically, these doctors operate on a rotating call schedule which means a woman may get any doctor from the clinic when she is ready to birth her baby. Low risk maternity doctors typically support moms birthing wishes when possible.
When birthing under the care of a low risk maternity doctor you’ll be birthing at the designated hospital that your maternity clinic operates out of. Your family doctor may automatically refer you to a specific maternity clinic without asking you where you wish to give birth. Families may choose which maternity clinic/hospital they wish to give birth at. Be sure to tell your family doctor where you’d like to be referred too! These maternity clinics are also able to provide follow-up care to new mothers and their babies for up to 6 weeks post-birth. After this, care is usually transferred back to the mom’s regular family doctor.
Midwife: Women who are considered low-risk also have the option of having a midwife as their primary care provider during their pregnancy. A midwife is someone who has obtained a bachelor’s degree after 4 years of extensive study and practice into caring for low-risk women during their pregnancy, birth and early postpartum weeks.
Midwives follow the midwifery model of care which includes a focus on viewing pregnancy and birth as a normal, not pathological, process in a women’s life. Often women seeking midwifery care are planning a birth with as little intervention as possible, including pain medication. In Calgary, women with a midwife as their primary health care provider are given a choice of birth place: home, hospital or a birth centre. Midwives will also facilitate water births in all places of birth. There is a huge wait list for Midwives in our province. Applying as early as possible in pregnancy gives moms the best chance at being accepted. If you end up wait listed don’t give up hope as many women are accepted late into their pregnancies.
Obstetrician (OB): An obstetrician is a doctor who specializes in the management of pregnancy, labor and birth. They have specialized knowledge and surgical experience with high-risk pregnancies but may also see low-risk women as well. Obstetricians see all high risk pregnancies and are more likely to manage complications using medical interventions.
Low risk women may be automatically referred to an Obstetrician clinic for maternity care by their family doctor. In these instances there is no underlying medical reason for seeing an Obstetrician.
Obstetricians may also work closely with low risk maternity doctors and midwives. For example, a woman may “risk out” of midwifery care due to a twin pregnancy or the after a complication in her pregnancy. Furthermore, a low risk maternity doctor or midwife may also consult with an obstetrician on how to best manage a complication that occurs during the pregnancy or birth such as pre-eclampsia or the need for a cesarean section. Obstetricians operate on a rotating call schedule and every hospital has an Obstetrician team on call at all times.
So the only question left is... Who the heck is catching your baby??
~ Doula In The Wild
By: Doula Sonja
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