July 25, 2025 • 22 mins
"Let us know what you think about this episode"
Episode Summary:
Thinking about choosing a midwife but unsure what they actually do? Heard that midwives only attend home births or that you can’t get an epidural with one? It’s time to clear up the myths and get real about what midwifery care looks like in Ontario — especially in Windsor-Essex.
In this episode, I’m joined by Corey, a registered midwife with Midwives of Windsor, and we’re unpacking the most common misconceptions around midwifery care — from payment and pain relief to postpartum support and hospital births. Whether you're newly pregnant, birth curious, or supporting someone through their journey, this conversation is packed with facts, compassion, and a few good laughs.
We talk about:
✨ Why midwifery care is fully covered (even without a health card!)
✨ The truth about home births vs. hospital births — and who really chooses what
✨ Getting an epidural or induction with a midwife (yes, it’s possible!)
✨ How midwives support choice and continuity of care
✨ What postpartum care looks like: including lactation, bleeding, and newborn checks
✨ Why calling your midwife might come before you call your partner 😉
✨ What makes midwifery care so personal and powerful for families
Mentioned in This Episode:
🔗 Midwives of Windsor – www.midwivesofwindsor.com
🔗 Pelvic Love Massage & Doula Care – www.pelviclove.com
📲 Follow Deborah on Instagram – @deborathedoula
Looking to prepare for your own birth journey?
💬 Book a birth consultation with Deborah: www.pelviclove.com
🎙 Thanks for Tuning into Tend & Befriend!
🌿 Learn More & Work With Me:
💻 Visit Website for my birth course, resources, and to book a session with me.
📲 Stay Connected:
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🔗 Find all links here: Our website
I hope to talk to you soon!!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Deborah (00:06):
Hey Mamas, you're listening to Tend and Befriend,
a podcast about women's mentaland physical health.
This is Debra.
I'm a mom of two, a labor andbirth coach and birth advocate,
a health professional, and todayI'm your host.
Let's dive into today's episode.
Let's dive into today's episode.
(00:29):
Any information you hear orthat is suggested or recommended
on these episodes is notmedical advice.
Hi Corey, thank you so much forbeing with me today.
I'm really excited abouttalking about midwifery care
here in Ontario, andspecifically Windsor and Essex
County.
I would love for you tointroduce yourself.
Corey (00:48):
Hi Debra, thanks for having me.
My name is Corrie.
I'm a registered midwife.
I work with the midwives ofWindsor and I catch babies at
Windsor Regional Hospital, atErie Shores Healthcare and also
at home.
I've been a midwife for justabout eight years and started my
practice in Hamilton, ontario,but moved to this region in 2020
in the middle of a pandemic.
(01:10):
As you do, have really enjoyedmy time living and working in
this region Awesome.
Deborah (01:16):
Okay, let's talk about some of the biggest myths with
midwifery care, because there'sa lot of them, but I want to
talk about a couple of thereally big ones, and the first
one being that midwifery care isbilled privately.
Corey (01:32):
Yeah, so actually midwives are covered under the
provincial health insurance plan, but also covered for people
who don't have provincial healthinsurance as well, which I
think a lot of people don't knowabout.
So you show your health card atyour very first visit with your
midwife and you never have topay us a cent in order to
receive care from us.
(01:52):
We also have arranged we havean arrangement with our transfer
payment agency to covermidwifery services, as well as
lab work, ultrasounds andconsultations with other
professionals for folks whodon't have insurance, and that's
because we know that whenpeople get excellent prenatal
care, they deliver healthy,happy babies.
Healthy, happy babies grow upto be healthy, happy adults as
(02:14):
well, and so protecting thewell-being of the pregnant
individual and their developingbaby is super important.
So that's been something reallyimportant that we are able to
provide as well.
Deborah (02:27):
That's awesome, I didn't know that.
Okay, let's continue on withthe myths.
I want to talk about the nextone.
I want to come back to that alittle bit.
I want to talk about the nextmyth which I hear in my clinic
every single day, and that isthat midwives only do home
births.
Corey (02:41):
Yes, you have to have your baby in the forest under a
full moon and you only have sageto rub on your belly for pain
relief, which, of course, isabsolutely also untrue.
So midwives support choice, andone of the choices that we
promote is choice of birthplace.
So we are the only regulatedhealthcare professionals in
Ontario who do attend deliveriesat home for those who choose
(03:01):
that.
But for those who would preferthe safety or security of
delivering in hospital, or forthose who know, for example,
that part of their birth plan isepidural which is probably the
next myth you're going to get tomidwives also facilitate
deliveries in hospitals, and inthis region we're about 70-30.
So about 70% of folks will havea baby in hospital and about
(03:24):
30% will not Okay.
Deborah (03:28):
So, like 70% of the people that have a midwife
delivering a hospital, only 30%are home birth Correct.
Wow, I thought it was higherthan that.
That's really good to know.
Corey (03:38):
It's really high for the province, actually 30%.
To give you some context, whenI was a midwife in Hamilton, I
was a midwife in Hamilton forthree years and when I came to
this region in six months I hadalready attended more home
births than I attended inHamilton in my whole entire
three years there.
Deborah (03:54):
Wow, I actually love that.
I really really love that.
That tells us that people areeducated on their choices and
they're facilitating yourservices in a way that that
feels right for them.
But I didn't know that number.
So the next myth, yes, is, ofcourse, that you can't get an
epidural if you're with amidwife.
Corey (04:14):
Yeah.
So this is a persistent mythactually and it doesn't come
from nowhere.
So in some communities folkswho wanted an epidural their
care historically would havebeen required to have been
transferred to an obstetricianbecause for a period of time,
for whatever reason, it wasconsidered an increase in risk
or a deviation from normal.
(04:34):
And so we talk about full scopecommunities and full scope.
When we talk about that, reallywe're talking about epidurals
and we're talking about oxytocin.
So do midwives maintain carefor epidurals?
Do midwives maintain care foroxytocin?
So there is a bit of apersistent myth that if you want
an epidural you can't have amidwife.
I don't think that's true inmany communities in Ontario
(04:57):
anymore.
I would say so the epiduralrate for generally for
obstetrics is about 60%, and Iwould say for midwifery it's
maybe a little bit lower, butstill a fair number of people
will get an epidural, andsometimes the epidural is the
thing that helps them have avaginal delivery.
So it's a great tool that wecan have in our toolbox.
Yes, in this community we don'ttransfer care for the labor for
(05:22):
an epidural, but we do involvea nurse to manage the epidural
part of things while the midwifecarries on managing the labor.
So if you want a transfer ofcare, absolutely you can have an
epidural, as long as we havetime to get the epidural into
you.
Deborah (05:35):
Right.
Corey (05:36):
So sometimes we have what we call drive-by births, where
you show up and have a baby andthen go home.
Deborah (05:43):
So I love that you mentioned that it's not a
transfer of care and you're nottransferred to an OB if you want
an epidural, but there isanother care provider brought
into the picture only to takecare of the epidural, correct?
Yes, okay.
Also, you talked you brought upoxytocin, which we know as
(06:07):
Pitocin, and I want to talkabout that a little bit because
that's another thing that noteveryone talks about.
Is that, even with a midwife,you can still have a medical
induction, correct?
Correct?
You guys do it a little bitdifferently depending on the
situation and the medicalhistory and the risk, but you
(06:29):
can still have pitocin, oxytocin, if you're with a midwife and a
girl and all of the things thatcomes with a hospital birth,
correct?
Corey (06:40):
yep, yeah and and so like we know that, if you're even
for people who just plan to havea home birth, their rates of
intervention are much lower,even if they end up in the
hospital having a hospital birth.
But I also am feeling likeinterventions get a bit of a bad
reputation and that you knowthere's this idea that maybe no
interventions is the best way tohave a baby.
(07:01):
But sometimes interventions arewhat is going to be the thing
that gets you the vaginaldelivery that you're looking for
or gets the baby out.
You know, before we have a babythat's compromised that we then
have to worry about afterthey're on the outside.
So I would say interventionsare maybe a little bit more
routine when you're with anobstetrician, but that's not to
(07:22):
say that midwives don't use themas well and try to use them as
judiciously as possible.
Deborah (07:29):
From my experience, I don't feel like intervention has
a bad name.
I feel like from the communitythat I'm in, I'm seeing on a
regular basis, is that themisuse of intervention and, you
know, not an informed consentwhen it comes to intervention.
So I think any intervention iswelcomed as long as, as you
(07:50):
understand that you have thepermission to say yes or no to
it.
But I do.
I do see a lot of the socialmedia marketing and the fear
mongering that's happeningamongst birth workers saying
that interventions are bad andthere should be no interventions
, and the more interventions themore problems occur, and that's
obviously being told.
(08:11):
But I also feel like that canbe a bit of fear mongering as
well.
So I think for me, I hear a lotlike why would I go with a
midwife?
I don't want a home birth, andI think that this answers a lot
of the questions and I find thatI like to recommend people talk
to a midwife just because theydon't fully understand what it
(08:32):
looks like for a midwife to betheir primary care provider.
So I would like to talk aboutthat.
Like I know that midwifery carein Ontario is in high demand
and there's a low supply orthere's not enough midwives to
spread around.
Let's say, someone got pregnantand they were looking to have a
midwife.
(08:53):
What would you recommend thatthey do?
Corey (08:56):
And I know this is a joke amongst us, but tell me, To be
honest, if you call your midwife, then you call your partner.
Deborah (09:05):
Yes, I love it.
And then what happens fromthere?
Corey (09:09):
So we can be like fully autonomous primary care
providers for folks who arehaving low risk, uncomplicated
pregnancies and we can providethat care like from the moment
of conception, although becausewe're so, I would say we're high
touch, low volume.
So because the kind of care weprovide is so comprehensive, we
(09:30):
maintain a very small caseloadand so it's a little bit nicer
if we're taking people into carea little bit later, like once
we're sure of a due date, forexample because we've had a
confirmation by ultrasound.
So that whole pee on a stickcall your midwife, call your
partner maybe not so essentialthese days as we're trying to
like fit people in it's moreinformation than listeners
(09:51):
probably care about but fitpeople in around vacation,
people's vacations and thingslike that.
So once you're in care withmidwives we see you along the
same schedule as you would see aphysician, so every four weeks
until you are 28 weeks and thenbi-weekly until 36 weeks and
then weekly until you have ababy.
And we like routine pregnancycare is routine pregnancy care.
(10:15):
So you're going to have accessto the same tests and
ultrasounds Early in pregnancy.
We're going to talk to youabout genetic screening.
You'll have a mid-pregnancyanatomy ultrasound.
We still offer and recommendroutine gestational diabetes
screening.
We still talk about group B,strep or GBS and doing that swab
towards the end, and then atthe end of pregnancy, we have
(10:37):
options in terms of waiting fora period of time, and then
sometimes we're recommending aninduction for one reason or
another.
Recommending an induction forone reason or another we also
one of our tenets of care, oneof our core principles as
midwives is continuity of care,and so what this means is we
care for you through yourpregnancy, but then also during
the labor and the delivery andthen into the postpartum as well
(10:59):
.
And when you're seeing an OBfor your pregnancy, the care
you're going to get is going tobe excellent, but you're not
pregnant, you're really not veryinteresting anymore, and you
also may not see thatobstetrician during your labor
and your delivery either,because OBs work on a call rota.
So it's if you have one of theLeamington docs, there's a 50-50
(11:19):
chance you'll get one of thosedocs.
If you have one of the docs atWindsor Regional, you'll get
whoever's on call that day.
Yes, when you have a midwife,there's a really high
probability that you'll get yourmidwife at your labor and then
if your midwife isn't available,for whatever reason, then
another midwife will attend you,so you'll still have midwifery
care.
(11:40):
Some of the things we do alittle bit differently in labor
we know that folks who getone-to-one labor support tend to
have higher satisfaction withtheir labor.
They also tend to have lowerrates of intervention, and so
that's the only time I'm not inthe labor room with you in labor
is if you're sleeping with anepidural because nobody needs to
watch you sleep.
(12:01):
Then of course in the hospitalwe have access to the OB team if
we have anything that requiresany kind of higher level of care
.
Once baby's on the outside wecome and see you at home.
You end baby for the firstcouple of weeks and then see you
in clinic until baby's sixweeks old and then we discharge
you to your family doc.
It's kind of a unique communityfor a couple of reasons.
(12:22):
So one of the reasons is thatOBs start seeing you quite early
in your pregnancy.
So in some communities youwon't be seen by an obstetrician
until 20 weeks, and this isimportant for non-Windsor Essex
County listeners to know about,because your family doctor might
not know that if you're waitingto see a midwife, you can't
wait until 20 weeks or you'renot going to get one.
Deborah (12:40):
Yes, yeah, that's important to know, yes, whereas
you can wait for an OB becausetechnically it's later that they
wait on care.
Corey (12:49):
The other thing that's interesting is in this community
we'll see well babies, which isnot true in every community, so
some families would opt for apediatrician instead of their
baby seeing their family doc.
Deborah (13:00):
Yeah, it's just preference Usually.
I find that's what I'm thefeedback that I'm getting I want
to talk about.
If you deliver at home, youstill do all of the typical
assessments of baby and of momthat are routine, right?
Yeah, talk about some of thosethings that happen.
Corey (13:20):
Like the newborn screen and the CCHD.
Yeah, so when you have a baby inhospital around 24 hours, the
nurses will come and do acritical congenital heart defect
screen where they look at atrisk of sudden cardiac arrest.
We also do a bilirubin screen,so in the hospital they'll take
(13:48):
a sample of baby's blood andthey'll check to see what baby's
bilirubin is.
This is a test that tells us ifthis baby is at risk for
something calledhyperbilirubinemia, which is
basically an accumulation ofbilirubin under the skin.
It's what makes babies lookyellow.
We don't ever expect babies tobe yellow at 24 hours, but this
(14:10):
will tell us.
Do we have to watch this babyquite closely or do we follow up
, just as clinically indicated?
And then we also do a bloodtest to check for 29 rare but
potentially very serious blood,hormone and metabolic diseases.
This is called the Ontarionewborn screen and all of these
tests are recommended.
They're considered a standardof care and if you choose to
(14:33):
have your baby at home, or ifyou have a baby in hospital but
you leave the hospital before 24hours, which is something that
midwifery patients often dowe'll come and do those tests
for you at home.
Deborah (14:45):
I like that you brought that up, because that's my next
question.
If you give birth at home, youleave them as soon as everything
is taken care of and settleddown Typically, from my
experience, three hoursapproximately yeah, between two
and three hours usually and then, if they're in the hospital,
you stay with them until andthey can leave two to three
(15:06):
hours as long as everything is,everybody is okay, or they can
choose to stay at the hospitalExactly Until the next day, and
either way, you see them.
Corey (15:15):
Yep, we'll see them in hospital if they're there at 24
hours, or we'll see them at home, if that's where they are, we
come and find you.
Deborah (15:23):
Like hunting.
Yeah, one of the things that Ireally like about the postpartum
care, with midwifery, is thebreastfeeding help, the support
about the bleeding, which youdon't get if you have an OB,
unless you're going into triageand or the emergency room, and I
think it's really importantthat moms have that continue.
(15:44):
The continuance of care Do youwant to talk about that a little
bit?
And how obviously thebreastfeeding is a part of the
things that you learn, whereasthat's not something that
happens with OBs and how youhave, specifically, a lactation
consultant on staff.
Corey (16:01):
Yeah, so we do have one of our midwives is a board
certified lactation consultanton staff.
Yeah, so we do have one of ourmidwives is a board certified
lactation consultant who is aprivate lactation consultant
business but also brings thatenergy into her practice.
She runs a regularbreastfeeding class out of our
clinic and is always happy to beavailable for she's always
(16:21):
happy to be available for myclients.
If I ask her for a specificassessment, yes, but you have
breastfeeding.
We all yeah, we all have as partof our education we're required
to do a placement with.
So I did a placement at thebreastfeeding assessment,
(16:42):
breastfeeding and newbornassessment clinic or the BANA
clinic at St Joe's Hospital inHamilton, and so we all have to
do some sort of breastfeedingplacement as part of our
undergrad education to evenbecome a midwife.
Health teaching, I think, is areally important component of
what I do, and one of the thingsthat I really enjoy is just
like teaching people about theirbodies and how their body works
(17:03):
and the physiology of pregnancyand the physiology of fetal
development and then, oncebaby's on the outside, newborn
development and postpartumrecovery like all of those
things are, I think, essential.
I think everybody in an idealworld would have access to
midwifery care, at least fortheir first pregnancy, to be
able to learn all of thesethings.
Yes, but then something that Ididn't touch on when I was
(17:27):
talking about continuity of careis that folks, when they have
midwifery care, they have accessto their midwife 24 hours a day
, seven days a week.
For urgent concerns they canalways call our pager, and so
one of the things that thehealth care system really loves
about midwives is that we workreally hard to keep people out
of hospital if they don't needto be there, whereas if you call
OB triage, like an OB triagenurse doesn't know you, doesn't
(17:50):
have an existing relationshipwith you, doesn't necessarily
feel confident.
Talking about expectantmanagement as an option,
management is just what we sayin medicine.
When we're watching and waiting, so basically doing clinically
doing nothing A nurse, if youcall OB triage, is pretty much
always going to tell you to comein if you're not sure, if you
(18:12):
need an assessment, whereas witha midwife I know you, we have a
relationship.
Maybe this is not your firstbaby with me, maybe you've had
similar things in your previouspregnancy, maybe I know that
sometimes you just need to bereassured.
Maybe I can talk about what'smore versus less concerning, and
so we are able to help peoplemanage things at home a lot more
(18:32):
often than they do in OB triagejust by virtue of that
relationship.
Deborah (18:37):
Yeah, I really like that Also, like fully
understanding, and I do.
I do think that most peopledon't know that, like even when
you're in labor at home, even ifyou are planning a home birth
or planning on going to thehospital, the midwife can tell
you like, yeah, I think it'stime, cause that's what a lot of
people do ask, right?
(18:59):
They're like, how will I knowwhen it's time to go to the
hospital?
Yeah, having a relationshipwith your midwife can really
help those things.
But also in the days before, ifyou have a concern, you can
reach out via text or themidwife can swing by.
I know that you've done thatwith patients of mine if there
is a big concern.
Corey (19:19):
Yeah, like I always tell people, I'd rather do a hundred
assessments I didn't need to dothan not do that one assessment
that we should have.
If I feel like there's abenefit in being conservative,
then that's the management I'llrecommend, and if I think that
expected management is anappropriate course, then that's
what I'll recommend.
But I'll take my cues from theperson on the other end of the
(19:43):
phone.
Deborah (19:44):
How she's feeling and what she's needing at this time
to move forward or to feel safeand secure.
I love that.
I love all of these questionsthat we've talked about.
I also want to talk about how,in Windsor and Essex County that
there is a large number ofmidwives, and a little bit about
(20:04):
how you talked about if youhave a midwife that you've
chosen or have been assigned toyou, then you will most likely
get that midwife.
But also about when you call,because we're a large community
and there's a certain number ofyou that when you call, you get
assigned.
You can't typically chooseunless that person is actually
(20:25):
available.
So talk about that a little bit.
About we talked about how theOBs are on a certain schedule
and how with the midwiferyclinic, it's a collective.
Corey (20:35):
Yeah, there is some wiggle room for requests, like
we try to.
If I have a previous clientwho's requesting me again, we
try to honor those requests.
If we have a Spanish speakingclient, for example, one of our
midwives is from Venezuela, sowe would try to match those
individuals up with her.
But a lot of what goes into theassignment of clients is really
(20:58):
like our availabilityavailability.
So we don't want to be givingme a bunch of clients less than
two weeks before I'm off for acouple of weeks for vacation,
for example, because I reallywant to be able to be there for
those deliveries, and so that's,I would say, like the primary
motivator in terms of when, interms of who you get, it's who's
(21:18):
available around the time thatyou're expecting to have your
baby.
Deborah (21:22):
Yeah, I would imagine.
It's also really important thatyou have the time off that you
need to regroup, right, you'refor sure, for seven, so vacation
is extremely important.
So what I'm understanding isthat you can call them requests,
but mostly it's a rotationsystem and, depending on the
(21:42):
schedule already existing,you're being assigned a midwife.
Yeah, I think we covered prettymuch everything and also, if
anyone has any questions, theycan reach out to us.
They can reach out to us in theshow notes or send the message
to us on Instagram.
Also, corey is with themidwives of Windsor and Corey.
(22:02):
If you wouldn't mind sharingthat website, yep, it's just
midwives of Windsor and Corey,if you wouldn't mind sharing
that website.
Corey (22:05):
Yep, it's just midwivesofwindsorcom.
Perfect.
Deborah (22:08):
Yeah, this is Corey, and so if you want to request
her privately, you can try.
So, corey, thank you so verymuch for being with me today.
I'm so grateful that we got todo this conversation and that
we're helping educate thecommunity on midwifery care.
Thank you, thanks.
Hey Mamas, you're listening to Tend and Befriend,
a podcast about women's mentaland physical health.
This is Debra.
I'm a mom of two, a labor andbirth coach and birth advocate,
a health professional, and todayI'm your host.
Let's dive into today's episode.
Let's dive into today's episode.
(00:29):
Any information you hear orthat is suggested or recommended
on these episodes is notmedical advice.
Hi Corey, thank you so much forbeing with me today.
I'm really excited abouttalking about midwifery care
here in Ontario, andspecifically Windsor and Essex
County.
I would love for you tointroduce yourself.
Corey (00:48):
Hi Debra, thanks for having me.
My name is Corrie.
I'm a registered midwife.
I work with the midwives ofWindsor and I catch babies at
Windsor Regional Hospital, atErie Shores Healthcare and also
at home.
I've been a midwife for justabout eight years and started my
practice in Hamilton, ontario,but moved to this region in 2020
in the middle of a pandemic.
(01:10):
As you do, have really enjoyedmy time living and working in
this region Awesome.
Deborah (01:16):
Okay, let's talk about some of the biggest myths with
midwifery care, because there'sa lot of them, but I want to
talk about a couple of thereally big ones, and the first
one being that midwifery care isbilled privately.
Corey (01:32):
Yeah, so actually midwives are covered under the
provincial health insurance plan, but also covered for people
who don't have provincial healthinsurance as well, which I
think a lot of people don't knowabout.
So you show your health card atyour very first visit with your
midwife and you never have topay us a cent in order to
receive care from us.
(01:52):
We also have arranged we havean arrangement with our transfer
payment agency to covermidwifery services, as well as
lab work, ultrasounds andconsultations with other
professionals for folks whodon't have insurance, and that's
because we know that whenpeople get excellent prenatal
care, they deliver healthy,happy babies.
Healthy, happy babies grow upto be healthy, happy adults as
(02:14):
well, and so protecting thewell-being of the pregnant
individual and their developingbaby is super important.
So that's been something reallyimportant that we are able to
provide as well.
Deborah (02:27):
That's awesome, I didn't know that.
Okay, let's continue on withthe myths.
I want to talk about the nextone.
I want to come back to that alittle bit.
I want to talk about the nextmyth which I hear in my clinic
every single day, and that isthat midwives only do home
births.
Corey (02:41):
Yes, you have to have your baby in the forest under a
full moon and you only have sageto rub on your belly for pain
relief, which, of course, isabsolutely also untrue.
So midwives support choice, andone of the choices that we
promote is choice of birthplace.
So we are the only regulatedhealthcare professionals in
Ontario who do attend deliveriesat home for those who choose
(03:01):
that.
But for those who would preferthe safety or security of
delivering in hospital, or forthose who know, for example,
that part of their birth plan isepidural which is probably the
next myth you're going to get tomidwives also facilitate
deliveries in hospitals, and inthis region we're about 70-30.
So about 70% of folks will havea baby in hospital and about
(03:24):
30% will not Okay.
Deborah (03:28):
So, like 70% of the people that have a midwife
delivering a hospital, only 30%are home birth Correct.
Wow, I thought it was higherthan that.
That's really good to know.
Corey (03:38):
It's really high for the province, actually 30%.
To give you some context, whenI was a midwife in Hamilton, I
was a midwife in Hamilton forthree years and when I came to
this region in six months I hadalready attended more home
births than I attended inHamilton in my whole entire
three years there.
Deborah (03:54):
Wow, I actually love that.
I really really love that.
That tells us that people areeducated on their choices and
they're facilitating yourservices in a way that that
feels right for them.
But I didn't know that number.
So the next myth, yes, is, ofcourse, that you can't get an
epidural if you're with amidwife.
Corey (04:14):
Yeah.
So this is a persistent mythactually and it doesn't come
from nowhere.
So in some communities folkswho wanted an epidural their
care historically would havebeen required to have been
transferred to an obstetricianbecause for a period of time,
for whatever reason, it wasconsidered an increase in risk
or a deviation from normal.
(04:34):
And so we talk about full scopecommunities and full scope.
When we talk about that, reallywe're talking about epidurals
and we're talking about oxytocin.
So do midwives maintain carefor epidurals?
Do midwives maintain care foroxytocin?
So there is a bit of apersistent myth that if you want
an epidural you can't have amidwife.
I don't think that's true inmany communities in Ontario
(04:57):
anymore.
I would say so the epiduralrate for generally for
obstetrics is about 60%, and Iwould say for midwifery it's
maybe a little bit lower, butstill a fair number of people
will get an epidural, andsometimes the epidural is the
thing that helps them have avaginal delivery.
So it's a great tool that wecan have in our toolbox.
Yes, in this community we don'ttransfer care for the labor for
(05:22):
an epidural, but we do involvea nurse to manage the epidural
part of things while the midwifecarries on managing the labor.
So if you want a transfer ofcare, absolutely you can have an
epidural, as long as we havetime to get the epidural into
you.
Deborah (05:35):
Right.
Corey (05:36):
So sometimes we have what we call drive-by births, where
you show up and have a baby andthen go home.
Deborah (05:43):
So I love that you mentioned that it's not a
transfer of care and you're nottransferred to an OB if you want
an epidural, but there isanother care provider brought
into the picture only to takecare of the epidural, correct?
Yes, okay.
Also, you talked you brought upoxytocin, which we know as
(06:07):
Pitocin, and I want to talkabout that a little bit because
that's another thing that noteveryone talks about.
Is that, even with a midwife,you can still have a medical
induction, correct?
Correct?
You guys do it a little bitdifferently depending on the
situation and the medicalhistory and the risk, but you
(06:29):
can still have pitocin, oxytocin, if you're with a midwife and a
girl and all of the things thatcomes with a hospital birth,
correct?
Corey (06:40):
yep, yeah and and so like we know that, if you're even
for people who just plan to havea home birth, their rates of
intervention are much lower,even if they end up in the
hospital having a hospital birth.
But I also am feeling likeinterventions get a bit of a bad
reputation and that you knowthere's this idea that maybe no
interventions is the best way tohave a baby.
(07:01):
But sometimes interventions arewhat is going to be the thing
that gets you the vaginaldelivery that you're looking for
or gets the baby out.
You know, before we have a babythat's compromised that we then
have to worry about afterthey're on the outside.
So I would say interventionsare maybe a little bit more
routine when you're with anobstetrician, but that's not to
(07:22):
say that midwives don't use themas well and try to use them as
judiciously as possible.
Deborah (07:29):
From my experience, I don't feel like intervention has
a bad name.
I feel like from the communitythat I'm in, I'm seeing on a
regular basis, is that themisuse of intervention and, you
know, not an informed consentwhen it comes to intervention.
So I think any intervention iswelcomed as long as, as you
(07:50):
understand that you have thepermission to say yes or no to
it.
But I do.
I do see a lot of the socialmedia marketing and the fear
mongering that's happeningamongst birth workers saying
that interventions are bad andthere should be no interventions
, and the more interventions themore problems occur, and that's
obviously being told.
(08:11):
But I also feel like that canbe a bit of fear mongering as
well.
So I think for me, I hear a lotlike why would I go with a
midwife?
I don't want a home birth, andI think that this answers a lot
of the questions and I find thatI like to recommend people talk
to a midwife just because theydon't fully understand what it
(08:32):
looks like for a midwife to betheir primary care provider.
So I would like to talk aboutthat.
Like I know that midwifery carein Ontario is in high demand
and there's a low supply orthere's not enough midwives to
spread around.
Let's say, someone got pregnantand they were looking to have a
midwife.
(08:53):
What would you recommend thatthey do?
Corey (08:56):
And I know this is a joke amongst us, but tell me, To be
honest, if you call your midwife, then you call your partner.
Deborah (09:05):
Yes, I love it.
And then what happens fromthere?
Corey (09:09):
So we can be like fully autonomous primary care
providers for folks who arehaving low risk, uncomplicated
pregnancies and we can providethat care like from the moment
of conception, although becausewe're so, I would say we're high
touch, low volume.
So because the kind of care weprovide is so comprehensive, we
(09:30):
maintain a very small caseloadand so it's a little bit nicer
if we're taking people into carea little bit later, like once
we're sure of a due date, forexample because we've had a
confirmation by ultrasound.
So that whole pee on a stickcall your midwife, call your
partner maybe not so essentialthese days as we're trying to
like fit people in it's moreinformation than listeners
(09:51):
probably care about but fitpeople in around vacation,
people's vacations and thingslike that.
So once you're in care withmidwives we see you along the
same schedule as you would see aphysician, so every four weeks
until you are 28 weeks and thenbi-weekly until 36 weeks and
then weekly until you have ababy.
And we like routine pregnancycare is routine pregnancy care.
(10:15):
So you're going to have accessto the same tests and
ultrasounds Early in pregnancy.
We're going to talk to youabout genetic screening.
You'll have a mid-pregnancyanatomy ultrasound.
We still offer and recommendroutine gestational diabetes
screening.
We still talk about group B,strep or GBS and doing that swab
towards the end, and then atthe end of pregnancy, we have
(10:37):
options in terms of waiting fora period of time, and then
sometimes we're recommending aninduction for one reason or
another.
Recommending an induction forone reason or another we also
one of our tenets of care, oneof our core principles as
midwives is continuity of care,and so what this means is we
care for you through yourpregnancy, but then also during
the labor and the delivery andthen into the postpartum as well
(10:59):
.
And when you're seeing an OBfor your pregnancy, the care
you're going to get is going tobe excellent, but you're not
pregnant, you're really not veryinteresting anymore, and you
also may not see thatobstetrician during your labor
and your delivery either,because OBs work on a call rota.
So it's if you have one of theLeamington docs, there's a 50-50
(11:19):
chance you'll get one of thosedocs.
If you have one of the docs atWindsor Regional, you'll get
whoever's on call that day.
Yes, when you have a midwife,there's a really high
probability that you'll get yourmidwife at your labor and then
if your midwife isn't available,for whatever reason, then
another midwife will attend you,so you'll still have midwifery
care.
(11:40):
Some of the things we do alittle bit differently in labor
we know that folks who getone-to-one labor support tend to
have higher satisfaction withtheir labor.
They also tend to have lowerrates of intervention, and so
that's the only time I'm not inthe labor room with you in labor
is if you're sleeping with anepidural because nobody needs to
watch you sleep.
(12:01):
Then of course in the hospitalwe have access to the OB team if
we have anything that requiresany kind of higher level of care
.
Once baby's on the outside wecome and see you at home.
You end baby for the firstcouple of weeks and then see you
in clinic until baby's sixweeks old and then we discharge
you to your family doc.
It's kind of a unique communityfor a couple of reasons.
(12:22):
So one of the reasons is thatOBs start seeing you quite early
in your pregnancy.
So in some communities youwon't be seen by an obstetrician
until 20 weeks, and this isimportant for non-Windsor Essex
County listeners to know about,because your family doctor might
not know that if you're waitingto see a midwife, you can't
wait until 20 weeks or you'renot going to get one.
Deborah (12:40):
Yes, yeah, that's important to know, yes, whereas
you can wait for an OB becausetechnically it's later that they
wait on care.
Corey (12:49):
The other thing that's interesting is in this community
we'll see well babies, which isnot true in every community, so
some families would opt for apediatrician instead of their
baby seeing their family doc.
Deborah (13:00):
Yeah, it's just preference Usually.
I find that's what I'm thefeedback that I'm getting I want
to talk about.
If you deliver at home, youstill do all of the typical
assessments of baby and of momthat are routine, right?
Yeah, talk about some of thosethings that happen.
Corey (13:20):
Like the newborn screen and the CCHD.
Yeah, so when you have a baby inhospital around 24 hours, the
nurses will come and do acritical congenital heart defect
screen where they look at atrisk of sudden cardiac arrest.
We also do a bilirubin screen,so in the hospital they'll take
(13:48):
a sample of baby's blood andthey'll check to see what baby's
bilirubin is.
This is a test that tells us ifthis baby is at risk for
something calledhyperbilirubinemia, which is
basically an accumulation ofbilirubin under the skin.
It's what makes babies lookyellow.
We don't ever expect babies tobe yellow at 24 hours, but this
(14:10):
will tell us.
Do we have to watch this babyquite closely or do we follow up
, just as clinically indicated?
And then we also do a bloodtest to check for 29 rare but
potentially very serious blood,hormone and metabolic diseases.
This is called the Ontarionewborn screen and all of these
tests are recommended.
They're considered a standardof care and if you choose to
(14:33):
have your baby at home, or ifyou have a baby in hospital but
you leave the hospital before 24hours, which is something that
midwifery patients often dowe'll come and do those tests
for you at home.
Deborah (14:45):
I like that you brought that up, because that's my next
question.
If you give birth at home, youleave them as soon as everything
is taken care of and settleddown Typically, from my
experience, three hoursapproximately yeah, between two
and three hours usually and then, if they're in the hospital,
you stay with them until andthey can leave two to three
(15:06):
hours as long as everything is,everybody is okay, or they can
choose to stay at the hospitalExactly Until the next day, and
either way, you see them.
Corey (15:15):
Yep, we'll see them in hospital if they're there at 24
hours, or we'll see them at home, if that's where they are, we
come and find you.
Deborah (15:23):
Like hunting.
Yeah, one of the things that Ireally like about the postpartum
care, with midwifery, is thebreastfeeding help, the support
about the bleeding, which youdon't get if you have an OB,
unless you're going into triageand or the emergency room, and I
think it's really importantthat moms have that continue.
(15:44):
The continuance of care Do youwant to talk about that a little
bit?
And how obviously thebreastfeeding is a part of the
things that you learn, whereasthat's not something that
happens with OBs and how youhave, specifically, a lactation
consultant on staff.
Corey (16:01):
Yeah, so we do have one of our midwives is a board
certified lactation consultanton staff.
Yeah, so we do have one of ourmidwives is a board certified
lactation consultant who is aprivate lactation consultant
business but also brings thatenergy into her practice.
She runs a regularbreastfeeding class out of our
clinic and is always happy to beavailable for she's always
(16:21):
happy to be available for myclients.
If I ask her for a specificassessment, yes, but you have
breastfeeding.
We all yeah, we all have as partof our education we're required
to do a placement with.
So I did a placement at thebreastfeeding assessment,
(16:42):
breastfeeding and newbornassessment clinic or the BANA
clinic at St Joe's Hospital inHamilton, and so we all have to
do some sort of breastfeedingplacement as part of our
undergrad education to evenbecome a midwife.
Health teaching, I think, is areally important component of
what I do, and one of the thingsthat I really enjoy is just
like teaching people about theirbodies and how their body works
(17:03):
and the physiology of pregnancyand the physiology of fetal
development and then, oncebaby's on the outside, newborn
development and postpartumrecovery like all of those
things are, I think, essential.
I think everybody in an idealworld would have access to
midwifery care, at least fortheir first pregnancy, to be
able to learn all of thesethings.
Yes, but then something that Ididn't touch on when I was
(17:27):
talking about continuity of careis that folks, when they have
midwifery care, they have accessto their midwife 24 hours a day
, seven days a week.
For urgent concerns they canalways call our pager, and so
one of the things that thehealth care system really loves
about midwives is that we workreally hard to keep people out
of hospital if they don't needto be there, whereas if you call
OB triage, like an OB triagenurse doesn't know you, doesn't
(17:50):
have an existing relationshipwith you, doesn't necessarily
feel confident.
Talking about expectantmanagement as an option,
management is just what we sayin medicine.
When we're watching and waiting, so basically doing clinically
doing nothing A nurse, if youcall OB triage, is pretty much
always going to tell you to comein if you're not sure, if you
(18:12):
need an assessment, whereas witha midwife I know you, we have a
relationship.
Maybe this is not your firstbaby with me, maybe you've had
similar things in your previouspregnancy, maybe I know that
sometimes you just need to bereassured.
Maybe I can talk about what'smore versus less concerning, and
so we are able to help peoplemanage things at home a lot more
(18:32):
often than they do in OB triagejust by virtue of that
relationship.
Deborah (18:37):
Yeah, I really like that Also, like fully
understanding, and I do.
I do think that most peopledon't know that, like even when
you're in labor at home, even ifyou are planning a home birth
or planning on going to thehospital, the midwife can tell
you like, yeah, I think it'stime, cause that's what a lot of
people do ask, right?
(18:59):
They're like, how will I knowwhen it's time to go to the
hospital?
Yeah, having a relationshipwith your midwife can really
help those things.
But also in the days before, ifyou have a concern, you can
reach out via text or themidwife can swing by.
I know that you've done thatwith patients of mine if there
is a big concern.
Corey (19:19):
Yeah, like I always tell people, I'd rather do a hundred
assessments I didn't need to dothan not do that one assessment
that we should have.
If I feel like there's abenefit in being conservative,
then that's the management I'llrecommend, and if I think that
expected management is anappropriate course, then that's
what I'll recommend.
But I'll take my cues from theperson on the other end of the
(19:43):
phone.
Deborah (19:44):
How she's feeling and what she's needing at this time
to move forward or to feel safeand secure.
I love that.
I love all of these questionsthat we've talked about.
I also want to talk about how,in Windsor and Essex County that
there is a large number ofmidwives, and a little bit about
(20:04):
how you talked about if youhave a midwife that you've
chosen or have been assigned toyou, then you will most likely
get that midwife.
But also about when you call,because we're a large community
and there's a certain number ofyou that when you call, you get
assigned.
You can't typically chooseunless that person is actually
(20:25):
available.
So talk about that a little bit.
About we talked about how theOBs are on a certain schedule
and how with the midwiferyclinic, it's a collective.
Corey (20:35):
Yeah, there is some wiggle room for requests, like
we try to.
If I have a previous clientwho's requesting me again, we
try to honor those requests.
If we have a Spanish speakingclient, for example, one of our
midwives is from Venezuela, sowe would try to match those
individuals up with her.
But a lot of what goes into theassignment of clients is really
(20:58):
like our availabilityavailability.
So we don't want to be givingme a bunch of clients less than
two weeks before I'm off for acouple of weeks for vacation,
for example, because I reallywant to be able to be there for
those deliveries, and so that's,I would say, like the primary
motivator in terms of when, interms of who you get, it's who's
(21:18):
available around the time thatyou're expecting to have your
baby.
Deborah (21:22):
Yeah, I would imagine.
It's also really important thatyou have the time off that you
need to regroup, right, you'refor sure, for seven, so vacation
is extremely important.
So what I'm understanding isthat you can call them requests,
but mostly it's a rotationsystem and, depending on the
(21:42):
schedule already existing,you're being assigned a midwife.
Yeah, I think we covered prettymuch everything and also, if
anyone has any questions, theycan reach out to us.
They can reach out to us in theshow notes or send the message
to us on Instagram.
Also, corey is with themidwives of Windsor and Corey.
(22:02):
If you wouldn't mind sharingthat website, yep, it's just
midwives of Windsor and Corey,if you wouldn't mind sharing
that website.
Corey (22:05):
Yep, it's just midwivesofwindsorcom.
Perfect.
Deborah (22:08):
Yeah, this is Corey, and so if you want to request
her privately, you can try.
So, corey, thank you so verymuch for being with me today.
I'm so grateful that we got todo this conversation and that
we're helping educate thecommunity on midwifery care.
Thank you, thanks.
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