Frequently Asked Questions
WHY HAVE A COLLABORATIVE CARE PRACTICE WITH DOCTORS AND MIDWIVES?
Our plan is to build a community hub for pregnant people and their families. By combining forces, your team of midwives and family doctors has a diverse set of skills to help guide you through pregnancy and post partum. Midwives bring a focus on normal physiological, pregnancy and birth while family doctors have an increased scope to handle any complications that may arise in your pregnancy, birth or postpartum. Imagine a welcoming place where you build connections with team members, community supports, and other pregnant persons during this exciting journey. Both midwives and family maternity doctors are experts in healthy pregnancy and birth and can provide primary clinical maternity care to pregnant clients and their babies from early pregnancy, through labour, birth and the first six weeks postpartum. Our team of doctors and midwives listen, observe, educate, guide and care. We order and interpret tests and screen for physical, psychological, emotional and social health. We are with clients during pregnancy, labour and birth, normal and complicated. We catch (also known as “deliver” babies--but it’s you who’s doing the delivering). We do home visits after the baby is born. We help with breastfeeding and adjusting to life with a new baby. We work together and with other health professionals.
DO I NEED A REFERRAL FROM MY DOCTOR TO SEE YOUR TEAM?
No referral is required. Simply contact the clinic or fill out an intake form online.
ARE MIDWIFERY SERVICES REGULATED?
Yes. Midwives are registered with and regulated by the College of Midwives of British Columbia (CMBC) according to the BC Health Professions Act, the Midwives Regulation and the CMBC Bylaws. Midwives have been regulated and legally recognized as autonomous health care practitioners in BC since 1998.
ARE THE COSTS OF THE COLLABORATIVE MATERNITY SERVICES COVERED IN BC?
Yes, the BC Ministry of Health covers the cost of both midwifery and family doctor maternity services for all BC residents with a valid Carecard or BC Services Card through the BC Medical Services Plan (MSP).
SHOULD I SEE MY REGULAR DOCTOR FOR PRENATAL CARE AS WELL?
The BC Medical Services Plan covers only one primary care provider for the duration of your pregnancy and birth, to six weeks following birth for healthy pregnancies. The choice of care provider during your pregnancy is up to you. If you enter care with our team, you don't need to continue to see your regular doctor for pregnancy related issues, although you may return to see them to manage concerns that are unrelated to your pregnancy. Our local obstetricians do not offer primary care but are available for consultation for higher risk pregnancies.
Midwives and maternity doctors are experts in healthy pregnancy and normal birth, and consult with specialists such as obstetricians and paediatricians as the need arises. Six weeks after delivery, when your care with us is completed, your care will be transferred back to your regular family doctor who will resume responsibility for the health of you and your new baby. If you do not have a family doctor, we can assist to find one for your family.
I AM NOT COVERED BY MSP. CAN I STILL HAVE CARE WITH YOUR TEAM?
If you are not covered by MSP, feel free to contact our clinic and speak with us about the option of paying for your care privately. Our team does not charge you more than we would bill MSP, however those fees do not include supplies, laboratory tests and blood work, ultrasound scans, or any hospital or physician charges, including the costs associated with hospital births.
If you are a refugee covered by the Interim Federal Health Program (IFHP) you can call the Midwives Association of BC (MABC) at 604-736-5976 to find a midwife registered with Medavie Blue Cross in your area.
WHEN SHOULD I CALL TO MAKE MY FIRST APPOINTMENT?
Contact us as soon as you know you are pregnant. We want to ensure that you have prompt access to the care that you need.
HOW OFTEN DO I SEE MY CARE PROVIDERS?
Your prenatal visits happen on a similar schedule to most maternity care providers’ in BC. Most visits in the first part of pregnancy are scheduled every 4-6 weeks and last between 30-45 minutes. As of 28 weeks visits are every 2-3 weeks. Visits are often every week during the last month of pregnancy. Our longer visits allow for physical, emotional and social health assessments, time for informed decision making and the development of a trusting relationship between clients and their care providers.
After your baby is born, visits usually take place wherever the new family resides. This may be in the hospital after a hospital birth or at home. After the first week, visits are scheduled in the clinic and continue for about six weeks when your care is transferred back to your regular family doctor. Between visits, we provide 24/7 call coverage for urgent care or concerns.
HOW MANY CARE PROVIDERS WILL BE INVOLVED IN MY CARE?
Our practice has four midwives and four family doctors working in a shared care model. You will have have opportunities to meet all the midwives and doctors in our group before your birth if you would like, or you could choose to see only a few providers during your pregnancy if you are most comfortable with this. Our team rotates being on call for labouring and birthing clients, so you could have any member of our team at your birth. We share client care and work collaboratively. We also occasionally have locum midwives or doctors who work with us in the event of vacation coverage or illness.
The CMBC Midwifery Model of Practice highlights the concept of continuity of care in providing safe, individualized care.
CAN I CHOOSE WHO IS AT MY BIRTH?
Cedar House Collective works on a call system, rotating who is available for birth. This means you will have a well rested and excited midwife or family doctor providing care for you during your labour. Due to our call schedule, it won't be possible to choose who is at your birth, but each of our providers will be providing you with individualized, respectful and quality care.
WHAT IS THE WORKING RELATIONSHIP BETWEEN MIDWIVES/FAMILY DOCTORS AND OBSTETRICIANS?
We enjoy collaborative working relationships with our consultants. As needed, we will consult with obstetricians, paediatricians and other specialists to give you the safest care available. A transfer of care to an obstetrician is occasionally necessary in urgent situations. With transfers, unless a complication arises early in pregnancy (and requires a complete transfer of care) we typically remain involved in your care in a supportive role, with care often transferred back to us completely once the issue has resolved.
WHAT KIND OF TESTS AND PRESCRIPTIONS WILL I BE ABLE TO ACCESS ?
We offer a complete panel of prenatal laboratory tests, genetic screening and diagnosis options, ultrasound imaging and many other tests and procedures for clients and newborns. All our midwives and family doctors can prescribe and use of many medications that may be indicated in pregnancy, during labour (including in emergency situations or pain medication) and postpartum. The family doctors in our team can prescribe an even wider range of medications or testing if needed.
COULD COMPLICATIONS RULE OUT MATERNITY SERVICES WITH YOUR TEAM?
Most families who are interested care with our team are able to access it. However some conditions are best managed by a specialist. During your initial visit, we will be able to give you an idea of whether the care you need is covered by our scope of practice.
Should complications arise while you are in our care at any time, we follow provincial guidelines that help inform the decision to consult with or transfer care to the appropriate consultant or other specialist. https://www.cmbc.bc.ca/wp-content/uploads/2018/05/Indications-for-Discussion-Consultation-and-Transfer-of-Care.pdf
CAN I CHOOSE WHETHER I GIVE BIRTH AT HOME OR IN HOSPITAL?
We value your choice of birth place, and for a healthy low risk person, giving birth at home is as safe as in the hospital. Please talk to our team as soon as possible if you are interested in having a home birth.
For more information on home birth in BC, you can read the CMBC Place of Birth Handbook.
WHAT PAIN RELIEF OPTIONS ARE AVAILABLE FOR ME?
We offer a range of natural (massage, acupuncture, position change recommendations, verbal encouragement, breathing techniques, and more) and pharmaceutical pain relief options, including access to epidurals. It is important to us that you have access to the information necessary to make informed decisions about the use of pain relief options. These options are discussed during your prenatal visits as well as during prenatal classes.
WHAT HAPPENS IF I HAVE TO HAVE A C-SECTION?
Midwives have a 42% lower caesarean section rate than the provincial average. However, in certain circumstances a caesarean birth may be recommended as a safer option than a vaginal birth. An obstetrician will then become involved and will perform the caesarean. In most situations midwives are involved in the decision making process, and will be present during a caesarean birth to provide support, care to the baby, assist with skin to skin/breastfeeding in the OR as desired, and will resume postpartum care afterwards.
WHAT IF I HAVE A PROBLEM UNRELATED TO PREGNANCY?
During pregnancy, clients continue to see their regular family doctor or specialist physician for health issues unrelated to pregnancy, however if you don't have a family doctor, the family doctors on our team will be able to assist you as well.
WHAT IS THE DIFFERENCE BETWEEN A MIDWIFE AND A DOULA?
Doulas do not provide medical care and do not deliver babies. Midwives are trained to provide all the necessary medical care and to monitor the health and well-being of you and your baby.
Doulas work as a part of the team, with a midwife or doctor and nurse. Doulas provide continuous emotional and physical support and are a positive addition to the birth team for clients who want extra support. For more information about doulas, please visit the BC Doula Services Association. If you or your partner are Indigenous, you may qualify for a free doula through the BC Association of Aboriginal Friendship Centres.
AM I HIGH RISK IF I AM OVER 40 YEARS OLD?
Many people who are 40 years or more have healthy pregnancies and uncomplicated deliveries. Although there is a higher rate of certain pregnancy conditions, you are not considered to be too high risk for midwifery care just because of your age. We will get to know you and your health history just like we do with all of our clients and will help you to make the best plan for your pregnancy and birth. There are some additional tests and care plans that will be offered to you to help you have the healthiest pregnancy possible. We will discuss this further with you at your prenatal visits.
ARE THERE ANY CULTURALLY RELEVANT RESOURCES OR SERVICES AVAILABLE TO ME IF I AM INDIGENOUS?
Yes. Your care providers will be happy to discuss these with you. We are committed as a practice to working towards the decolonization of birth. We have all accessed Indigenous Cultural Safety training, recognizing that cultural humility and the process of learning about cultural safety will be ongoing. We are each members of the Indigenous Women’s Sharing Society here in the Comox Valley (see https://www.facebook.com/pages/category/Nonprofit-Organization/Indigenous-Womens-Sharing-Society-1979281905727385/ for more info).
We look forward to continuing to share and learn about different resources that are available to our indigenous families.