How does style of Midwifery in Canada compare to UK?
 

Hello! First time here and hoping to find some answers. A bit about me: I’m a dual citizen; born & raised in UK until 13, moved to Canada and gained citizenship, then returned to UK at 26 to study Midwifery at King’s College. I lived on Vancouver island and if I was going to return, it would be to the west coast.

I’m about halfway through my course but can’t help think about what I’ll do when I graduate. I’d really like some insight into the model of midwifery care in Canada, BC specifically. My impression is that it’s case-loading, low-risk, community based and with a longer Postnatal care than the UK currently does. Do midwives also work in the hospitals on Labour wards or is that role more so for obstetric nurses? In the UK we are trained to manage high risk Labour and induction but from my researching I didn’t really get the impression that midwives performed this in Canada? If anyone with experience in both countries would be kind enough to outline the similarities/differences I would greatly appreciate that. Or if anyone just with experience in Canada could outline what midwifery looks like, that would be great too.

My ideal model of midwifery is continuity of care through case-loading, working in the community and birth centers. Which I can find here in the UK but the UK doesn’t offer the way of life I’m looking for. Which is also why I’m considering NZ, as I think it would have both the midwifery and lifestyle I seek. I know that also in NZ they have core midwives who do the hospital work which is something I’d like access to in order to keep up the skills I’m learning. However, I don’t want to overlook Canada though since I’m a citizen and that would make the whole process of moving much easier. Would you say Canadian midwives have the same skills and autonomous practice as in the UK?

Thank you 😊

Re: How does style of Midwifery in Canada compare to UK?
 

Hello and welcome to BE!

These links may be of interest to you.. but be prepared that you will have to convert your qualifications..
https://www.bcmidwives.com/model_practice.html

https://www.bcmidwives.com/
https://www.bcmidwives.com/practice_bc.html

https://www.bccnm.ca/RM/Applications...ationalEM.aspx

Re: How does style of Midwifery in Canada compare to UK?
 

Hello, it seems there are several differences but In my opinion it’s pretty much the same. My 9 year old was born in London, at St Thomas’s, where you probably are familiar with if you studied at kings. I also worked for kings college London fo 6 years!
I live in Vancouver now and my 5 year old daughter was born here. I had midwives both times. In the UK you are assigned one but here I had to find one myself. Everyone around me was not familiar with the idea of being looked after my a midwife including our family doctor who initially thought I wanted to give birth at home, however, once I started doing research I realized there is a growing demand for midwives and some clinics had too much cases they couldn’t take me on, I was also on wait list with another but I was finally was accepted by a clinic called pacific midwifery practice. I had a wonderful midwife. She was fully in charge of my care. I only had to see a doctor once because my iron levels were very low. At the time she told me she may have to handover my case to a doctor if my iron levels do not improve as I may be considered high risk for her to manage, which makes me think perhaps midwives here do not mange high risk pregnancies, but I’m not sure. However, I didn’t have to worry about it since all was fine in the end. From my observations, my midwife in London was very busy although she tried not to give that impression, she was so efficient, she was also warm, caring, I felt like she was my friend most of the time, I’m sure she was seeing so many pregnant women a day, she was assisted by a student from Kings almost all the time I saw her too. in contrast my midwife here had just me or perhaps another person in the waiting room, the environment had a private clinic feel, she was very professional and took her time. Half way through my pregnancy she moved to downtown (I didn’t like driving there.. parking etc specially as my pregnancy progressed and was seeing her regularly, I just wanted it to be like the UK where you only walk around the corner to your GP surgery!
I finally gave birth at St. Paul’s because she had many connections there. She was also in charge of the delivery, from arranging epidural to everything else that is involved...Just before my daughter was born, a Doctor was called in, perhaps 20 mins before, I’m not sure why, there were no problems but it may be a standard here. The doctor did not do anything until the baby was born, she examined the baby and left. I don’t remember seeing a Doctor in London in the delivery room, except the day my baby and I was discharged from the hospital when a doctor examined him just before we went home.
My care with my midwife was going to continue with home visits and then after a while I was going to visit her at the clinic with my baby, that was the plan and this was why I really wanted a midwife.. the continuity of care.. help with breastfeeding etc was important to me but that could not happen as my baby was very ill at only 3 days old and was hospitalized, but she is now a healthy kindergartener, thank God! But my midwife visited us at the hospital and kept in touch, she was lovely...so all in all, the things that really matter, like the care you receive is delivered the same way. I felt well looked after both here in Canada and the UK. This is only a perspective from a patient , but I hope it helps. There was a British midwife at the Vancouver clinic, she was not my midwife but I feel speaking with someone like her would most useful to you. Good luck with whatever you decide to do.

Re: How does style of Midwifery in Canada compare to UK?
 

This has given me such great insight, thank you for sharing your experience.

Re: How does style of Midwifery in Canada compare to UK?
 

For a bit of insight into midwives in BC. and Canada ...............

it is not that many years ago that midwives were not allowed to practise in BC, and many other provinces, if not all.

I had my daughter 47 years ago this month in Vancouver and there literally was not other choice than a doctor, no midwives at all. My GP had rights in the hospital so I was with him all the way through, although in the end i had to have a surprise caesarean, which meant he had to call in a gynaecologist, paediatrician etc etc.

I did meet an English-trained midwife however ........ she was working as a Licensed Practical Nurse on the ward, and she had chosen to do that because she couldn't work as a midwife, and the other alternative was to re-train as an RN.

Fast forward to the 1990s, and the push for midwives and then doulahs increased, but the doctors held firm. It was THEIR right to deliver babies, no midwives were capable.

There was no training then, and I have to admit that untrained women were working as "midwives" ............... bit like the elderly woman in an English village who had delivered most of the children. There were of course problems, mothers in trouble being taken to the hospital and left to make their own way into Emergency, with the "midwife" disappearing, babies dying, court cases, etc etc. All of which gave ammunition for the doctors to defend their right to deliver babies, and no-one else.

Now, there is midwife training here ....... but they are not generally connected with a doctor. You do have to find your own. It has become much more accepted, and some doctors may even recommend a name or two. Hopefully, the trend to have a clinic where all services are available from the doctor to physiotherapy, dietician etc will soon include midwives. It has progressed to the point that MSP (the Medical Services Plan) of BC covers the cost of a midwife just as they cover the cost of doctors.

In some very remote areas in the far north such as the Yukon or Nunavut, a midwife may even be charge.

Doulahs (or Doulas) are also popular, I gather, and I'm not sure what their training is ..... they do seem to coach a woman through her pregnancy, be there at delivery, and then after the baby is born. They are not medically trained, and cannot deliver a baby. Their cost is not covered by MSP

But do not expect to find midwifery as accepted a profession as in England. As Siouxie said, you will have to be accepted by the association, and may have to re-train or take some extra courses.


LondonM ...... you probably saw a doctor in the delivery room and then another before you left the hospital as a requirement of the hospital and their legal requirements. You were quite correct in thinking that a midwife does not handle high-risk cases.

Re: How does style of Midwifery in Canada compare to UK?
 

Looks like this profession has come a long way in BC. Thank you for this background information Scilly.

Re: How does style of Midwifery in Canada compare to UK?
 

Hi OP- I have re-registered to answer your question (I haven't been active here in awhile and can't remember by username) as I have a lot to say about this!

I trained and worked as a midwife in the UK and now work as one on Vancouver Island. Firstly, midwifery is well established here. I live in a community where well over half of women have midwifery care- it's the norm. However in all honestly, I do not recommend midwifery here unless you are a very tough, confident person and a workaholic. The system is wonderful for women and terrible for midwives. So many midwives are burnt out and desperate for a change to the model of care. Being on-call so much is difficult and stressful especially if you have children or any kind of caring responsibilities. The level of responsibility is higher here. There is also an enormous amount of admin involved in the job, far more than a community midwife in the UK would have! (Ordering tests, sending faxes, writing consult notes- it takes hours.) There is also no alternative career path, and this is a huge frustration for midwives here. It's not like in the UK where plenty of different 9-5 roles exist.

It is also not a low risk model of care- here on the island we look after all but the most high risk women. For clients with risk factors care is likely to be shared with an OB, but we are still in charge of coordinating care for some very high risk pregnancies. We go to lovely home births but most of our births are in the hospital and of similar complexity to the ones you'd be managing on a UK labour ward. The big difference is that the hospitals are staffed by nurses, and we are working alongside them. The roles and responsibilities are a little different in hospital and this is one of the main things you have to adapt to here. In some hospitals relationships are excellent, but in others they can be trickier.

The wonderful things about midwifery here are the autonomy and the relationships you develop with families. The pay initially seems good, though it's not nearly as good as it should be for the responsibility and workload. We also have no pension, maternity leave, no help with office expenses etc. And many midwives of young children have partners who stay home because of the demanding model of care, so they end up being the sole provider.

If you are looking for caseloading in a community, low risk model, I would honestly not consider BC. The UK has more and more home birth and continuity teams, which would offer a much better work-life balance and a lower risk care model than we have here. However it looks like you're not keen on the UK lifestyle, so I would probably look at similar models in Australia, or at NZ. I hope I haven't totally rained on your parade. For some people being a midwife in Canada is a wonderful job, but for many people the expectation and the reality are very different.