Hooray! You’re pregnant! That’s so stinking exciting right?!
There’s so much to plan and do to get ready for your sweet little’ one’s arrival – but the very VERY very first thing you need to do (after you tell your partner of course), is to decide whether or not you want to birth with a midwife. In fact, if you’re looking for a midwife in Calgary, it would be a good idea to know this BEFORE you start trying to conceive. While you’re at it, you might as well have the intake request forms completed and ready to submit the moment you find out you’re pregnant!
It sounds a bit like I’m overreacting, yes? I’m not. There is a severe shortage of midwifery funding in Alberta and, while it was recently increased a bit, the demand still vastly outweighs the availability. In fact, many women submit intake forms as early as 3 and 4 weeks pregnant (before they’re even really late for a period – thank goodness for early testing!) and STILL aren’t able to find a midwife with space.
So if you are one of the many who would prefer midwifery care for your baby’s birth but are not able to find one in your area, take heart! There are some steps you can take to help your birth and your relationship with your doctor more comfortable.
1 – Sign up on the Alberta Midwifery Request For Care registry and check back in!
Even if you’re turned away by every midwife in your city, REGISTER! This registry was designed, in part, to help Alberta Health Services understand the very high level of demand for midwifery care versus the actual availability. The hope is that this will help to increase funding in the future. As a bonus, if spaces become available, midwives are able to find patients using this registry.
Don’t forget to check back in in the second and third trimesters. It’s NEVER too late to transfer to another care provider (I’ve had clients change providers at 38 weeks!). Patients transfer out of midwifery care as their pregnancies progress. Either for reasons of preference, or because they are no longer considered low risk. Spaces DO open up in these later stages and the squeakiest wheel gets the grease so call back and inquire.
2 – Let yourself grieve
Take some time to let yourself mourn the birth that will not be. Unless you are planning to have an unassisted home birth, you will be delivering in a hospital without a midwife on your team. For some women, this isn’t a big deal. To others it’s completely heartbreaking. Don’t let anyone tell you you’re being silly or overreacting if you need to have some time to sit with the sadness and disappointment of not having the care you wanted.
3 – Make a plan and be sure to include things you’re not likely to consent to or that you would likely AMA
Your birth plan is not to actually an attempt to PLAN birth (you can plan birth like you can plan the weather!) but for working through the different options available to you. Going through the motions of making a birth plan helps you determine what you’re likely to consent to, unlikely to consent to, and even what you plan to AMA.
AMA means Against Medical Advice. It’s a tightly kept secret, but you ARE allowed to decline any procedure or medication (including cesarean birth, inductions, and not eating while in labour) by signing an AMA form. This form essentially says that you understand the risks of declining said procedure or medication and are choosing to do so. This releases the hospital from liability should you sign the form and go against hospital policy. This is not something to be taken lightly and I encourage you to discuss this plan with your care provider before committing to an AMA plan of action. If you feel very strongly about something and would choose to sign an AMA should that circumstance arise, it’s important to have a conversation with your doctor about it ahead of time if at all possible so that they can plan the appropriate approach for managing your care.
4 – Talk to your doc about why you wanted a home birth or midwifery care
Once you’ve got your birth plan, make an appointment with your doctor to go through it (try to make a separate appointment from your quick in and out checkup so that you have a few minutes to chat!)
Doctors, the vast VAST majority anyway, are not evil birth machine black coat practitioners. They actually DO care – a LOT – about their patient’s emotional and mental needs. On top of that, they’re just people. People with authority and with a tremendous amount of knowledge of expertise, but still people. Reach out to them and let them know what you’re hoping can be duplicated or what you love about the midwifery model of care and get that conversation started!
5 – Bring things to make the space less sterile
Body pillows, ear plugs, music, your favourite blanket, essential oils (put these on cotton balls inside of zip lock bags! Diffusers are a no go in Calgary hospitals, and if you end up hating the scent during labour it’s easier to flush a cotton ball than to cleanse the air!). When packing your birth bag, bring whatever would make you feel calmer, less stressed, and more at ease!
6 – Try to stay home for as long as possible
Barring any medical concerns, staying at home for as long as possible can be a great way to halfway have your home birth. Get to know the signs of active labour and transition and talk to your doctor about medical reasons to be assessed so that your partner (and doula) can help you recognize if it’s time to head in or if you can probably stay home a bit longer. (Caveat: if you feel antsy about staying home, feel like you need or want to be assessed, or really feel like you’d be calmer being wherever the birth will take place, follow your instincts. ALWAYS follow your instincts).
7 – Find a doula
On top of providing physical comfort techniques and support for your partner, a doula can help you be as comfortable as possible in a hospital setting. Many birth doulas (like myself) work primarily in hospitals and so are very comfortable helping you navigate the policies and procedures, gather information, advocate for yourself, and facilitate conversation between you and your medical team during labour.
8 – Make a postpartum plan
One of the perks of having care under a midwife in Calgary is that they will see you relatively frequently after your baby is born and you have ONE touchpoint for concerns. Find out who will be contacting you for follow up after your baby is born, when your health care checkups will be, and who you can talk to if you have questions about breastfeeding or baby care. Having this information on hand before you’re on day 3 with 5 hours of sleep is definitely a good idea.
Having a postpartum doula can help immensely with the transition of the first weeks (or even first few months) of parenthood. Like a birth doula, the postpartum doula’s focus is on you. Postpartum doulas help you stay as rested and nourished as possible, provide in home breastfeeding or bottle-feeding assistance, work to improve your confidence as a new parent through evidence based education and practice, assist with basic tidying and even little errands so that YOU can spend your energy recovering and bonding with your new baby.
9 – BREATHE
No matter where your baby will be born and who your care provider will be, the one person who makes the most difference in your baby’s birth will be there – YOU!