So you’re going to have a baby – congratulations! Before you get to the fun parts like choosing a name or the details of your baby shower, you’ll need to pick a care provider and start considering how you’d like to give birth.
When the baby’s in your belly, we’ve got your back with the mother-of-all guides to giving birth in Canada.
WHO CAN GET THAT BABY OUT OF YOU?
Options vary slightly by province, but in general you’ll be given the choice between a family doctor or a registered midwife, if available. Sometimes OBGYNs are on the menu too, although some provinces will only pay for OBGYNs to attend high-risk pregnancies (see the links below for details by area). It’s best to start prenatal care as early as possible, so if you’re not sure where to start, book an appointment with your family doctor, who can explain care choices in your region, and set you on the path to good prenatal nutrition and care.
Why choose a midwife?
Midwives are the most flexible practitioners, and can deliver your baby in a hospital, birth centre or at home. Although midwifery is often associated with crunchy granola mamas, midwives are regulated health professionals who specialize in pregnancy and birth.
Studies show that low-risk women under a midwife’s care are less likely to be induced, have a lower C-section rate, and fewer maternal and newborn hospital readmission rates than those with an OBGYN. Midwives are also likelier to preside over drug-free births, although you certainly have the option of choosing a midwife and an epidural, as long as you give birth in a hospital. Midwives typically spend more time with clients than doctors and much more time than OBGYNs.
Should you develop a high-risk profile at any point in your pregnancy, a midwife may transfer care to, or share care with, a doctor or OBGYN.
Once your baby is born, a midwife will come to you for the first few postpartum checkups.
Why choose a doctor?
It can be reassuring to choose a practitioner who already knows you, your family and your medical history, particularly if you have a good relationship. And since your child will likely be a patient in the same practice, you may want to start the relationship early. If you live in a remote or sparsely populated region, a doctor may be your only choice.
Doctors within a family practice will share your care with a team of professionals including their colleagues and registered nurses. If you develop high-risk complications, your doctor may refer you to an OBGYN.
Once your baby is born, you will have to visit your doctor for the first few postpartum checkups.
Why choose an OBGYN?
Maybe you want to hedge your bets in case of potential complications, maybe you’ve had a previous high-risk pregnancy or perhaps you’re already experiencing a medical condition that can lead to complications, like diabetes, thyroid disease, polycystic ovary syndrome, HIV/AIDS or certain auto-immune disorders.
Whether you start with an OBGYN or not, developing complications or risk factors is generally your ticket to receiving OBGYN care, whether it’s exclusive, or shared with your family doctor or midwife. The Canadian Maternity Experiences Survey shows that most Canadian women (58 per cent) choose an obstetrician as their pregnancy care provider.
Once your baby is born, you will have to visit your OBGYN for the first few postpartum checkups.
What about doulas?
Doulas are private pregnancy assistants you can pay to attend your pregnancy, delivery and your “fourth trimester” or postpartum period. They’re not allowed to give medical advice, but they can provide practical and emotional support. During labour, a doula may offer breathing instructions, positioning advice or perineal massage, and can facilitate communication between a labouring woman and her partner or care providers. After delivery, a doula might offer newborn care or help with light housework.
WHERE CAN YOU DELIVER THAT BABY?
Leave the dramatic roadside births to YouTube; most Canadian babies are delivered in a hospital, a birth centre or at home.
Why choose to deliver in a hospital?
The overwhelming majority of pregnant Canadians (97.9 per cent) deliver their babies in hospitals or clinics. Hospital deliveries are the most cautious choice, and many parents find it reassuring to know that if something goes wrong, emergency care will be immediate.
Still others are comforted knowing that in a hospital, an epidural is only a pager notification away.
Anyone can give birth in a hospital, but if an induction or C-section is on your delivery menu, a hospital delivery is the only choice.
Although safe, hospitals aren’t the most comfortable choice: the bright lights, loud noises, and rigid routines aren’t for everyone. On a philosophical level, hospitals are medical facilities and therefore treat birth as a medical event.
Why choose to deliver in a birth centre?
Birth centres are a solid middle ground between hospital and home; they’re staffed with midwives and midwives-in-training and stocked with equipment like oxygen machines, baby warming stations and deep tubs. If you’re looking for a natural childbirth with minimal interventions, but want to avoid the mess of a homebirth, a birth centre is your best bet. Although they are equipped with medical tools, birth centres treat labour and delivery as a life event, rather than a medical situation.
You must be low-risk, under the care of a midwife, and willing to forgo an epidural to give birth at a birth centre (nitrous oxide and positioning tools may be available for pain relief). If risk escalates at any point during labour, you will be transferred to a hospital.
Demand for birth centres is growing faster than they can be built; your request to deliver at one will depend on availability. Check with your midwife to see if there’s a birth centre with space in your area.
Why choose to deliver at home?
For the vast majority of human history, homebirths have been the norm. A recent McMaster University study compared home birth outcomes to hospital deliveries, finding that planned, midwife-attended homebirths had no more adverse neonatal outcomes than hospital deliveries, and fewer interventions.
Choosing a homebirth means you won’t have to plan your transportation or pack an overnight bag – but you will have to prepare sheets, towels and cleaning supplies to help manage the considerable mess of childbirth.
What’s the story in my home province or territory?
See this list for the deets on care options in your area: