Services
We follow the regulations and standards for midwifery care as laid out by the College of Midwives of Ontario, which include screening for risks and consulting with other practitioners when necessary. These standards and our practice protocols are available at request. We offer complete midwifery care during pregnancy, labour, birth and the postpartum period. Our care involves physical assessments, lab work, time to address your questions, and discussion of a number of topics such as:

Pregnancy care includes regular visits, approximately once a month for the first seven months, then more frequently until the birth. Our clinic appointments give us ample time to provide clinical care and address discussion topics. We strongly encourage both partners to be present, and welcome other family members.

During active labour we are in attendance to provide clinical care, reassurance, and an extra pair of loving hands. After the birth, we stay until confident that the mother and baby are stable and adjusting well. Postpartum care includes three visits within the first week, and two additional clinic visits prior to completion of our care at six weeks postpartum. We are happy to make more appointments as needed. We welcome phone calls during the baby’s first months to assist in making the transition to parenting as
smooth as possible.

Midwives are primary healthcare providers for pregnant women, it is therefore unnecessary for you or your baby to see a physician for additional obstetric or newborn care. Any concerns relating to pregnancy and postpartum should be directed to the midwife. We will refer any medical concerns relating to the pregnancy, birth, or postpartum to the appropriate specialist. If care must be transferred, we continue to provide advocacy and support. In the case of non-pregnancy related concerns, we will refer you to your family doctor or another health care provider. We do refer clients to chiropractors, physiotherapists, homeopaths, acupuncturists, massage therapists, lactation consultants, and others as appropriate.

You are welcome to use our library, consisting of books, DVDs and videotapes. During the course of your care we may recommend various readings and viewings that are relevant to your individual needs.

Availability
Each client is assigned to a primary midwife who will be the coordinator of your care and the first person to contact for your individual needs. In the event of a pregnancy related concern, your midwife is your primary resource, and is available to you 24/7 by her pager. Your midwife will determine the appropriate course of action and make referrals as appropriate.

You will have the opportunity to meet and establish a relationship with both midwives as we offer alternating appointments between the two midwives.

There are two midwives at each birth, the primary staying with the woman during active labour, the second arriving closer to the time of birth. To preserve the well-being of the midwives by allowing for some time off-call, we utilize second birth attendants. Occasionally, the second midwife at a birth is replaced by a second birth attendant or a registered nurse, depending on you choice of birthplace. Second birth attendant’s are women with experience in birth who are not midwives, but are registered with the College of Midwives of Ontario to assist us at homebirths.

It is most likely that at the time of birth you will be cared for by your primary midwife. During your primary midwives off-call time, your second midwife will take over the role of primary. It is important for you to be comfortable with us as a team. Although the personalities of the midwive’s may differ, we are both committed to informed choice, continuity of care, and the highest standards in midwifery care. Please feel free to question us further regarding off-call arrangements.

We make every attempt to attend each of our clients in their desired birth place. However, because we are such a small practice in such a large geographic area, times may arise when we are unable to honour a woman’s birth plan. For example; when we have two women in labour simultaneously, we will make every effort to attend both women by utilizing our second attendant’s, but on occasion, we may need to ask a woman planning a homebirth to move into hospital. We also need to take into consideration extreme weather conditions, accessibility of the woman’s home and distance from home to hospital when deciding whether home birth is appropriate.

There is always a midwife available 24 hours a day, 7 days a week for urgent needs. We ask that non-urgent calls and regular appointments be made during weekdays. The nature of the service we provide means that occasionally it may be necessary to cancel your appointment, for example, when another woman is in labour. Although it can be frustrating to have your appointment canceled, we ask that you consider that when you are in labour, we may be canceling appointments in order to attend to you.

It is advisable to call our message centre before leaving for your appointment. The message will inform you of any cancellations. Your midwife will be in touch with you to reschedule your appointment.

Responsibilities
Midwives tailor the care they give to the individual client. It is important for you to tell us what your expectations are, and to keep us informed of any situations that could affect your care. It is your responsibility to ask questions and make final decisions about your care and that of your baby. Our role is to help you access the information you need to make those choices.

Clients are responsible for their health and that of their babies, which includes paying attention to diet, rest, exercise and regular prenatal care. During pregnancy we request that you learn about the process of pregnancy, labour and birth, relaxation techniques, postpartum adjustment, infant care and breastfeeding. Prenatal classes, La Leche League meetings, and readings are recommended.

Birthplace
Kilmeny Heron and Leslie Soopalu have admitting privileges at the Pembroke Regional Hospital. In keeping with the College of Midwives of Ontario, we offer women the choice of homebirth or birth at Pembroke Regional Hospital.

Birth is not inherently a dangerous process, but there are distinct risks and benefits to any birth place. It is the responsibility of parents to become as informed as possible, to weigh those risks and benefits and to make decisions appropriate to themselves.

Some medical practitioners and organizations believe home birth poses added risks. The available research indicates that planned home birth is a safe option for, low risk, healthy mothers. The Ontario Ministry of Health and the College of Midwives supports choice of birthplace.

Deviation from the normal can usually be identified prenatally and in labour. Most problems are not life-threatening and can be dealt with at home. In some instances moving to hospital is the most appropriate decision. There are circumstances when use of the technology available only in tertiary care hospitals may be essential for the safety of mother and/or baby.

We can provide you with detailed information about some of the problems which may arise and, we encourage you to discuss with us our experience in dealing with them.

Scope of Practice, Standards and Transfer of Care
Midwives must practice within the scope of practice developed by the College of Midwives. The "indications for mandatory, discussion, consultation and transfer of care" are available to borrow and read. Please ask your midwife for a copy.

In addition to the College of Midwives guidelines for transferring care to a physician, there are some guidelines for transfer of care which are mandated by the Pembroke Regional Hospital.

If your midwife transfers your care to a physician this means that the physician becomes your primary caregiver instead of your midwife. For this period of time, your physician and/or nurses provide your care and monitoring. Your midwife’s role is to advocate and support. Care may be transferred back to the midwife when appropriate and when agreed upon by all parties.

Confidentiality
All professional communication with clients is kept confidential. Specific information regarding your situation is shared with professional colleagues who are providing you with care. You are free to examine your chart at any time, and a copy will be available for you after your last visit.

If we use a birth story as a tool for educating other families and midwives, this is done discreetly, without reference to names or places. If you do not want your story used, please tell us so.