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Choosing your Maternity Health Care Provider in BC, Canada

You are pregnant. Now what?

The first thing you will have to do after the initial excitement is over is choose a care provider. In B.C. Canada, we have many choices for care providers. We have Obstetricians, Family Doctors and Registered Midwives. These options are all paid for with your Medical Service Plan (MSP).

Obstetricians (also called OB's) are medical doctors who specialize in the care of high-risk pregnant women. Most obstetricians are also gynaecologists who diagnose and treat diseases of the female reproductive system and provide care for women when they are not pregnant. OB's do not look after newborns or support birthing people in the postpartum period. You will be referred to your family doctor or a postpartum midwife for the care of your baby after you give birth. Many OB's work as a team of 8-12 doctors. Find out what your OB's on call schedule is so you know what the chances are that they will attend your birth.

Family Doctors are medical doctors who work in general medicine. Not all Family Doctors work with birthing people, make sure the doctor you are with attends births. If not, you will be referred to a midwife, another family doctor, or OB once you are in your second or third trimester. It can be hard to find a someone for your birth if you wait too long.

Many family doctors work in larger teams so they can balance their family practice with being on call some work solo. It is good to ask your doctor what their practice model. Your family doctor will look after you and your newborn during the postpartum period at their clinic.

Registered Midwives specialize in normal pregnancy, birth and newborns. Midwives attend both hospital births and home births. Often midwifery appointments are longer and cover everything from diet, pregnancy health to which tests are available to you. Midwives provide all the same tests and drug options as physicians. Some midwives can also support clients in labour at home before they go to the hospital. In the Lower Mainland there are also midwives who work in large teams and have call shifts.

Postpartum Midwives come to your house in the initial postpartum phase to help with breastfeeding and check on the well being of both the newborn and the birthing person. This will either be your original midwife team or if you had a OB it might be a new midwife who specializes in postpartum care. In the first week the midwife will come to your house 2-3 times, then the rest of the visits will be in their clinic. They continue to be on call and care for you and your baby for 6 weeks.

Lactation Consultants that are midwives are covered by MSP up to 6 weeks postpartum. You can also hire a private lactation consultant in the community.

Doulas are non-medical support people that are not covered by MSP. You will hire a doula privately. Doulas support families during the birth process and often into the postpartum period. There are both Birth Doulas and Postpartum Doulas. Here is an article that explains what doulas do. Birth by Bloom offers Speed Dating with Doulas events every two months online. It is free and a great way to meet doulas who have availability for your due date. You can register here.

What to think about when choosing a care provider.

Doctors and midwives share the same goal. They both want you and your baby to be healthy. Their approaches may be different. When you choose your medical care provider, ask questions about their philosophy and approach. Do these match your preferences and values?

Some care providers work in big teams. Find out what their call schedule is like during your birthing time and who will attend your birth if they are not available.

Care providers have privileges at different hospitals. Some have privileges at multiple hospitals. If you want to birth at a specific hospital, make sure you are choosing a care provider who works at that hospital. Here is a link to an article about hospital options in the Lower Mainland.

Make sure you are happy with your care provider. Before you pick one, ask your friends who they had and how they felt about their care. If you are unhappy with your care at any point in your pregnancy, explore your options. You only give birth to your baby once. Make sure you are happy with the person taking care of you.

Here are some links to care providers in the Lower Mainland.

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