Home care a key component to midwifery services

Baby Violet is having her umbilical cord examined by her midwife. She’s having her temperature taken, her breastfeeding latch checked and her heart and lungs assessed. But Violet hardly notices because she’s nestled in her mom Jordan McCormack’s arms while they sit together on the cozy couch in their living room.

“I just loved being in my PJ’s and robe, relaxing and nursing my newborn when the front door squeaked open,” says McCormack. “In comes my midwife ready to cuddle my new baby to make sure she is growing and eating well. Nothing beats having a check-up, then going right back to snuggling under a blanket in your own bed.”

Ontario Registered Midwives provide clinical home care to all clients after birth, whether the baby was born in the hospital or at home. Normally, midwives visit clients six times at home in the first few days after the birth, then follow up at the clinic at two weeks, four weeks and six weeks. Midwives provide complete care for mom and baby during pregnancy, birth and the first six weeks after birth.

Registered Midwife Lisa Weston says postpartum home visits provide a multitude of benefits for both infants and mothers. “Healing is facilitated by home visits because our clients really get a ‘laying-in’ period,” she says. “It is better to keep the baby home, out of inclement weather and in familiar surroundings to minimize their exposure to unfamiliar germs and over-stimulation. Many of our clients do not have transportation and having a new mom take a brand-new baby on public transport is not ideal. At home visits, we check both baby and mother in terms of vital signs, breastfeeding and everything involved with recovery from the birth.”

Weston says a large part of her visits involve early parenting support, reinforcing self-care for moms and supporting the family unit to adjust to life with a new baby. “Clients always have many questions about their bodies, their babies and parenting that we can answer for them,” says Weston. “For new parents, many normal situations may cause them alarm. They know that we are available by pager 24-7 and can assess their situation and advise as to whether the baby needs additional care.”

Most times, the midwife can go and check that the baby is well, reassure the parents and save them the time and worry of having to go to emergency unnecessarily, which also saves the health-care system money. Conversely, sometimes midwives find a baby to be unwell and advise the parents to take him or her in for Paediatric assessment, catching illness or other situations early. Often, midwives can also spot signs of postpartum depression in the first few weeks and get the mother the help she needs early.

In addition, feeding is an important part of the transition, and moms and babies may need help to be successful. “Home visits allowed my midwives to offer personalized after-care according to my home environment,” says McCormack. “For instance, when my midwife watched me latch my daughter to nurse, she noticed the rocking chair I was sitting in was rather high. She recommended using a foot stool to correct my posture and help prevent stress on my abdomen.” 

McCormack knew about the home care that midwives provide because her sister had her baby with the same midwifery practice in Pickering three years ago. “Home visits are definitely a bonus to having midwives,” she says. “Having a brand new baby is overwhelming enough without having to pack up and head to the clinic when we both should be resting and enjoying our ‘babymoon,’ at home together.”

Midwives are experts in normal pregnancy, birth and infant care. In Ontario, midwives are paid by the Ministry of Health and Long-Term Care, which means care is free to clients. There are over 400 Registered Midwives in Ontario and over 85,000 babies have been born under midwifery care since 1994, including over 20,000 births at home. To find a midwife in your community, visit www.aom.on.ca.