Overview

Midwife means "with woman". To midwives and their clients, pregnancy and birth are normal, healthy life events. Midwifery promotes normal childbirth and the prevention of health problems. In 1994, midwifery became an integrated part of the Ontario healthcare system and is provided free of charge to residents of the province. Midwives offer clients the option of delivering:

  • at a hospital
  • at home
  • at a birth centres (available only in Toronto and Ottawa)

A midwife is a primary care provider who is responsible for all the care necessary for a healthy expectant person and the baby throughout pregnancy, birth and for six weeks afterward. Midwives refer clients and newborns to family doctors or specialist doctors like obstetricians and pediatricians if the care becomes complicated.

Even if care is transferred to a doctor at the birth, midwives will remain involved in the care as a support to the client and baby.

As primary care providers, midwives do the following:

  • care for healthy, pregnant persons and their babies
  • see clients for all prenatal visits and give prenatal education
  • order laboratory and ultrasound testing if needed
  • arrange for consultations with or transfers to doctors if needed
  • give some medications during pregnancy, labour, birth and the postpartum (after birth) period if needed
  • take responsibility for primary care during labour, birth and postpartum including delivering the baby
  • examine the newborn and care for clients and babies for six weeks after the birth

You do not need a referral from a physician to use midwifery services; you can call a midwife directly. It is best to call as early in pregnancy as possible to ensure that your midwife has space for you.

Providing midwife services

Currently, there are more than 850 midwives registered with the College of Midwives of Ontario.

The Midwifery Program at the Ministry of Health allocates midwifery services to communities across the province. Care providers can contact the program by:

  • mail:
    Program Manager
    Ontario Midwifery Program
    Primary Health Care Branch
    Ministry of Health
    438 University Avenue, 4th Floor
    Toronto ON M7A 1N3
  • telephone: 1-866-766-0266
  • fax: 416-326-4194
  • email: midwifery@ontario.ca

Midwifery principles of care

There are three important principles of midwifery care.

Continuity of care

Midwives usually work in small groups and are on 24-hour call. A pregnant client will get to know a small group of midwives (two to four) to ensure that the client is comfortable and familiar with the caregivers who will attend the birth. Generally, two midwives will attend each birth and share the care throughout the pregnancy, labour, birth and after the birth for six weeks. They will offer education, counselling, advocacy and emotional support. Each midwife will take the time to build a relationship of trust and safety with each client. If medical problems develop during pregnancy, labour, birth or postpartum, midwives work closely with specialist physicians and nursing staff.

Informed choice

Midwives encourage each client to take an active part in care throughout pregnancy and birth and will provide information so that the client can make choices about care. Midwives provide sufficient time during prenatal care to discuss questions about important issues like nutrition, birth plans, breastfeeding and parenting. Midwives recognize and support the client as the main decision-maker.

Choice of birthplace

The pregnant client chooses whether to give birth in a hospital, at one of Ontario’s two birth centres in Ottawa or Toronto, or at home under the primary care of the midwife.

Midwives are trained to attend births in these places as well as to help individual clients choose the safest place for them. Many clients who opt to have a hospital birth spend time at home with their midwife before going to hospital.

Midwives’ training prepares them to be responsible for decisions about labour, delivery, postpartum and newborn care both at home or in hospital. Midwives work closely with other community midwives, doctors and nurses to maintain a high standard of care.

Where to find a midwife

The Association of Ontario Midwives can provide information on where midwifery services are located in Ontario:

The College of Midwives of Ontario regulates the midwifery profession and provides an annual assessment and registration program for internationally trained midwives:

  • mail:
    College of Midwives of Ontario
    55 St. Clair Avenue West
    P.O. Box 27
    Toronto ON M4V 2Y7
  • address:
    21 St. Clair Avenue East
    Suite 303
    Toronto ON M4T 1L9
  • telephone: 416-640-2252
  • toll-free: 1-844-640-2252
  • fax: 416-640-2252
  • email: admin@cmo.on.ca

Indigenous midwifery

The province has expanded Indigenous midwifery services to provide culturally appropriate midwifery care immediately and help interested communities examine how Indigenous midwifery services could be developed in the future.

To help increase access to culturally appropriate midwifery care now and in the future, the province has supported the establishment of the following Indigenous Midwifery programs:

  • Dilico Anishinabek Family Care, Fort William First Nation
  • K'Tigaaning Midwives, Nipissing First Nation
  • Kenhte:ke Midwives, Tyendinaga Mohawk Territory
  • North Channel Midwifery, Elliot Lake
  • Onkwehon:we Midwives, Akwesasne
  • Shkagamik-Kwe Health Centre, Sudbury
  • Southwest Ontario Aboriginal Health Access Centre, London
  • Seventh Generation Midwives Toronto, Toronto
  • Giishkaandago’ikwe Health Services, Fort Frances
  • Waasegiizhig Nanaandawe'iyewigamig Health Access Centre, Keewatin
  • Akausivik Inuit Family Health Team, Ottawa

Aboriginal midwives who practice in their own communities are exempt under the Midwifery Act which are midwives who are not registered with the College.

For more information about Aboriginal Midwifery, you can contact the National Council of Indigenous Midwives (NCIM) by:

Midwifery education programs

Midwifery Education Program
McMaster University
McMaster Health Sciences Centre
HSC 4H24
1280 Main Street West
Hamilton ON L8S 4L8
Toronto Metropolitan University
Midwifery Education Program
288 Church Street
Room DCC-676
Toronto ON M5B 1Z5