Birthing in Ontario

Pregnancy – I've often heard patients lament the irony of how hard we try to avoid it in our youth, only to one day have to strive to accomplish it.

For many of us, the focus of getting pregnant is so consuming that we often don't plan for what to do during pregnancy, or prepare for the many choices we will face and need to make with respect to our health, the health of life we are growing within, and the process of birthing and then caring for our new child.

Most of us know that it's advisable to avoid alcohol, and start with a folic acid or prenatal multivitamin once we are pregnant – but are there any other diet or lifestyle choices we should consider?

Then – for prenatal care – do work we with our family doctor? An obstetrician? A midwife? What about further care for things like morning sickness? Chiropractic for lower back pain? Massage for calf cramps? Should we take herbs during pregnancy? Is it advisable to exercise? What should we worry about and who can we consult with?

And then the birth – home or hospital? "Natural", epidural, lamaze? Can I work with a doula – and what is a doula?

The constants in pregnancy are few, and often are taken for granted – we are pregnant for "9 months" – which is actually 40 weeks, with 2 weeks of wiggle room; there is morning sickness and fatigue (but it doesn't have to be this way); we need to take folic acid (but it may be better if we start the folic acid before conception – and we may want to consider other nutrients that are best supplemented in pregnancy), and the list continues. Many of us just assume that everything we "know" from our mothers, our friends and the women around us must be true – but the business of pregnancy and birth has evolved and changed significantly in the past 100 or so years in developed nations. There are still places where home births are the norm, and where it is family or an older woman from the village who attends, in parts of Europe, women are encouraged to birth at home if their pregnancy has been healthy, and in North America women can request to have a scheduled caesarean section if there is a better date for them to have their child.

There are so many questions that often arise only once we are pregnant – and unless we've had close friends or family who have been pregnant recently, we may not know where to look for answers.

Each woman's pregnancy is different, and so too are her needs, wishes and beliefs – what many of us are not aware of are the choices available – and the current trends in prenatal and obstetrical care.

In Ottawa today, women have the option to birth at home or in the hospital under the care of a midwife or with an obstetrician at a hospital. What many women may not realize is that they also have the choice to work with other care providers – during their pregnancy, to prepare for pregnancy, and in the postpartum period – who can make this special time healthier, happier, and more comfortable. We hope that each woman takes some time to explore whether or not she would like to work with a naturopath, a chiropractor, a massage therapist, a doula, a lactation consultant, a physiotherapist or a counsellor in order to feel empowered and in control of her pregnancy and eventual birthing.