Hello

I've read your editorial in From Belly to Baby and I'd like to confirm your understanding of midwifery care.

You wrote of a client of yours who said that "she wanted to work with an obstetrician so that she could have an epidural." In the article, you did not correct your client.

I hope you are aware that a woman choosing an epidural in labour is still a candidate for midwifery care. We do not preclude women from our care who opt for pain management. We find that sometimes women come into our care initially wanting an epidural due to fear of labour. This doesn't mean that by the time they go into labour, they still think this way. Building a trusting relationship with their care provider, learning about the mechanics of labour and knowing that their midwife will be with them during active labour often has women rethinking their initial pain management plans. And, even if it doesn't change their plans, the midwife is there and supportive of their client's wishes.

As you stated, it truly is about informed choice and informed consent.

Sincerely,

Dale Greer, Administrator, Midwifery Group of Ottawa

Dear Dale,

Thank you so much for your letter. You of course, are absolutely correct; it is possible to have an epidural (or other forms of pain management) if you are working with a midwife, just as it is possible to have a birth in a hospital - not just at home. I do take the opportunity to educate my patients about their options, and to dispel any myths regarding midwifery care. The purpose of my last editorial was to underscore the right all women (and all people for that matter) have to respect for their decisions around their pregnancies and birth. So I did not take the opportunity within the editorial to go into a lot of details about any of the forms of care available, rather I focussed on ensuring that women feel empowered to make decisions for themselves without censure or judgement from their health care and support team.

For a further understanding about midwifery care in Ontario, please visit the College of Midwives of Ontario's website: www.cmo.on.ca.

Best of Health!

Colleen McQuarrie, ND Editor, From Baby to Belly