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Birth Choice

Midwifery brings old-fashioned medicine into the modern world — and Victoria moms-to-be are embracing it
Mom-to-be Julie Salmon and her midwife, Ilana Stanger-Ross, count down the days until Salmon's big day — bringing a new life into this world from the comfort of her own home.

Midwifery brings old-fashioned medicine into the modern world — and Victoria moms-to-be are embracing it

Julie Salmon has spent the last few months collecting towels, plastic sheets, waterproof mattress pads and all the materials she’ll need for her upcoming event happening any day now — it may sound like an extreme art project, but don’t be deceived: Salmon is becoming one of an increasing number of Victoria women planning a home birth.

It may be a stretch from the days of pioneer women coaching each other through labour pains and deliveries, but home births, midwifery and “treating birth as a normal event in a woman’s life” has far from gone out of style.

If you’re fortunate enough to be pregnant in Victoria, you’re one of the luckiest women around — between physicians, midwives and alternative medicine, your choices are vast. With those options, it’s interesting to see the number of women who are choosing midwifery as their paramount way to welcome new life into the world — 25 per cent of all births in Victoria utilize midwives, more than any other city in Canada. In B.C. as a whole, 10 per cent of babies are delivered by midwives.

“We were so excited to have the ability to choose a midwife, because it’s been my dream to have a home birth,” says Salmon, 27, whose first baby is due this month. “It’s starting to get very exciting.”

It’s little coincidence that each year, only a few days before we celebrate mom, May 5 is the International Day of the Midwife. Despite an ever-increasing number of clients, many expectant parents still don’t know what a midwife is, let alone that midwives are covered under B.C.’s health plan, and that they attend births in a variety of settings — including home and hospital.

“Some of the biggest misconceptions people have about midwives are that, if you choose to go this route, you can’t have an epidural, or have to have a home birth, or that we don’t work with obstetricians,” says Ilana Stanger-Ross, Salmon’s registered midwife with the Midwives Collective on Yates Street. “But we do get to practice an old-fashioned medicine that is really rare now, and that’s what’s so rewarding — working with the women to teach them that birth is not a medical emergency: it’s a normal and important event in a woman’s life.”

So what is a midwife?

For those still foggy about the trade, a midwife is a trained professional who provides comprehensive care and support during pregnancy, labour, birth and the six-week postpartum period — that means mom-to-be develops an up-close relationship with her midwife of choice, and that same woman is present throughout the entire birthing process.

Midwives specialize in healthy, normal cases based around the belief that unnecessary intervention is an interruption of a normal process. That’s not to say they don’t use technology, though, and every midwife will consult with physicians and specialists when necessary. She is also skilled in careful monitoring to detect abnormalities during pregnancy and birth. But while midwifery has been a regulated profession in Canada for the past 20 years, and was added to the provincial health plan in the ’90s after much political lobbying, it is still largely misunderstood — years of misinformation, including accusations of witchcraft dating back to the 1300s, have skewed public perception to this day. Calming those stigmas takes time and trust.

“So many of our clients come to us by referral — someone’s mom or sister or friend had a midwife and so they are considering it, too,” says Stanger-Ross. “It’s a privilege to be part of that selection process.”

Of the 196 midwives currently practicing in B.C., just over 20 are located in Victoria. With each performing 40 to 50 births in a year, it’s no surprise the wait lists are long. However, Stanger-Ross says women who start their search early are usually accommodated.

Luba Lyons, co-head of the Vancouver Island Health Authority Victoria Department of Midwifery, has been a practicing midwife since 1976. Lyons says an estimated 30 per cent of clients choose home birth as an option, while others plan to have their midwife assist them in hospital.

“Our philosophy is that the woman is the right person to make the choice on how she wants to deliver her baby,” Lyons says. “We’re still not a culture that is comfortable with the idea of home births, because it is not familiar to us. Slowly, though, we are coming back to making those options more mainstream.”

For women like Salmon, home-birthing preparations have become an integral part of her “nesting” period.

“This is a big event, and it’s exciting and new,” says Lyons. “But so much of what we work through ahead of time is diet and health during pregnancy, and what baby means at this point. When the day comes, there has been a lot of education and preparation, and a lot of time to plan out how it will go. Afterwards, the same care is taken.”

Mommy, midwife and me 

Midwifery care itself can be so comprehensive because of how midwives specialize — they aren’t physicians or nurses, and are not qualified to prescribe prescriptions unrelated to pregnancy. Due to the provincial health plan, however, while a pregnant woman may choose her care provider, she can only pick one. Yet in the event a woman chooses a midwife but experiences complications or health factors that mean she has to have a hospital birth with an obstetrician, the midwife will still attend the birth.

Such a case happened to Melissa and Paul Mitchell, who gave birth to their daughter, Lily, only weeks ago.

“When we found out we were pregnant back in August, we were so excited and went straight to our doctor. It’s a busy office, though, and I wasn’t receiving any calls back, so I realized this wasn’t going to work for me,” says Melissa. “That’s when we came and met Ilana [Stanger-Ross], and we just had this connection and I knew I wanted her to be a part of my process.”

Despite the fact that Melissa opted for Stanger-Ross as her midwife and had planned on having a hospital birth, complications on delivery day wound up giving her the best of all worlds: her midwife and an obstetrician were present to complete the delivery. Now that the new parents have been through the process, both Melissa and Paul say they would plan on using a midwife again in the future.

“You get this perception from TV and movies that the water breaks, then five minutes and one commercial break later the baby pops out,” says Paul. “This was nothing like we expected it, but we learned every step of the way. Ilana was wonderful, and it was such a relief to have her there. We’d do it again, 100 per cent.”

Stanger-Ross, who started her practice in 2010, says no matter how many births a midwife has attended, every experience is different. One thing is clear though — many people still don’t know what giving birth is really all about.

“Most women haven’t had the opportunity to see a real birth, and pop culture portrays it as a catastrophic event, so it’s little wonder so many women are scared about what’s going to happen to them,” says Stanger-Ross. “We’ve lost touch with the fact that birth is a normal process — not as seen on TV.” M

Stop by the Midwives Collective (107 – 1120 Yates) on May 5, from noon to 4 p.m., for the Mothers Day Craft Sale and peruse handmade gifts for mothers, by mothers. Learn more at