Midwives Grey Bruce
Informed Choice Resource Binder

Section 1: Midwives Grey Bruce
Privacy Statement


This Midwifery Practice Group is bound by law and professional ethics to safeguard your privacy and the confidentiality of your personal information.

This includes:

    * Collecting only the information that may be necessary for your care
    * Keeping accurate and up-to-date records
    * Safeguarding the medical records in our possession
    * Sharing information with other health-care providers and organizations on a “need-to-know” basis where required for your health care
    * Disclosing information to third parties only with your express consent, or as permitted or required by law
    * Retaining/destroying records in accordance with the law


You will be asked to sign a consent form that gives your consent for our collection, use, and disclosure of your personal information for purposes related to your care.

You have the right to see your records. You may also obtain copies of your records – please see Privacy Officer Lucie Nichols.

Please speak to your midwife if you have any concerns about the accuracy of your records.

If you would like to discuss our privacy policy in more detail, or have specific questions or complaints about how your information is handled, please speak to your midwife.

For additional information, you may obtain a copy of our Privacy Policy from our staff.


Informed Choice Document


INFORMED CHOICE
We are providing you with this information so that you will be aware of the services offered by this group of Registered Midwives. Responsibility for well-being rests not only with health care providers, but also with each individual. We believe the best health care is attained when individuals make informed choices regarding their care. In this practice Registered Midwives and students from the Baccalaureate Program for Midwifery work out of two clinics: Owen Sound and Collingwood.

WHAT IS A MIDWIFE?
As midwives we see pregnancy and childbirth as normal states for the healthy mother. Out of respect for the birth process and the woman’s ability to bear a child, we believe unnecessary interference is an unwise interruption of the body’s function. We carefully monitor and guide, respecting the choices and values of you and your family. We are skilled practitioners, specialists who attend normal birth, giving care and advice to the mother in pregnancy, and care for the newborn and mother following birth. As midwives we are trained in the detection of abnormalities in you or your baby. We are skilled and prepared to use emergency measures within the scope of our education and experience.

MIDWIFERY IN ONTARIO
On December 31, 1993 midwives became regulated under both the Regulated Health Professions Act, 1991 and the Midwifery Act, 1991. A midwife must be registered with the College of Midwives of Ontario to practice (except in the case of an aboriginal midwife practicing within her own community).

As Registered Midwives, we provide a total course of care from the beginning of your pregnancy until 6 weeks after the birth. As a primary health care provider, we can requisition any necessary laboratory and ultrasound tests. We can also write prescriptions as described in the regulations of our profession. As a woman in the care of Registered Midwives, you will not need to see your family physician except for medical care not related to pregnancy, or if directly referred by one of the midwives.

CHOICE OF BIRTHPLACE
We feel it is necessary that the safety of the birthplace be discussed with all clients seeking midwifery care. As with all your health care, you are responsible for making informed choices about your caregivers and the setting for that care.

Your choice of birth setting, home or hospital, is completely funded by the Ministry of Health. Two Registered Midwives will attend births in any settings. The Registered Midwives in this practice have admit and discharge privileges at Grey Bruce Heath Services, Owen Sound and South Bruce Grey Health Centre, Walkerton.

HOW YOUR CARE IS ARRANGED
Our practice of Registered Midwives (and student midwives) follows a model of shared care. You will be assigned a primary midwife who will responsible for overseeing your care, and is your main contact person. Primary midwives are assigned based on geography and availability due to holidays.

We follow an on-call rotation of one week on call, then one week off call working in the clinic. You have access to on-call midwives at all times throughout your care. Your primary midwife will inform you of any longer periods of off-call, for example holidays. The on-call midwives attend any births that occur during that week, and will do postpartum visits. The off-call midwives see women for prenatal visits in the clinics, or at home if indicated.

MIDWIVES
Our practice of midwives is comprised of partners and associates all of who are Registered Midwives. Some associates may be New Registrants who are in a similar circumstance to physicians completing an internship of twelve to fifteen months in duration. Other associates may be locums, Registered Midwives working temporarily in the practice to replace a midwife on a leave of absence for a discreet period of time.

MIDWIFERY STUDENTS
Midwives Grey Bruce is a teaching practice, providing clinical experience for students from the university program for midwifery. It is essential to provide prenatal, birth and postnatal experiences for midwifery students, and to have them follow women through their pregnancy and birth. By involving a student in your care, you contribute to the education of future midwives in our community.

Second year students will be with us for 11 weeks, and their primary focus will be on learning prenatal and postnatal assessments, providing labour support and monitoring maternal and fetal well being during labour. By the end of their placement they will be assisting in the delivery with the assistance of your midwife. Third and fourth year students will be with us from 3 to 12 months. They will take on greater responsibilities as their skills increase, including managing labours and delivering babies. Students are always under the direct supervision of a Registered Midwife.

PRENATAL CARE
Adequate prenatal care is required for all women preparing for birth. This is a safeguard for your health, and offers you the opportunity to learn about changes your body goes through as pregnancy advances. Monitoring of blood pressure, urinalysis, weight, fetal growth and fetal heart patterns are included in prenatal care. We will see you monthly up to your 28th weeks, more frequently until your 36th week, and then weekly until your baby is born. A home visit in the last trimester may be included in this schedule of care for clients planning a home birth.

Prenatal visits are 45 minutes in length. We need to see you often enough to become well acquainted with you and your baby in advance of labour. We will then be better able to recognize signs that deviate from normal for you and your baby.

SCREENING TESTS AND DIAGNOSTIC PROCEDURES
Your midwife can order routine prenatal blood and urine testing. Ultrasound scans, amniocentesis and other specialized procedures can be ordered for you when indicated for clinical reasons.

COMPLEMENTARY THERAPIES
The midwives in this practice may recommend complementary therapies such as chiropractic care, massage therapy, acupuncture, herbal medicine or Homeopathic remedies. For minor complaints in the course of your pregnancy, any one of these therapies may be offered to you. We only recommend practices that we are familiar and comfortable with using in pregnancy and breastfeeding, and always follow the principles of Informed Choice when offering any suggestions for your care.

AFTER THE BIRTH
One midwife will remain with you 2 to 4 hours after the birth. Early discharge from a hospital birth normally includes up to three hours postpartum stay in hospital by your midwife. Should the need arise; the midwife may admit you to the hospital for a longer period of time.

You are visited 24 hours postpartum, and on days three, five and approximately day 10 to 14. A clinic visit may be offered at 4 weeks postpartum. Breastfeeding and baby care advice; baby weight checks and newborn screening are preformed at these visits. The telephone will be our main means of contact between visits. Midwifery care for you and your baby is concluded with a final clinic visit at 6 weeks.

SUPPORTIVE CARE
As primary health care providers we look after healthy pregnant women. Sometimes your pregnancy moves out of “normal” and your care must be transferred to a specialist, usually an obstetrician. In such a case, you may continue to receive supportive care from your midwife, as the specialist will now be primarily responsible for your care. Also, only one midwife may be involved in your care from that point, as only one midwife may attend the birth.

If your baby’s care moves out of “normal” we may transfer care to a physician, usually a pediatrician. You will continue to be under our care and we will provide supportive care for your baby until the pediatrician transfers care back to the midwives.

HOW TO CONTACT US
You can use our pagers to contact us in labour or regarding other urgent concerns. Non-urgent questions or concerns can be handled by calling the clinic and leaving a message with our administrator or on the answering machine. Your midwife will return your call, usually the same day. Clinic phone numbers, pager number and clinic hours will be provided at the initial visit.

PRENATAL CLASSES
We recommend prenatal classes especially for first pregnancies and first home births. Any interested family members are welcome to participate. Prenatal classes are an important opportunity to explore birth options and the birth process in detail, and are an essential tool to help you understand and enjoy your birth experiences.

YOUR RECORDS
A copy of the records kept during your care will be given to you at the final visit. Upon completion of your care we request that you complete an evaluation of the services we provided. This enables our practice to evaluate client satisfaction and implement suggestions to improve care.

PRIVACY
Our practice complies with the Federal Privacy legislation and has assigned a midwife, Lucie Nichols, as our privacy officer.

CONFIDENTIALITY
Our clients’ experiences of birth and breastfeeding are an important tool we use in teaching other parents about child rearing and childbearing. Although names are not used, if you prefer your birth story not be shared, please advise us.

Whenever we must discuss or consult during your care we speak only to the professionals necessary. As well, if you ask us details of another client’s birth (a friend or someone you may have met in the clinic) we would not be able to give them to you without her permission.

CONSULTATION WITH OTHER CARE PROVIDERS
In certain circumstances in your care we may be required to discuss your pregnancy with your family physician or specialists. (Refer to the Indications for Mandatory Discussion, Consultation and Transfer of Care document.) In these situations we will need to provide the consultant with information about you in preparation for discussing your care. This will mean sharing copies of previous obstetrics records, laboratory results, prenatal notes, and any other relevant information with the consultant. Under medical and midwifery professional guidelines, your situation will be discussed in strict confidentiality.

CONFLICTS AND CONCERNS
If you (or your family) have concerns about what you have read here or anything that has been discussed in an appointment, please discuss your concerns with your midwife. If a conflict should occur during your care you should first explore the issue with your midwife. If you are not satisfied with the results of that discussion then the concern will be brought to the practice for conflict resolution. The conflict resolution manager is Michelle Kryzanauskas, with Heather Keffer being the alternate.

CANCELLING CARE
Midwifery care is based on a non-authoritarian relationship developed out of mutual respect between you and the midwives. Care throughout pregnancy is a partnership between midwives and client. Failure to fulfill the obligations and spirit of this partnership may result in the termination of the midwife-client relationship by either party.