Welcome to Midwifery at Saltspring Island Health Centre
Pregnancy is a dynamic time of anticipation, planning, and getting to know yourself and your family in a whole new way. This is a time of profound change. It can be a joyous, exciting process and sometimes an overwhelming one. It is our aim that the clients and families we care for have the right support to learn about their choices, make informed decisions, and have the opportunity and confidence to fully connect with their personal experience of giving birth and becoming parents.
The midwifery team can be reached through the clinic switchboard or by email at midwife@ssihealth.ca
Philosophy of Care
We believe that pregnancy and postpartum care should be client and family centered. All clients should have access to evidence-based care that respectfully centers around the clients needs, choices and concerns for themselves and their babies.
As Registered Midwives, our emphasis is on supporting the normal, physiological experience of pregnancy and birth, with minimum intervention. However, we are there to recognize when the need for more complex medical support is indicated, and will work with you and any relevant obstetrical / medical specialists to determine a care plan that best provides for the needs of yourself and your baby.
Is Midwifery Right for You?
Saltspring Island Health Centre is currently the only primary care clinic on Salt Spring Island providing maternity care services. Our services are fully funded by MSP. We provide comprehensive prenatal and postpartum care for our clients, whether you plan to give birth on island, or eventually transfer to a larger off-island hospital for delivery. We will work with you to determine a personalized care plan that best reflects your preferences and needs throughout your pregnancy, birth and postnatal period.
If you have further questions about whether midwifery care is right for you, we offer the opportunity to meet with the midwife for an initial consultation in order to discuss your care preferences and plans for this pregnancy and birth. We will share information about the B.C. midwifery model of care, our scope of practice, and review your choice of birthplace options. You are then free to decide which care plan best suits your needs.
Choosing Place of Birth
Where should I have my baby?
After getting a positive pregnancy test, this is one of the first things that most expectant parents ask themselves! We know how important your baby is to you and your family, and our goal is the same as yours- a healthy baby and a healthy you! Let’s take a look at some of the things to think about as you consider your options here on Salt Spring, and then have a look at the evidence to support these decisions.
How is your health?
We will spend time in your first several appointments gathering information about your health and your previous obstetrical experiences, as well as doing a physical wellness exam. Throughout your pregnancy, we can arrange and review all standardized lab and ultrasound reports in accordance with Perinatal Services of BC guidelines (http://www.perinatalservicesbc.ca/), and the College of Midwives of BC (http://cmbc.bc.ca/). As long as your pregnancy remains healthy, you may choose to give birth at home or at the Lady Minto Hospital birthing suite.
Risk Factors
If you develop risk factors during pregnancy, the safest place to have your baby may be in, or close to a larger hospital. Since we do not have local high risk OB/GYN, Paediatric or surgical services, we do not plan to deliver VBACs, twins, breeches, or preterm (<37weeks) or post term (>42weeks) babies here on Salt Spring. Any indication for medical induction of labour will also require a transfer off island.
As members of the Vancouver Island Health Authority (VIHA) Department of Maternity Care and Pediatrics, we can readily make arrangements for your care with an OB/GYN specialist and /or one of the local midwives in Victoria, Duncan or Nanaimo. Typically, we continue to provide your routine pregnancy care locally, in collaboration with your off island care team. When indicated, clients may relocate off island in the last few weeks of their pregnancy, and then return to our care, along with their newborns postpartum.
Where do you feel most comfortable?
Some moms feel safest giving birth at home, others prefer the convenience of our local Lady Minto hospital (LMH) and others prefer the 24/7 availability of epidural, C-section, etc. that only a large off-island hospital can provide. As long as you are healthy and low-risk, the choice is yours!
Why do moms choose to birth on Salt Spring?
Besides being a safe option for healthy, low-risk moms and babies, Saltspring Island Health Centre and our local level 1a hospital provides a personalized service that is hard to match in a larger centre. Our statistics show that we are able to provide safe care, with low rates of caesarean sections and transfers to a larger hospital, with good outcomes for babies and moms (Kornelsen and Ramsey 2014) . Because we are a small birth service with 1-2 full time midwives, clients enjoy the personal touch of knowing their care provider, versus working with a larger on-call group.
Lady Minto Hospital provides a family-friendly place to give birth, offering a private birth room with a generous ensuite shower and bath. Families wanting a home birth can also choose water birth as an option. We know that birth progresses most smoothly when moms feel comfortable and safe. We also know that going to the hospital too soon can lead to an increase in caesarean sections and other interventions. It is recommended by midwives, doctors and nurses that healthy women stay home supported by family and friends until labour is well established. That is much easier to do when you stay in your own community to give birth!
What about an epidural, can I get that on SSI?
At this point in time, no. There are many non-medical options that help relieve pain in birth such as prenatal education, a doula (labour companion), massage, walking, acupuncture, and soaking in the bath or shower. Medical options include Entonox (laughing gas) and short acting (and very effective) pain medications such as Fentanyl. Epidurals are a great tool if required and we do transfer some moms off island for that reason. If you anticipate wanting an epidural in labour you should plan on birthing at a hospital that has 24/7 access.
Finally, what if I change my mind?
No problem! In fact, we encourage you to remain flexible about your birth plans including place of birth. As you progress through your pregnancy and gain more knowledge, you may find that your original choice has shifted. Once labour starts, your original plan of going to the hospital may just not seem right to you. Or the opposite may happen and the idea of staying home may no longer work for you. Your need for an epidural may fade as you cope beautifully with early labour and the last ferry might just sail off without you! Similarly, health concerns for you or your baby may emerge in late pregnancy and you may need to birth at a large hospital. Keeping flexible helps make dealing with changing plans less stressful. In the end, when you hold your beautiful baby in your arms, the place where you actually gave birth will seem to have been just right!