Midwifery Care North Shore (MCNS) is a well-established Lower Lonsdale community practice located at Quayside Village.
MCNS was the first practice to be established on the North Shore when midwifery became regulated in British Columbia in 1998. Since then, we have provided midwifery services to over 925 women and their families.
The majority of women receiving MCNS care have spontaneous, uncomplicated labour and childbirth and the practice currently has a 25% home-birth rate. Clients interested in home-birth can find out more by going to our resource page. Those intending homebirth can arrange to pick up supplies provided by the province from MCNS office. MCNS arranges for a North Shore or Vancouver midwifery colleague to be the second attendant at a homebirth. Partners are welcome at all appointments and are especially encouraged to attend at least 3 prenatal appointments when women are interested in homebirth.
The remaining 75% of our clientele give birth at Lions Gate Hospital where MCNS holds long-standing relationships with the midwives, physicians and nurses. A nurse is assigned as a second attendant in hospital. All of our clientele are encouraged to take a hospital tour, as regardless of birth setting, Lions Gate Hospital is our back up Hospital. While most of our clients use non-medical means of pain relief during labor, medical pain relief is an option for women who request medication. Researchers have noted that a need for medical pain relief is a common reason for a woman pregnant with her first baby, to change birth place and move from home into hospital.
MCNS has primarily been a solo practice since January 2013 when limitations were placed on the number of registered midwives allowed to practice in the area. The advantage of a solo practice is that women enrolled in care can anticipate a greater than 80% chance of having Vera attend their births. As she is on 24hour/7day urgent call for at least 23 -25 days per month. Women that need to meet with the midwife colleague who might attend in Vera’s absence are given this opportunity when feasible. Vera and her colleagues are committed to actively involving women in care and to providing a personalized service during pregnancy, labor and postpartum. We aim to assist each woman feel that she has done everything possible to lovingly bring her baby safely into the world. Regardless of whether a woman has a short or long labor, births at home or in hospital, has a vaginal birth with or without pain medication, or an assisted vacuum, forceps or c/section delivery aided by medical specialists, we work with a woman so that she and her family may have the best experience possible.
Vera Berard RM regrets that MCNS is unable to continue postpartum group appointments at this time. As in her experience, group care has provided an opportunity for childbearing women and their families to form supportive networks. Vera hopes to be able to offer this service again in the future and appreciates Kathy McGrenera, Sherry McGinnis, Heather Laine and others that have helped her facilitate group care over the years.
MCNS is a University of BC multi-disciplinary teaching practice committed to maternity education and the promotion of women-centered health care. Various students (midwifery, medical and nursing) have been supervised at different times. While a woman’s right to decline student involvement in her care is respected, our clients are encouraged to participate in the vital process of preparing new practitioners to serve more of British Columbia’s women. There are now several midwives who have worked as students in MCNS that are currently registered and providing midwifery services throughout the province. If you have an issue with students let your midwife know.
COMMONLY ASKED QUESTIONS ABOUT HOW MCNS PROVIDES WOMEN CARE
- How is midwifery services paid for?
BC residents’ services are covered by a BC care card for a course of care. There is a private fee schedule for women without medical services coverage or a woman that only wants a one-time consultation with a midwife.
- Can midwives provide services to all women?
Midwives have a limited number of courses of care that can be provided annually by one midwife.
Healthy women are the population best served by midwives that have expertise in uncomplicated ‘low risk’ pregnancies. Pregnant women with serious physical or mental health issues are better served by an obstetrician, or a team of doctors and midwives that share care.
- Can a woman see a midwife and doctor at the same time?
Midwives are primary caregivers of well pregnant women during their whole pregnancy, labor, birth and postpartum. We are also primary caregivers of well newborns until 6-8 weeks postpartum and have expertise to assist women with breastfeeding. Consequently, well women do not see a doctor at the same time they see a midwife for maternity care. We are able to order and interpret all maternity tests and prescribe treatments for maternity related conditions during pregnancy, labor, birth and postpartum. Including medications needed for pain relief or emergency care. You can access test results by applying for my e-health and can discuss results with a midwife during your appointments or over the phone. Should a need arise for a doctor at any time during your pregnancy, labor, birth or postpartum care, your midwife will make an appropriate referral. It is important to inform your midwife of your health concerns. In the rare instance that a midwife is unable to provide services, it is our responsibility to arrange for another midwife or doctor to provide your care.
- When do I need to see a midwife and how will my appointments be provided?
It’s important to begin your care in the first trimester, before you are 14weeks pregnant. So that you can access ultrasound to accurately date your pregnancy and reduce your chance of having unnecessary medical intervention at the end of pregnancy. Starting care early, also affords an opportunity to undertake optional time-sensitive prenatal genetic screening that can tell a pregnant woman her chance of having a baby with Down syndrome, trisomy 18, or an open neural tube defect.
MCNS regular appointments are routinely scheduled on Tuesday and Wednesday only. Thursday is reserved to reschedule appointments that have been cancelled due to a labor. When a woman chooses to come into Vera’s care, there are usually 2 initial appointments relatively close together, so that a history can be obtained, a physical examination be untaken and requisitions provided for all routine and optional tests. After a woman has reached 19 – 23 weeks pregnant and has had a detailed ultrasound, MCNS likes to provide a schedule of appointments until a woman’s estimated due date. These appointments are scheduled every 4 – 5weeks until a woman is around 30 weeks pregnant; every 2-3 weeks until around 37weeks and then every week until a baby is born. We try hard to provide women their preferred times within our regularly scheduled appointment times that take place between 9.00am and 5.00pm. We have found that flexibility is needed when working with a midwife in a solo-practice.
Most prenatal and postnatal appointments take place in Quayside Village‘s comfy space. The exception being for women living in area and planning a homebirth, one prenatal appointment will be scheduled at home. In regards to visits after baby is born, all women living in area have home visits scheduled their first week postpartum. Thereafter, they like women that live out of area, meet with Vera or a colleague in MCNS’s office until everyone is discharged from midwifery care around 6 to 8 weeks postpartum.
Midwifery appointments can be arranged via email. While email is our preferred method of contact, appointments can also be made via telephone (604 984 6960). Please note that depending on how busy we are with births and appointments, we may not be able to immediately answer your email or call. However, messages are checked regularly and responded to within one – two business days. At this time our staff are mostly doing office work remotely from home.
- How can a midwife be contacted for time-sensitive or urgent concerns?
For women who are enrolled into care, MCNS has a 24 hour paging service for urgent concerns. A voice message on Vera’s pager will either instruct a woman to punch in her telephone number, so that Vera can return her page within 15 – 30 minutes or will provide the name and contact number of the midwife providing 24 hour coverage. Vera works with other midwives, so that you have access to services seven days a week and receive consistent care, even when she is having time off, is fatigued, ill or is on holiday.
How can I speak to a midwife about non-urgent issues in between my appointments?
Please note that clinical issues cannot be discussed via email. If you have a question that is non-urgent and cannot wait until your next appointment, just send an email providing your telephone number and indicating that you have a non-urgent question that you would like to discuss. Vera or her colleague will telephone call you within 1 -2 business days.
- What happens if I were to experience a complication?
Midwives are trained to recognize the early signs of medical conditions or complications as these become apparent. As such, midwives discuss, consult with or transfer care as needed to other health care providers – including obstetricians or pediatricians. If such complications arise that care is transferred, midwives continue to be involved in a supportive role, often care is transferred back to the midwife once a complication has resolved.
Midwives, like doctors are also trained to deal with obstetrical or neonatal emergency situations and carry equipment and medications needed to deal with these situations in women’s homes.
- I am well into my care with another provider – can MCNS take me into care?
It is a woman’s choice to change care at any time during her pregnancy. Providing that MCNS has space, we may be able to accommodate. Vera has two requests in this situation: First, let MCNS know. Second, if we have space, as a courtesy inform your current provider directly of your need to change care and inform that they can expect to receive from MCNS a signed release of information for your records. If there is a personal reason behind the need to change, let your provider know at this time too. It is through direct conversation that services can be improved.
Most times women change care to meet a need of their own, it is nothing personal. In Vera’s opinion, it is important in life to identify needs and take steps to meet these. This is the foundation upon which a positive labor, birth and postpartum experience can be built. She encourages her own clients to identify their needs and if finding another provider is on their list, then she would appreciate the courtesy of being informed, before she receives a release of information from another provider. She is also pleased to refer clients to another provider if necessary.
- Just to be certain, can I have medical pain relief in my labor?
Absolutely, any woman that needs medical pain relief can have this ordered by her midwife.
Often women are surprised how helpful non-medical copings options are, such as intention, breath, affirmations, visualization, movement, massage, transcutaneous electronic nerve stimulation (TENS), water, acupressure and encouragement.