The Truth About Midwives: With Corey Bryant

Episode Summary:
Thinking about choosing a midwife but unsure what they actually do? Heard that midwives only attend home births or that you can’t get an epidural with one? It’s time to clear up the myths and get real about what midwifery care looks like in Ontario — especially in Windsor-Essex.

In this episode, I’m joined by Corey, a registered midwife with Midwives of Windsor, and we’re unpacking the most common misconceptions around midwifery care — from payment and pain relief to postpartum support and hospital births. Whether you're newly pregnant, birth curious, or supporting someone through their journey, this conversation is packed with facts, compassion, and a few good laughs.

We talk about:
 ✨ Why midwifery care is fully covered (even without a health card!)
✨ The truth about home births vs. hospital births — and who really chooses what
✨ Getting an epidural or induction with a midwife (yes, it’s possible!)
✨ How midwives support choice and continuity of care
✨ What postpartum care looks like: including lactation, bleeding, and newborn checks
✨ Why calling your midwife might come before you call your partner 😉
✨ What makes midwifery care so personal and powerful for families

Mentioned in This Episode:
🔗 Midwives of Windsor – www.midwivesofwindsor.com
🔗 Pelvic Love Massage & Doula Care – www.pelviclove.com
📲 Follow Deborah on Instagram – @deborathedoula

Looking to prepare for your own birth journey?
💬 Book a birth consultation with Deborah: www.pelviclove.com

Chapters

• 0:00 Introduction to Midwifery Care
• 1:16 Debunking Major Midwifery Myths
• 4:13 Hospital Births and Medical Interventions
• 9:05 Continuity of Care and Process
• 15:00 Postpartum Support and 24/7 Access
• 20:30 Finding a Midwife in Windsor-Essex

Transcript

Deborah: 0:06

Hey Mamas, you're listening to Tend and Befriend, a podcast about women's mental and physical health. This is Debra. I'm a mom of two, a labor and birth coach and birth advocate, a health professional, and today I'm your host. Let's dive into today's episode. Let's dive into today's episode. Any information you hear or that is suggested or recommended on these episodes is not medical advice. Hi Corey, thank you so much for being with me today. I'm really excited about talking about midwifery care here in Ontario, and specifically Windsor and Essex County. I would love for you to introduce yourself.

Corey: 0:48

Hi Debra, thanks for having me. My name is Corrie. I'm a registered midwife. I work with the midwives of Windsor and I catch babies at Windsor Regional Hospital, at Erie Shores Healthcare and also at home. I've been a midwife for just about eight years and started my practice in Hamilton, ontario, but moved to this region in 2020 in the middle of a pandemic. As you do, have really enjoyed my time living and working in this region Awesome.

Deborah: 1:16

Okay, let's talk about some of the biggest myths with midwifery care, because there's a lot of them, but I want to talk about a couple of the really big ones, and the first one being that midwifery care is billed privately.

Corey: 1:32

Yeah, so actually midwives are covered under the provincial health insurance plan, but also covered for people who don't have provincial health insurance as well, which I think a lot of people don't know about. So you show your health card at your very first visit with your midwife and you never have to pay us a cent in order to receive care from us. We also have arranged we have an arrangement with our transfer payment agency to cover midwifery services, as well as lab work, ultrasounds and consultations with other professionals for folks who don't have insurance, and that's because we know that when people get excellent prenatal care, they deliver healthy, happy babies. Healthy, happy babies grow up to be healthy, happy adults as well, and so protecting the well-being of the pregnant individual and their developing baby is super important. So that's been something really important that we are able to provide as well.

Deborah: 2:27

That's awesome, I didn't know that. Okay, let's continue on with the myths. I want to talk about the next one. I want to come back to that a little bit. I want to talk about the next myth which I hear in my clinic every single day, and that is that midwives only do home births.

Corey: 2:41

Yes, you have to have your baby in the forest under a full moon and you only have sage to rub on your belly for pain relief, which, of course, is absolutely also untrue. So midwives support choice, and one of the choices that we promote is choice of birthplace. So we are the only regulated healthcare professionals in Ontario who do attend deliveries at home for those who choose that. But for those who would prefer the safety or security of delivering in hospital, or for those who know, for example, that part of their birth plan is epidural which is probably the next myth you're going to get to midwives also facilitate deliveries in hospitals, and in this region we're about 70-30. So about 70% of folks will have a baby in hospital and about 30% will not Okay.

Deborah: 3:28

So, like 70% of the people that have a midwife delivering a hospital, only 30% are home birth Correct. Wow, I thought it was higher than that. That's really good to know.

Corey: 3:38

It's really high for the province, actually 30%. To give you some context, when I was a midwife in Hamilton, I was a midwife in Hamilton for three years and when I came to this region in six months I had already attended more home births than I attended in Hamilton in my whole entire three years there.

Deborah: 3:54

Wow, I actually love that. I really really love that. That tells us that people are educated on their choices and they're facilitating your services in a way that that feels right for them. But I didn't know that number. So the next myth, yes, is, of course, that you can't get an epidural if you're with a midwife.

Corey: 4:14

Yeah. So this is a persistent myth actually and it doesn't come from nowhere. So in some communities folks who wanted an epidural their care historically would have been required to have been transferred to an obstetrician because for a period of time, for whatever reason, it was considered an increase in risk or a deviation from normal. And so we talk about full scope communities and full scope. When we talk about that, really we're talking about epidurals and we're talking about oxytocin. So do midwives maintain care for epidurals? Do midwives maintain care for oxytocin?

Corey: 4:48

So there is a bit of a persistent myth that if you want an epidural you can't have a midwife. I don't think that's true in many communities in Ontario anymore. I would say so the epidural rate for generally for obstetrics is about 60%, and I would say for midwifery it's maybe a little bit lower, but still a fair number of people will get an epidural, and sometimes the epidural is the thing that helps them have a vaginal delivery. So it's a great tool that we can have in our toolbox. Yes, in this community we don't transfer care for the labor for an epidural, but we do involve a nurse to manage the epidural part of things while the midwife carries on managing the labor. So if you want a transfer of care, absolutely you can have an epidural, as long as we have time to get the epidural into you.

Deborah: 5:35

Right.

Corey: 5:36

So sometimes we have what we call drive-by births, where you show up and have a baby and then go home.

Deborah: 5:43

So I love that you mentioned that it's not a transfer of care and you're not transferred to an OB if you want an epidural, but there is another care provider brought into the picture only to take care of the epidural, correct? Yes, okay. Also, you talked you brought up oxytocin, which we know as Pitocin, and I want to talk about that a little bit because that's another thing that not everyone talks about. Is that, even with a midwife, you can still have a medical induction, correct? Correct? You guys do it a little bit differently depending on the situation and the medical history and the risk, but you can still have pitocin, oxytocin, if you're with a midwife and a girl and all of the things that comes with a hospital birth, correct?

Corey: 6:40

yep, yeah and and so like we know that, if you're even for people who just plan to have a home birth, their rates of intervention are much lower, even if they end up in the hospital having a hospital birth. But I also am feeling like interventions get a bit of a bad reputation and that you know there's this idea that maybe no interventions is the best way to have a baby. But sometimes interventions are what is going to be the thing that gets you the vaginal delivery that you're looking for or gets the baby out. You know, before we have a baby that's compromised that we then have to worry about after they're on the outside. So I would say interventions are maybe a little bit more routine when you're with an obstetrician, but that's not to say that midwives don't use them as well and try to use them as judiciously as possible.

Deborah: 7:29

From my experience, I don't feel like intervention has a bad name. I feel like from the community that I'm in, I'm seeing on a regular basis, is that the misuse of intervention and, you know, not an informed consent when it comes to intervention. So I think any intervention is welcomed as long as, as you understand that you have the permission to say yes or no to it. But I do. I do see a lot of the social media marketing and the fear mongering that's happening amongst birth workers saying that interventions are bad and there should be no interventions, and the more interventions the more problems occur, and that's obviously being told. But I also feel like that can be a bit of fear mongering as well.

Deborah: 8:16

So I think for me, I hear a lot like why would I go with a midwife? I don't want a home birth, and I think that this answers a lot of the questions and I find that I like to recommend people talk to a midwife just because they don't fully understand what it looks like for a midwife to be their primary care provider. So I would like to talk about that. Like I know that midwifery care in Ontario is in high demand and there's a low supply or there's not enough midwives to spread around. Let's say, someone got pregnant and they were looking to have a midwife. What would you recommend that they do?

Corey: 8:56

And I know this is a joke amongst us, but tell me, To be honest, if you call your midwife, then you call your partner.

Deborah: 9:05

Yes, I love it. And then what happens from there?

Corey: 9:09

So we can be like fully autonomous primary care providers for folks who are having low risk, uncomplicated pregnancies and we can provide that care like from the moment of conception, although because we're so, I would say we're high touch, low volume. So because the kind of care we provide is so comprehensive, we maintain a very small caseload and so it's a little bit nicer if we're taking people into care a little bit later, like once we're sure of a due date, for example because we've had a confirmation by ultrasound. So that whole pee on a stick call your midwife, call your partner maybe not so essential these days as we're trying to like fit people in it's more information than listeners probably care about but fit people in around vacation, people's vacations and things like that. So once you're in care with midwives we see you along the same schedule as you would see a physician, so every four weeks until you are 28 weeks and then bi-weekly until 36 weeks and then weekly until you have a baby. And we like routine pregnancy care is routine pregnancy care. So you're going to have access to the same tests and ultrasounds Early in pregnancy. We're going to talk to you about genetic screening. You'll have a mid-pregnancy anatomy ultrasound. We still offer and recommend routine gestational diabetes screening. We still talk about group B, strep or GBS and doing that swab towards the end, and then at the end of pregnancy, we have options in terms of waiting for a period of time, and then sometimes we're recommending an induction for one reason or another.

Corey: 10:45

Recommending an induction for one reason or another we also one of our tenets of care, one of our core principles as midwives is continuity of care, and so what this means is we care for you through your pregnancy, but then also during the labor and the delivery and then into the postpartum as well. And when you're seeing an OB for your pregnancy, the care you're going to get is going to be excellent, but you're not pregnant, you're really not very interesting anymore, and you also may not see that obstetrician during your labor and your delivery either, because OBs work on a call rota. So it's if you have one of the Leamington docs, there's a 50-50 chance you'll get one of those docs. If you have one of the docs at Windsor Regional, you'll get whoever's on call that day. Yes, when you have a midwife, there's a really high probability that you'll get your midwife at your labor and then if your midwife isn't available, for whatever reason, then another midwife will attend you, so you'll still have midwifery care.

Corey: 11:40

Some of the things we do a little bit differently in labor we know that folks who get one-to-one labor support tend to have higher satisfaction with their labor.

Corey: 11:48

They also tend to have lower rates of intervention, and so that's the only time I'm not in the labor room with you in labor is if you're sleeping with an epidural because nobody needs to watch you sleep. Then of course in the hospital we have access to the OB team if we have anything that requires any kind of higher level of care. Once baby's on the outside we come and see you at home. You end baby for the first couple of weeks and then see you in clinic until baby's six weeks old and then we discharge you to your family doc. It's kind of a unique community for a couple of reasons. So one of the reasons is that OBs start seeing you quite early in your pregnancy. So in some communities you won't be seen by an obstetrician until 20 weeks, and this is important for non-Windsor Essex County listeners to know about, because your family doctor might not know that if you're waiting to see a midwife, you can't wait until 20 weeks or you're not going to get one.

Deborah: 12:40

Yes, yeah, that's important to know, yes, whereas you can wait for an OB because technically it's later that they wait on care.

Corey: 12:49

The other thing that's interesting is in this community we'll see well babies, which is not true in every community, so some families would opt for a pediatrician instead of their baby seeing their family doc.

Deborah: 13:00

Yeah, it's just preference Usually. I find that's what I'm the feedback that I'm getting I want to talk about. If you deliver at home, you still do all of the typical assessments of baby and of mom that are routine, right? Yeah, talk about some of those things that happen.

Corey: 13:20

Like the newborn screen and the CCHD.

Corey: 13:22

Yeah, so when you have a baby in hospital around 24 hours, the nurses will come and do a critical congenital heart defect screen where they look at at risk of sudden cardiac arrest.

Corey: 13:34

We also do a bilirubin screen, so in the hospital they'll take a sample of baby's blood and they'll check to see what baby's bilirubin is. This is a test that tells us if this baby is at risk for something called hyperbilirubinemia, which is basically an accumulation of bilirubin under the skin. It's what makes babies look yellow. We don't ever expect babies to be yellow at 24 hours, but this will tell us. Do we have to watch this baby quite closely or do we follow up, just as clinically indicated? And then we also do a blood test to check for 29 rare but potentially very serious blood, hormone and metabolic diseases. This is called the Ontario newborn screen and all of these tests are recommended. They're considered a standard of care and if you choose to have your baby at home, or if you have a baby in hospital but you leave the hospital before 24 hours, which is something that midwifery patients often do we'll come and do those tests for you at home.

Deborah: 14:45

I like that you brought that up, because that's my next question. If you give birth at home, you leave them as soon as everything is taken care of and settled down Typically, from my experience, three hours approximately yeah, between two and three hours usually and then, if they're in the hospital, you stay with them until and they can leave two to three hours as long as everything is, everybody is okay, or they can choose to stay at the hospital Exactly Until the next day, and either way, you see them.

Corey: 15:15

Yep, we'll see them in hospital if they're there at 24 hours, or we'll see them at home, if that's where they are, we come and find you.

Deborah: 15:23

Like hunting. Yeah, one of the things that I really like about the postpartum care, with midwifery, is the breastfeeding help, the support about the bleeding, which you don't get if you have an OB, unless you're going into triage and or the emergency room, and I think it's really important that moms have that continue. The continuance of care Do you want to talk about that a little bit? And how obviously the breastfeeding is a part of the things that you learn, whereas that's not something that happens with OBs and how you have, specifically, a lactation consultant on staff.

Corey: 16:01

Yeah, so we do have one of our midwives is a board certified lactation consultant on staff. Yeah, so we do have one of our midwives is a board certified lactation consultant who is a private lactation consultant business but also brings that energy into her practice. She runs a regular breastfeeding class out of our clinic and is always happy to be available for she's always happy to be available for my clients. If I ask her for a specific assessment, yes, but you have breastfeeding.

Corey: 16:31

We all yeah, we all have as part of our education we're required to do a placement with. So I did a placement at the breastfeeding assessment, breastfeeding and newborn assessment clinic or the BANA clinic at St Joe's Hospital in Hamilton, and so we all have to do some sort of breastfeeding placement as part of our undergrad education to even become a midwife. Health teaching, I think, is a really important component of what I do, and one of the things that I really enjoy is just like teaching people about their bodies and how their body works and the physiology of pregnancy and the physiology of fetal development and then, once baby's on the outside, newborn development and postpartum recovery like all of those things are, I think, essential. I think everybody in an ideal world would have access to midwifery care, at least for their first pregnancy, to be able to learn all of these things. Yes, but then something that I didn't touch on when I was talking about continuity of care is that folks, when they have midwifery care, they have access to their midwife 24 hours a day, seven days a week.

Corey: 17:33

For urgent concerns they can always call our pager, and so one of the things that the health care system really loves about midwives is that we work really hard to keep people out of hospital if they don't need to be there, whereas if you call OB triage, like an OB triage nurse doesn't know you, doesn't have an existing relationship with you, doesn't necessarily feel confident. Talking about expectant management as an option, management is just what we say in medicine. When we're watching and waiting, so basically doing clinically doing nothing A nurse, if you call OB triage, is pretty much always going to tell you to come in if you're not sure, if you need an assessment, whereas with a midwife I know you, we have a relationship. Maybe this is not your first baby with me, maybe you've had similar things in your previous pregnancy, maybe I know that sometimes you just need to be reassured. Maybe I can talk about what's more versus less concerning, and so we are able to help people manage things at home a lot more often than they do in OB triage just by virtue of that relationship.

Deborah: 18:37

Yeah, I really like that Also, like fully understanding, and I do. I do think that most people don't know that, like even when you're in labor at home, even if you are planning a home birth or planning on going to the hospital, the midwife can tell you like, yeah, I think it's time, cause that's what a lot of people do ask, right? They're like, how will I know when it's time to go to the hospital? Yeah, having a relationship with your midwife can really help those things. But also in the days before, if you have a concern, you can reach out via text or the midwife can swing by. I know that you've done that with patients of mine if there is a big concern.

Corey: 19:19

Yeah, like I always tell people, I'd rather do a hundred assessments I didn't need to do than not do that one assessment that we should have. If I feel like there's a benefit in being conservative, then that's the management I'll recommend, and if I think that expected management is an appropriate course, then that's what I'll recommend. But I'll take my cues from the person on the other end of the phone.

Deborah: 19:44

How she's feeling and what she's needing at this time to move forward or to feel safe and secure. I love that. I love all of these questions that we've talked about. I also want to talk about how, in Windsor and Essex County that there is a large number of midwives, and a little bit about how you talked about if you have a midwife that you've chosen or have been assigned to you, then you will most likely get that midwife. But also about when you call, because we're a large community and there's a certain number of you that when you call, you get assigned. You can't typically choose unless that person is actually available. So talk about that a little bit. About we talked about how the OBs are on a certain schedule and how with the midwifery clinic, it's a collective.

Corey: 20:35

Yeah, there is some wiggle room for requests, like we try to. If I have a previous client who's requesting me again, we try to honor those requests. If we have a Spanish speaking client, for example, one of our midwives is from Venezuela, so we would try to match those individuals up with her. But a lot of what goes into the assignment of clients is really like our availability availability. So we don't want to be giving me a bunch of clients less than two weeks before I'm off for a couple of weeks for vacation, for example, because I really want to be able to be there for those deliveries, and so that's, I would say, like the primary motivator in terms of when, in terms of who you get, it's who's available around the time that you're expecting to have your baby.

Deborah: 21:22

Yeah, I would imagine. It's also really important that you have the time off that you need to regroup, right, you're for sure, for seven, so vacation is extremely important. So what I'm understanding is that you can call them requests, but mostly it's a rotation system and, depending on the schedule already existing, you're being assigned a midwife. Yeah, I think we covered pretty much everything and also, if anyone has any questions, they can reach out to us. They can reach out to us in the show notes or send the message to us on Instagram. Also, corey is with the midwives of Windsor and Corey. If you wouldn't mind sharing that website, yep, it's just midwives of Windsor and Corey, if you wouldn't mind sharing that website.

Corey: 22:05

Yep, it's just midwivesofwindsorcom. Perfect.

Deborah: 22:08

Yeah, this is Corey, and so if you want to request her privately, you can try. So, corey, thank you so very much for being with me today. I'm so grateful that we got to do this conversation and that we're helping educate the community on midwifery care. Thank you, thanks.