Prenatal Care Providers

People who choose to continue their pregnancies will often start by considering their prenatal care options. Depending on your individual circumstances, you might go see a family doctor, nurse practitioner, midwife or obstetrician for your care throughout your pregnancy. Here are some important differences between these options to help you decide:

Family Doctor

• General medical professional who provides care to all people
• Appointments are usually between 10 and 15 minutes
• Do not always deliver babies, they may refer you to either a midwife or an obstetrician
• Only attend births at a hospital
• If a complication arises at any stage of your pregnancy an obstetrician may be called in for a consultation and support
• Costs are fully covered if you have Ontario Health Insurance (OHIP)

Nurse Practitioner

Nurse practitioners, like family doctors, act as primary care providers and deliver quality, personalized health care to patients. Nurse practitioners often work in partnership with physicians, nurses and other health care professionals such as social workers, mental health professionals and pharmacists. If you see a nurse practitioner for your primary care, you may choose to see them for your prenatal care.

You will start seeing your nurse practitioner shortly after you discover you are pregnant. Your appointments will be between 10 and 15 minutes in length. On your first visit, you will probably have to have a pelvic exam to check the size and shape of your uterus, and a Pap smear if needed. Your nurse practitioner will also weigh you and check your blood pressure at every visit. Generally, you may see them once a month until you are at 30 weeks gestation. From 32 to 36 weeks gestation, you may see them every two weeks. In your final weeks of pregnancy, you may see your nurse practitioner as often as once a week.

Nurse Practitioners may attend to births at hospitals. They do not always deliver babies and may refer you to either a midwife or an obstetrician if this is outside their scope of practice. Nurse practitioners can see all of their patients, regardless of whether they are covered under OHIP. Uninsured patients may prefer to see a nurse practitioner for their prenatal care.

Key Points 

• General medical professional who provides care to all people
• Appointments are usually between 10 and 15 minutes
• Do not always deliver babies, they may refer you to either a midwife or an obstetrician
• Only attend births at a hospital
• If a complication arises at any stage of your pregnancy an obstetrician may be called in for a consultation and support
• Costs are fully covered if you have Ontario Health Insurance (OHIP)

Midwife

Midwives are prenatal care providers who specialize in low-risk pregnancies and births. They see themselves as partners in their clients’ care and work to ensure that you are the primary decision maker in your pregnancy pre- and
postnatally. If complications arise at any time during your pregnancy, your midwife will consult or refer to an obstetrician as appropriate. As midwives work in teams, you may be assigned several to support you throughout your pregnancy. Midwives are available to their clients 24 hours-a-day, 7 days a week, for any urgent concerns. Some midwives also specialize in trauma informed care.

If you choose this option for your prenatal care, you will start seeing your midwife team around the 10th week of your pregnancy. Appointments with your midwife will be thorough and include emotional support, often lasting
30 to 45 minutes. You will see your midwife once a month for the first 28 weeks of pregnancy, every two weeks until the 36th week of pregnancy, and then once a week until the baby is born. After the birth, your midwives will do home visits with you and your baby for up to 6 weeks.

Midwives are qualified to attend to birth at a place of your choosing, either in a hospital, birth centre, or in your own home. Since you have worked with a team of midwives, the person called in at your delivery will likely be very familiar to you. People without OHIP coverage can still see a midwife for free because they are funded through the Ministry of Health and Long Term care. Please note that without OHIP, pregnancy related requirements such as lab testing, ultrasounds, consultants, and some hospital fees are not covered.

Key Points

• Specialist in normal, low-risk pregnancies
• Appointments are 30-45 minutes long
• Your labour and delivery will be attended by a midwife known to you
• Can attend births at hospitals, birth centres or at your home
• If a complication arises at any stage of your pregnancy an obstetrician may be called in for a consultation and support
• Do home visits with you and your baby until six weeks after you deliver
• Funded through the Ministry of Health and Long Term care, free to clients with OHIP coverage
• Without OHIP, lab testing, ultrasound, consultants and some hospital fees are not covered

Obstetrician

Obstetricians are highly trained in reproductive health during preconception, pregnancy, labour and birth, and postpartum care. Obstetricians support vaginal delivery but also manage more complicated pregnancies (e.g. high blood pressure, heart disease, twins, triplets, and higher-order multiples). You will likely be referred to an obstetrician when complications arise. Obstetricians may also provide shared care together with a family doctor or midwife. If you have a pre-existing health condition that affects or could affect your pregnancy, you will probably be seen by an obstetrician.

You will start to see your obstetrician between the 20th and 30th week of your pregnancy. Your personal history and your pregnancy will dictate when your obstetrician starts seeing you. Appointments are focussed exclusively on pregnancy and usually 10 minutes or less in duration.

Obstetricians attend births at hospitals. The obstetrician who attends your delivery may or may not be known to you depending on which doctor is on call when you are ready to deliver. Obstetricians are specially trained to perform more complex deliveries, like C-sections. The cost of seeing an obstetrician is fully covered by OHIP.

Key Points

• Specialist that has particular expertise in pregnancy and childbirth
• Appointments are often 10 minutes or less
• Provides all your prenatal and postpartum appointments
• Often work in teams, sharing their on-call time
• The obstetrician that attends your delivery may or may not be known to you
• Only attend births at the hospital
• Costs are fully covered if you have Ontario Health Insurance (OHIP)