Meet Dr. Pamela Smith, ND

Dr. Pam has a family practice at Village Health Clinic which offers naturopathic and midwifery care. Dr. Pam combines science-based natural medicine with conventional medical therapeutics. Find out more about Dr. Pam and visit her health and wellness blog

If you have a question or would like to suggest a topic for a blog post or other resource, send us an email. We can't make any promises but we'll certainly try our best to get back to you!


The Q&A - By Topic 


What is an episiotomy?

An episiotomy is a surgical incision along the perineal tissue to enlarge the outlet during delivery. Your practitioner may decide an episiotomy is necessary to prevent severe trauma to the vagina and perineum especially if instrumental assistance is needed (i.e. with forceps or vacuum) or to accelerate birth when there is evidence of fetal distress. Episiotomy’s are not routine procedures anymore and are generally not recommended as healing from a spontaneous tear heals quicker and is less risk to mother and baby.

Read this post for how to prepare for labor and delivery.

When are vacuums and forceps required during childbirth?


A vacuum or ventouse applies suction by placing a cup to the baby’s scalp to help draw the baby out of the pelvis. Forceps are typically metal prongs that slide over the baby’s head to also help draw the baby out of the pelvis but are also used in some caesarean births. Indications for use of these tools include delay of second stage labour due to insufficient contractions, epidural analgesia, improper rotation of baby’s head, or maternal fatigue. They may also be used if baby’s health is compromised and quick delivery is required. Epidurals increase the risk of requiring an instrument to assist with delivery.

In Canada, instrumental assisted birth is approximately 15% of all births.

Complications for both vacuum and forcepts procedures are similar. For the mother these include soft tissue damage and hemorrhage, and for baby include bruising, trauma to the head or face, and worst but rare case nerve or brain damage.

Read this post for tips to prepare for labor and delivery.

What is a natural childbirth?

A natural childbirth is where no invasive techniques or medications are used during labour and delivery. Instead, techniques such as breathing exercises, self-hypnosis, and massage are all used for pain management instead of medications such as with an epidural.  Some women feel very strongly about having a natural childbirth and in most circumstances this can be achieved; however, it is important to be aware of the scenarios where intervention is necessary to prevent harm to the mom or the baby. See this post for when this may be the case. 

For more about having a natural childbirth, read this post.