New midwifery unit at MacKids a ‘perfect balance’ between home and hospital births

Kavitha Shiju had a difficult" choice to make when she found out she was having a baby, her second child but her first birth in Canada: doctor or midwife?

Through recommendations on Facebook, she and her husband, Shiju Inder, decided on a brand-new midwifery unit at McMaster Children's Hospital.

Their daughter, Ilyn, was born on May 22, 2022, the second baby born on the unit.

Kavitha said she was given the royal treatment."

It's not like in a huge hospital where you get to see so many patients," she said. This unit was so separate and very, very quiet."

The four-bedroom, hospital-based unit that opened last spring down the hall from labour and delivery has the comforts of a midwifery clinic such as birthing chairs, an inflatable tub, and prenatal and postpartum care in a homelike setting," but with the security and pain-relief options of a hospital.

Kavitha said she gets goosebumps" when she remembers the kindness, care and skill of the midwives who supported Ilyn's birth.

I was in so much pain ... and they got that little baby out like a piece of cake," she said of her daughter, now nine months old.

Lisa Sabatino, interim midwifery lead in the Hamilton Health Sciences (HHS) obstetrics and gynecology department, said the unit is a perfect balance" between home and hospital, with a calm, peaceful, quiet atmosphere" and access to pain relief such as an epidural, only available in hospital.

The main advantage is to give individuals more choice in terms of birthplace," she said.

Historically, pregnant people in Ontario would have to choose between hospital or home, she said.

Sabatino said some clients may want to give birth at home, but might not have a living arrangement conducive to a safe and comfortable experience.

Midwifery has grown in popularity since it was first regulated in Ontario nearly three decades ago. According to McMaster University's midwifery department, there were around 1,700 midwives in Canada in 2019, up from 60 in 1994.

Midwives deliver babies in hospital and home as well as offering prenatal care such as checkups and ordering ultrasounds and blood work, and postpartum care for six weeks after birth.

Approximately 3,500 to 4,000 babies are born at MacKids each year, and about 14 per cent of births at HHS - which includes MacKids and West Lincoln Memorial Hospital - are supported by midwives.

We want midwifery services to be available to as many people that want them, and historically, we have had challenges in meeting that demand," Sabatino said.

The unit is unique, with just one other Ontario hospital (Oak Valley Health's Markham-Stouffville Hospital) offering hospital-based midwifery care.

In its first months of operation, the midwifery unit admitted 253 people, more than two-thirds of whom gave birth in the centre. Higher-risk clients who don't meet the criteria for the midwifery units - a parent having twins or who's previously had a Cesarean delivery (C-section), for example - would be transferred to labour and delivery, but would continue to receive care from a midwife.

HHS says the hospital employs six midwives who provide care both in the specialized unit and on labour and delivery.

Shasta Cividino, clinical manager of labour and delivery in the midwifery care and women's health critical care units, said the program seeks to address the growing need for capacity" at the hospital, which is the regional centre for high-risk pregnancies.

The population is growing and we continue to see challenging cases in obstetrics while also trying to provide ... low-risk care to a population who needs it," she said.

McMaster says the unit is still in early stages of development, but feedback from clients has been overwhelmingly positive, staff say.

We think it's innovative and I think we're really keen to continue to grow this," she said.

Kate McCullough is an education reporter at The Spectator. kmccullough@thespec.com