Congratulations on your pregnancy!
Midwifery clients in Toronto have a new option when choosing their preferred place to give birth – the Toronto Birth Centre. A Birth Centre is a regulated, community-based health care facility that offers pregnant people a safe, comfortable, family-centred place to give birth. You will make many choices throughout your pregnancy; two of the most important will be deciding which health care provider you will go to for prenatal care and where you’re going to have your baby. If you choose to have a registered midwife, you can choose to have your baby at a hospital, at home or at the new Toronto Birth Centre.
The Toronto Birth Centre aims to create an environment that supports diverse communities in Toronto. This safe and welcoming space is open to you and your registered midwife to create the kind of birth experience you’d like to have. Families using the Toronto Birth Centre are encouraged to incorporate their own culture, background, traditions and preferences in their experience. Supporting Aboriginal families through pregnancy and birth is a particular focus of the Toronto Birth Centre.
There’s more to the Toronto Birth Centre than giving birth. The Toronto Birth Centre is committed to being a resource for information and support for women, families and communities in the city. Prenatal classes, access to alternative care providers, educational opportunities, referrals and community partnerships provide extra support for pregnancy, labour, birth, breastfeeding and parenting.
What facilities or services are available at the birth centre?
The equipment and technology available at a birth centre are equivalent to what would be available at a home birth.
The birth centre is set up for normal, uncomplicated births. At the birth centre you and your midwives will have access to equipment to help you give birth with little intervention. There are no doctors or nurses working in the birthing area of the centre.
Midwives offer a variety of options for comfort and pain management in labour. Comfort measures such as massage, sterile water injection, counter-pressure, position changes, or heat or cold are options available to you at home, in the birth centre, or hospital. Access to other pain management options varies by setting:
At home: You can use your bath, shower or a rented birth pool for comfort and pain relief in labour. Some midwives are able to provide nitrous oxide or TENS at home births.
In the birth centre: You have access to birth pools and showers for comfort and pain relief in labour (and water birth). Nitrous oxide and TENS will be available at the birth centre as well as a variety of other options for comfort and pain management (birth stools, suspended slings, birth balls, floor mats for kneeling and squatting, etc.).
In hospital: You have access to narcotics and epidural as well other methods of pain relief. Access to bath tubs, whirlpool tubs, waterbirth, showers or nitrous oxide varies by hospital.
Many hospital interventions are not available at the birth centre, including medical induction and augmentation of labour, continuous electronic fetal monitoring, instrumental delivery (forceps and vacuum) or c-section. Epidural and narcotics are hospital-based pain relief options that require consultation with a doctor and are not available at the birth centre.
When you give birth at home or in a birth centre, your midwife has access to supplies needed for many common emergencies, including oxygen and equipment that may be necessary in the event that your baby needs additional help to breathe immediately after birth, drugs to stop bleeding, and sterile instruments.
Birth centres aren’t just for birth – they are a place where clients, families and community members can get information and support about pregnancy, labour and birth, breastfeeding, and parenting.
A birth centre is a regulated, community-based health care facility that offers clients a safe, comfortable, family-centered place to give birth. Midwife-run birth centres have long existed in the United Kingdom, Australia and the United States. Research on birth centres in these countries shows that:
Birth centres are a safe place for clients with low-risk pregnancies to have their babies. Interventions, such as caesarean section, are less likely to occur when clients plan to give birth at a birth centre, rather than in a hospital. Midwifery care in a birth centre has the potential to be more cost-effective than care in hospital. Birth centres are a demonstration project funded by the Ministry of Health and Long-Term Care. Specific criteria and standards have been set for this new type of health care facility in Ontario.
Giving birth at home or at a birth centre is considered an “out-of-hospital” birth. Out-of-hospital births are an option for midwifery clients who are in good health and have had a normal, uncomplicated pregnancy. An out-of-hospital birth is not appropriate for all midwifery clients. Your health during pregnancy and labour and your personal circumstances are considerations you and your midwife will discuss in preparation for your decision about where to plan to have your baby. Your midwife will continue to assess your health needs throughout your pregnancy, labour and birth to determine whether out-of-hospital birth remains an ideal option for you and your baby. See the “What happens at a typical birth in a birth centre” section for more information about birth centre safety.
What happens at a typical birth in a birth centre?
Your midwife or student midwife will tell you when to page or call her once you’re in labour. They will assess your labour over the phone or in person to decide the best time for you to go to the birth centre.
You will be admitted to the birth centre once you are in active labour. At the birth centre, you will be greeted by a Birth Centre Aide who will bring you to your labour room and orient you to the birth centre. The Birth Centre Aide will provide assistance and support to your family and your midwife throughout your labour and birth.
You will be able to stay at the birth centre for up to 4 hours after your baby’s birth. At this point you will be discharged home. The birth centre is not meant as a place to stay for an extended period of time following birth. If you or your baby need close observation after the birth, you will be transferred to hospital.
With your permission, students might be involved in your care. Birth centres have an important educational function – they are a place where midwifery students and other health care professionals-in-training learn about normal birth. A student midwife who is doing a placement at the birth centre may be present at your birth, along with students who may have been involved in your prenatal care.
What if complications arise?
Midwives ensure that you remain a good candidate for out of hospital birth during your pregnancy and labour. If complications arise while you’re at the birth centre, your midwife may recommend that you transfer to hospital. If an emergency arises at the birth centre, your midwife will arrange transport to a hospital for you and/or your baby. Having quick access to hospital care is part of what makes out-of-hospital births safe!
If transfer to a hospital is not urgent and time allows, you will go to the hospital where your midwife has privileges, by car or ambulance (depending on the situation).
If transfer is urgent, 9-1-1 will be called and the ambulance will transport you to the nearest hospital.
In some circumstances it may be necessary for a doctor to then take over aspects of your care (transfer of care). If this is the case, your midwife will continue to provide support to you and will take over your care once your condition has improved.
Having a baby at the Toronto Birth Centre
There are six central Toronto midwifery practice groups affiliated with the Toronto Birth Centre, one Scarborough midwifery practice group, and another in Etobicoke. The space is designed to accommodate approximately 450 births per year. If you are not with one of the midwifery groups affiliated with the Toronto Birth Centre and are interested in out-of-hospital birth options, please speak with your midwife.
AFFILIATED CENTRAL TORONTO MIDWIFERY PRACTICE GROUPS
Seventh Generation Midwives Toronto – clinic located at the Toronto Birth Centre (416) 530-7468 website
Community Midwives Toronto (416) 944-9366 website
Kensington Midwives (416) 928-9777 website
Midwives Collective of Toronto (416) 963-8842 website
Riverdale Community Midwives (416) 922-4004 website
The Midwives Clinic of East York Don Mills (416) 424-1976 website
SCARBOROUGH MIDWIFERY PRACTICE GROUP Diversity Midwives (416) 609-8187 website
ETOBICOKE MIDWIFERY PRACTICE GROUP Midwife Alliance (416) 534-9161 website
If you plan to give birth at the birth centre
Everyone who plans to give birth in the birth centre needs to have a back-up plan – an alternate place to give birth, either at home or in hospital. The reasons for this are:
– Birth centres are an appropriate setting for normal, uncomplicated births. If complications arise in your pregnancy or during your labour, your midwife will recommend that you give birth in hospital.
– The birth centre has a limited amount of space and while it is unlikely, it could be full when you are in active labour and ready to go to the birth centre. It’s not possible to reserve a birth centre room in advance. Clients are admitted only when they are in active labour on a first-come, first-served basis.
There are many factors to consider when deciding where to have your baby. Your midwife can answer your specific questions, provide additional information and support you in making a decision that’s right for you and your baby.
WHAT TO BRING
We have developed a list of common items you may want to pack before your admission to TBC. You may find a pamphlet in your midwifery clinic or our birth space.
We have also translated the content to a 4-page PDF document in accessible 16-point font for download or view on your portable device.
There is no additional cost for families to give birth at the Toronto Birth Centre, but you must be registered with a midwifery group from before you go into labour to give birth here.
NOTICE OF AVAILABILITY
The Toronto Birth Centre is committed to excellence in serving all customers including people with disabilities. Our policy and service plan related to accessible customer service are available upon request by contacting the Toronto Birth Centre reception at: (416) 366-8080 x. 201 or by email at: firstname.lastname@example.org