Teamwork keeps birth close to home at rural community hospitals

In order to ensure that women in rural communities can give birth close to home, midwives work collaboratively with physicians and other members of the health care team.

Midwife Natalie Wright says she and her four colleagues at Caring Hands Midwifery Services in Alliston (pop. 15,000) have very positive working relationships with obstetricians at Stevenson Memorial Hospital.

“We do 50 to 60 percent of the births at the hospital each month so they know us really well,” says Wright. “They know how we work and they trust us, and vice versa.”

She says midwives appreciate the fact that the obstetricians they work with are advocates of home birth and provide excellent breastfeeding support to their own clients.

Working in a level one hospital requires a team-based, “all hands on deck” approach.

“We’ve been called in to do deliveries because the OB isn’t in house – and that’s not unusual,” says Wright.

She says during winter storms, a midwife may be required to manage an emergency before the physician arrives or assist in the operating room if the OR nurse can’t drive through a blizzard.

Wright says midwives who work in rural hospitals are team players.

According to Wright, the Alliston midwives experienced their biggest challenge in December 2006 when Stevenson Memorial Hospital closed its birthing unit. She says the hospital administration made this decision because the OBs working in the community at that time weren’t offering 24/7 coverage; this meant the unit was closed for two weeks every month.

Without access to a birthing unit in Alliston, women had to drive to a hospital an hour away. Women worried they wouldn’t get to the hospital in time and found the additional time on the road stressful. After community action to publicize the importance of saving the birthing unit, the hospital re-opened it in April 2008.

Today the midwives are an integral part of the birthing unit and the obstetrics program and also actively participate in hospital committees.

“We’re very proud of where we’ve come from and where we are now. Now we feel it’s a very stable unit that provides 24/7 obstetrical care and people appreciate the work that we do,” says Wright.

While the hospital’s special care unit doesn’t have all the “bells and whistles” clients would find in a larger hospital, Wright says women appreciate the fact that they don’t have to leave their community to go to prenatal appointments or give birth.          

The Stevenson Memorial Birthing Unit is a high quality, valuable community resource. It was recently named one of Ontario’s top performers in maternity care in a report from the Ontario Hospital Association and National Research Corporation Canada – an independent research institute that surveys and compares all hospitals in the province.

The Association of Ontario Midwives supports keeping birth close to home. By playing a key role in keeping their birth unit open, Wright and her midwifery colleagues have helped to give families in the community the resulting positive outcomes.