On July 9, Canada’s first Alongside Midwifery Unit (AMU) will open at Markham Stouffville Hospital (MSH). The specialized childbirth unit will provide more access to women choosing to have a midwife for their childbirth experience in a hospital setting for normal births for low-risk healthy women.
The AMU was made possible through the collaborative work of MSH midwives, obstetricians and patients. It gives patients of midwives access to obstetricians, neonatal and anaesthetic care along with diagnostic imaging on the same floor, should they be needed during labour and birth.
“MSH is excited to be a leader in this innovative model of care,” says Carol Cameron, AMU executive director. “It’s called a midwifery unit because it’s staffed, run and governed by midwives. We’re self-regulatory, we’re autonomous and we’re very well integrated at MSH.”
Every effort has been made to make the unit a warm, welcoming environment with emphasis on natural elements that align with midwifery philosophy. Instead of a clinical environment, the AMU birthing rooms offer alternatives typically found at a birthing centre — where the bed is not the focal point of the room. The AMU has six specially equipped birthing rooms outfitted with upright birthing stools, hanging slings and tubs suitable for water births, allowing women to adopt upright positions. The rooms will also have double-sized Murphy beds for rest after giving birth.
“Midwives are experts at normal birth,” says Cameron. “The vast majority of women expect a normal birth, but some experience birth interventions. Studies in Canada and internationally found women who receive midwifery care are less likely to need interventions.”
About 12 per cent of women are transferred during labour due to complications, in which case the obstetrician will become the main care provider while the midwife plays a supportive role. In the AMU, however, the midwife is the lead professional.
“Midwives have been successfully integrated into the childbirth care team at MSH since 1994 and work collaboratively to deliver optimal services to patients in this community,” says Cheryl Osborne, Childbirth and Children’s Services patient care director. “This partnership improves access to the right care close to home for our patients and their families.”
Clients of Markham Stouffville Midwives, Midwifery Services of Durham or Uxbridge Midwives who remain low risk at the time of labour are able to give birth on the AMU. Both hospital and community midwives will support a patient-focused, quality based and integrated approach to healthcare, without sacrificing the high quality and patient-centred care that midwives offer.
With the AMU, midwives can care for more women in the community – from the current level of 600 per year to 1,100 – with the same number of midwives. And it’s done without increasing costs. In fact, midwifery services save a significant amount of money.
“The cost to deliver is so much lower, roughly about half,” says Cameron.
The option of home birth will continue to be offered to all appropriate midwifery clients in addition to the births planned to take place at the AMU.