The Midland Midwives By The Bay was established in 2018 with the vision and goal to provide midwifery care that is responsive to community needs and within the community we serve, either at home or at Georgian Bay General Hospital (GBGH). Our core service area includes Midland, Penetanguishene, Tiny, Tay, parts of Severn Township, and neighbouring towns (our official catchment area can be found here). When we launched our practice five years ago, GBGH’s birthing unit was at-risk of closure. We regularly had to deliver at Orillia Soldier Memorial Hospital (OSMH) due to ongoing unit closures and lack of access to anaesthesia. We are thrilled to share that starting April 1st, 2024, we are staying local, supporting both home births and hospital births at GBGH.
Over the last few years, access to maternity supports have greatly expanded at GBGH. For example, GBGH has a dedicated birthing unit with a locked unit, and private triage, labour and postpartum rooms. The maternity unit is staffed 24/7 with OB nurses and access to anaesthesia for epidurals, c-sections, and assisted vaginal delivery. Additionally, there is 24/7 access to a respiratory therapist for babies in house. At GBGH, the Midwives can now labour with and care for a greater range of patients compared to 2018 (i.e. VBACs and less restrictions from anaesthesia). These changes and access to more resources at GBGH means that our Midwives feel it is time to stay local. Midwives also want to work to their full scope of practice, and plan to start advocating to expand our scope of practice to its fullest as defined by the College of Midwives in Ontario. In turn, this will enhance the continuity of care we provide our clients locally at GBGH.
Midwives are trained to be experts in normal physiologic birth and are specialists in home birth. Given the consistent doubling of our client caseload on an annual basis, and with two thirds of births occurring at home or GBGH, it makes sense for us to concentrate our services locally, specifically supporting home births and clients that choose GBGH. We feel so thankful to of been a part of rebuilding GBGH’s maternity unit and look forward to continuing the advancement of maternity care in our community.
There are many reasons why delivering at home may be right for you. Some reasons to choose a home birth include:
Comfort and familiarity - home provides a familiar and comfortable environment, allowing the birthing person to feel more at ease during the process.
Control and autonomy - home birth allows for more control over the birthing experience. The individual can create a personalized birthing plan and make decisions about their birthing environment.
Reduced medical interventions - some individuals prefer to minimize medical interventions like epidurals.
Privacy and intimacy - home birth offers greater privacy and intimacy, allowing the birthing person to share the experience with a smaller, chosen support team.
Lower risk profile - for low-risk pregnancies, home birth can be a safe option.
Note: you can transfer to hospital if you decide while in labour or if risk factors develop in labour. For more information on choosing a home birth, click here.
There are many reasons why delivering at Georgian Bay General Hospital (GBGH) may be right for you. Some reasons to choose GBGH include:
Quiet intimate environment.
Only private rooms available.
Increased in-hospital one-on-one post-partum care.
More pain relief options available, such as water immersion for labour.
Location is closer to Christian Island and other priority populations.
Continue to provide collaborative care with OSMH for clients, including consultations and, when appropriate, share care.
Established pathway for transfers to a higher-level hospital in pregnancy, birth, and postpartum period, i.e. if baby is transferred to OSMH, we aim to transfer both mom and baby together.
Is it better to deliver at a higher-level hospital with a NICU in case something happens during my delivery?
Midwives primarily offer care to low-risk clients and are trained to effectively triage individuals throughout their pregnancy, labour, and postpartum periods. Generally, clients categorized as low risk are unlikely to necessitate NICU intervention. However, in rural settings, midwives consistently engage in triage as part of their management plan. If unforeseen events arise before labour, every effort is made to ensure clients are transferred to the most appropriate facility for delivery. When reviewing our transfer statistics from GBGH to other centers for postpartum care due to infants requiring a higher level of attention, we found that 94% of babies born at GBGH do not require a transfer of care. In the rare instances where transport is necessary, our strong relationships with the pediatric team at Orillia Soldier’s Memorial Hospital guide us in managing these situations. The GBGH team is highly proficient in the initial steps to stabilize newborns and ensures prompt and safe transportation when needed.
Is a higher-level hospital “safer”?
Not necessarily. The safety of a birthing location depends on various factors, and a higher-level hospital may not always be safer for a normal physiological birth. Many uncomplicated births can be appropriately managed in a low-intervention setting, such as a lower-level hospital or at home, with the support of Midwives.
It is never safer (or more comfortable!) to drive past a nearby hospital that can meet your needs, while attempting to reach a more distant higher-level hospital. This is particularly crucial given the unpredictable nature of labour and the possibility of worsening road conditions during the winter months. Midwives, especially those in rural areas, undergo continuous training to assess risks throughout pregnancy, childbirth, and the postpartum period, ensuring that clients are placed in the appropriate clinical settings.
If my baby does need to be transferred to a higher-level hospital, isn’t the drive to the hospital risky?
During both home births and at GBGH, midwives come prepared with the necessary equipment, training, and personnel to stabilize infants. Programs like CritiCall Ontario, funded by the Ministry of Health, empower midwives to engage in telemedicine, enabling timely access to a higher level of care as close to home as possible (e.g., receiving orders from pediatricians over the phone). When necessary, CritiCall can dispatch a team (via ambulance or helicopter) directly to GBGH, bringing higher-level care to the patient. Infants are only transferred when stable and safe to do so, and they are never transferred alone. A dedicated healthcare provider or providers ensure continuous monitoring and care during the journey to a higher-level hospital. It is encouraged for parents to travel or be transferred at the same time if deemed safe. While transfers can be overwhelming, it's crucial to note that statistics indicate the majority of babies (94.4%) remain at GBGH following delivery.
What if there is an emergency while giving birth at GBGH?
Facing an emergency can be daunting for both the birthing person and their partner, regardless of the delivery location. However, in the context of more rural centers, we are acutely aware that emergencies may present unique challenges, potentially impacting our center differently than urban centres. We diligently strive to anticipate such situations and employ evidence-based practices to effectively manage emergencies. Our center is equipped with clear procedures and policies to guide us during these critical times, and the close-knit nature of a smaller hospital fosters a strong sense of teamwork, enhancing communication among our staff.
How many Midland Midwives clients are choosing to birth either at home or at GBGH?
Between 2018 to 2019 half of our clients delivered at GBGH or at home (half at OSMH). Between 2022 to 2023 two thirds of our clients delivered at GBGH or at home (one third at OSMH).