What Facilities and Services Are Available at The Birth Centre?

The equipment, supplies and medications available at a birth centre are approximately equivalent to what midwives provide at a home birth or a level 1 / community hospital.

The birth centre is set up for, physiological, uncomplicated births. At the birth centre you and your midwives will have access to equipment and supplies needed for many common situations and more rare emergencies, including:

• To repair 1st and 2nd degree lacerations that may happen during birth (suturing – perineal repair).
• To help your baby to breathe, if needed (neonatal resuscitation).
• To treat any excessive bleeding after birth (Postpartum hemorrhage).
• To respond to other complications that midwives train and practice for.

Midwives offer a variety of options for comfort and pain management in labour. For more information about comfort measures and pain management at TBC, please see our pamphlet on this topic TBC Comfort Options Pamphlet.

To learn more about choosing between birth centre, home and hospital birth, please see the AOM’s resource Birthplace Options.

There are no doctors or nurses working in the birthing area. 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 caesarean section. Epidural and narcotics are hospital-based pain relief options that require consultation with a doctor and are not available at the birth centre.

Safety

Midwives have been attending birth outside of hospitals for a long time, and are a big part of collecting information and conducting reviews to keep everyone informed about the safety of birth in birth centres and at home.

For more resources on the safety of birth outside of hospitals, visit the AOM’s pages on this topic.

These infographics put the information on safety into graphs and pictures:

• Giving birth for the first time - link
• Giving birth for a second, or subsequent time – link

For a video on choosing to birth outside of hospital, watch:

What happens at a Typical Birth in a Birth Centre?

You will learn from your team of midwives how to recognize the stages of the labour process as they unfold for you, and when to page your team in labour. Your midwife will assess your labour over the phone or in person to decide the best time for you to go to the birth centre.

You can be admitted to the birth centre once you are in active labour. You will be greeted by a Birth Centre Aide, who will show you to a birth room and orient you to the birth centre. The Birth Centre Aides provide assistance and support to your support people and your midwives throughout your labour and birth.

You may stay at the birth centre for 2-4 hours after your baby’s birth, and then your midwives will help you prepare to be discharged home. The birth centre is not meant as a place to stay for an extended period of time following birth. In exceptional circumstances, the length of stay can be extended to a maximum of 6 hours. If you or your baby need closer observation after this time, you will need to transfer to hospital.

Students involved in your care

We need to train more midwives and other healthcare providers to keep birthing care available to everyone who needs it. If you have students involved through your midwives’ practice group, those students will usually also attend during your time at TBC.

TBC offers learning spaces to students of Midwifery. We also work with students from other health and social service training programs, eg: Nursing, Social Work, Medicine, Health Administration, Nutrition, Global Health. Students can learn a lot from involvement in your birth experience, if you give consent. Births at the birth centre are unique and important, as this facility is set up especially for midwife-led care, and birth centres are not yet available in every community.

When you complete a booking form for TBC with your midwives, you’ll be asked about your consent to involve students completing placements at the birth centre. A student placed at TBC could attend your labour and birth along with other student(s) from your midwives’ practice group if you consent to it. If you or your baby transport from TBC to a hospital, a TBC-placed student’s involvement would end when you leave the TBC.

• 3rd year Midwifery students
  • Students completing a 3rd year placement at TBC spend ~120h in various activities. They have completed training in neonatal resuscitation, an initial 18 week placement with midwives, and may have done some training with nurses, lactation consultants, OBs or other inter-professional colleagues of midwives.
  • During labour and birth, they may provide you support and/or clinical care under supervision of your midwives. In particular, they may observe and/or receive your baby at birth and give care in their first hours of life.
• Learners from other health and social service programs
  
  • Students from other programs may never have been present at birth before, especially in the care of midwives. They may provide you with support and respectfully observe the care midwives provide. They would not take any clinical role.

The roles and responsibilities a student would take in your care can always be negotiated with your midwives, who are responsible to supervise all students present.

Thank you for considering including students in your birth experience. For more information, please see our pamphlet about students TBC Student Pamphlet.

What if Complications Arise?

Midwives are trained to continually assess risk, recognize the signs if complications begin to arise, and connect you with the resources you need for safe care. If complications arise while you’re at the birth centre, your midwife may recommend that you transfer transport to hospital. Having quick access to hospital care is part of what makes out-of-hospital births safe.

If transport to a hospital is not an emergency, and time allows, you will usually go to the hospital where your midwife has privileges, by private vehicle (eg. your family’s car or taxi) or ambulance (depending on the situation).

If transport is more urgent, Birth Centre Aides can assist your midwives in calling 9-1-1 for an ambulance to transport you. This is most often to the hospital where your midwives have privileges, but in the most serious emergencies, can be to the nearest hospital with the service your or your baby needs.

Please talk with your midwife team about which hospital(s) they transport to from Toronto Birth Centre, and the influences in this decision.