The Pulse of the Community

Michelle Holden
Quilts commemorating the Three Sisters Accord between the Toronto Birth Centre, Women's College Hospital, and Seventh Generation Midwives Toronto.
Quilts commemorating the Three Sisters Accord between the Toronto Birth Centre, Women's College Hospital, and Seventh Generation Midwives Toronto.

At the Toronto Birth Centre, a long history of midwifery plays a role in programming and care delivery today. For Executive Director, Roberta Pike, looking to the past is, on one hand, about celebrating the advances since the regulation of Ontario midwifery 25 years ago. But it is also about honouring those midwives, especially Indigenous midwives, who practiced long before.


When asked what drew Ms. Pike to the Centre, she had a lot to say about community. Before becoming Executive Director of the Toronto Birth Centre, Ms. Pike was a social worker in Toronto’s Indigenous community and coordinated homecare in Toronto. After, she spent a number of years with the Ontario Ministry of Health and Long-Term Care and the Ministry of Community and Social Services. “What I missed most during my time in government was feeling the pulse of the community,” said Ms. Pike.

Ms. Pike was no stranger to midwifery before coming to the Centre. While in government, she worked with Tsi Non:we Ionnakeratstha Ona:grahsta, also known as the Six Nations Maternal and Child Centre – the first birth centre in Ontario. “From my experience working with Six Nations I knew that I wanted to have an Indigenous midwife for the birth of my first child,” she said; “having my baby was a beautiful experience.” What Ms. Pike values most about midwifery is how midwives work alongside the pregnant person. “They are experts in birthing out of hospital,” she said, adding that midwifery, at the end of the day, is about clients’ decisions and informed choice.

No two days

For Ms. Pike and her team, there is no such thing as a typical day at the Centre. From the birthing rooms downstairs, to the classroom upstairs – “You really can feel the energy in the space,” she said.

Over 100 midwives practice out of the Centre, while 16 full and part-time staff keep things running smoothly. 
The Toronto Birth Centre is also home to a number of students who rotate in and out on placements. For midwifery students, having access to laboring clients is a critical part of their education. However, Ms. Pike and the team are also focused on broadening the understanding of midwifery to other professional groups – which is why they also host students from programs like nutrition, social work and nursing. “They are learning from us and we are definitely learning from them,” said Ms. Pike, who loves to see students who want to suggest improvements and reflect deeply on their learning at the Centre.

Building trust

What sets the Centre apart in a busy city like Toronto is its focus on events and educational programming. Ms. Pike says that the driving force behind each event is to help build a safe space to connect communities. “As a relatively new organization it takes time to build connections and gain peoples’ trust,” she said. They offer events tied to childbirth, pre- and post-natal, seasonal feasts, but also health and wellness seminars. Knowing they can’t do it alone, the Centre also rents and gives away free space to midwives, doulas, educators, community groups and other professional practitioners.

“There’s a thirst for more education about who we are as people – our bodies and how we’re interconnected mentally, spiritually and emotionally,” said Ms. Pike. What they’ve found is that people want this information, but they’ll also bring their friends and families along and have a conversation. “That’s the ripple effect that we’re beginning to see.”
And the Centre’s admission numbers certainly tell this story. In the past two years, the Toronto Birth Centre has exceeded its funded numbers.

“It’s been phenomenal how much growth we’ve had year-over-year,” said Ms. Pike. As one of two government-funded birth centres in Ontario, their numbers reflect the growing need for more funding and additional centres. “I personally would like to see other birth centres established here in the city,” said Ms. Pike who explained that their Dundas St. E location is not necessarily an option for everyone across the GTA.

Partnering for safe care

On the subject of safe care, Ms. Pike says the Centre regularly reviews its policies and procedures, working toward constant improvement. “We definitely address all possible risks,” said Ms. Pike, using the example of slips and falls. “We have mats in place in the wet seasons, have wheelchairs for laboring clients, and we ensure the space is cleaned regularly to reduce this type of risk.”

In terms of process and safety, Ms. Pike says she owes a lot to those midwives and staff who played a role in setting the Centre up for success in its early days. The Centre celebrated its five-year anniversary this past February. 

For HIROC, the relationship with both free-standing midwifery-led birth centres in Ontario is about more than just providing insurance, it’s a partnership. We work with the two organizations to offer guidance in the areas of risk and safety, and to collaborate on education initiatives.

“We are so proud of how far the Toronto Birth Centre has come since its inception,” said Joanna Noble, Supervisor, Knowledge Transfer at HIROC, adding that the Centre is an embedded asset within the urban Toronto health landscape. “Roberta and her team are always looking at ways to improve their service and care delivery to ensure pregnant people and families have access to safe and culturally respective care.”

When asked what plans Ms. Pike has for the Centre in the coming years, she focused on partnership and building deeper relationships with healthcare and educational institutions. “We all need to get better at partnering and sharing resources.”

The Centre has a longstanding partnership with St. Mike’s in Toronto, but also with Women’s College Hospital who was a vital partner in the establishment of the Centre. Ms. Pike also spoke of the Three Sisters Accord, between Seventh Generation Midwives Toronto and Women’s College Hospital. “The Accord is a formalized way of talking about our mutual values and goals and commitments to one another,” said Ms. Pike.

And as the only two Independent Health Facilities-funded birth centres in Ontario, Toronto and the Ottawa Birth and Wellness Centre have strong ties. Ms. Pike and Ottawa’s Executive Director, Elyse Banham, work together with their Clinical Directors to ensure they are advocating for the needs of the two centres and for families across Ontario.

Ms. Pike says she feels blessed to work at the Toronto Birth Centre – mainly thanks to her staff. “I have to give huge credit to the people who work here,” she said. “Each and every one of them is not only passionate about the Centre, but they really love their job.”

Michelle Holden is Communications and Marketing Specialist, HIROC

This article was originally published in The HIROC Connection – Spring 2019.