Melanie Mahrt-Smith is a registered midwife leading the new Postpartum Midwifery Care Clinic at St. Michael’s Hospital.

Sign up for the Unity Health Toronto newsletter, a monthly update on the latest news, stories, patient voices and research emailed directly to subscribers. If you haven’t subscribed yet, you can do that by clicking here.

Melanie Mahrt-Smith hangs up the phone with a smile on her face.

“That was an example of this clinic at work and an ideal outcome,” she says.

“We have a patient who recently delivered her baby at St. Michael’s and lives in a shelter that she has to leave. Through a network of connections and navigation, we found her a program in her new region for new moms and eight weeks of postpartum care with a midwife.”

Mahrt-Smith is a registered midwife leading the new Postpartum Midwifery Care Clinic at St. Michael’s Hospital. The clinic provides up to six weeks of postpartum care for women and their newborns who gave birth at St. Michael’s. The clinic is prioritizing patients who do not have a primary care provider or have barriers to accessing care, so they can receive care in a timely way and avoid the escalation of issues that may lead to visits to emergency departments.

The clinic is staffed by two midwives who provide the full scope of midwifery postpartum care. This includes assessment of postpartum bleeding, suture care, post-caesarean section wound care to avoid infections, lactation support, as well as routine well baby care, weight checks and jaundice follow-ups for the newborn. The clinic also supports health system navigation and mental health assessment.

“I think it’s so critically important that we try to give some really early support around mental health and anxiety,” says Mahrt-Smith, who is also a registered social worker. “Assessing what is within the realm of normal new parent fears and worries, what is deviating from normal, and what we are going to do to intervene while we still have them in our care are all important to consider.”

“To send somebody out into the community when they’re struggling only exacerbates the situation and makes that early transition into parenting really challenging.”

Mahrt-Smith is the first midwife employed by Unity Health. Ontario midwives are primary care providers who can care for patients through pregnancy, labour, and the first six to eight weeks after their baby is born – and midwifery care is covered by OHIP. They are qualified to give some medications during pregnancy, labour, birth and postpartum, as well as order laboratory and ultrasound testing if needed.

Mahrt-Smith also takes the time to talk about the importance of early literacy with families visiting the clinic.

“Midwives are highly trained and well positioned to provide excellent, holistic postpartum care to moms and babies. What appealed to us about having a midwife-led postpartum clinic is helping to actualize  our plan to provide as many options as possible to create the birthing experience that women want,” says Marisa Cicero, Senior Clinical Program Director, Women’s and Children’s Health at Unity Health.

“For those who want or need to deliver with a physician in a hospital, we think having the postpartum care with a midwife can be the best of both worlds. Bringing this opportunity to our patients felt like a good way to expand our offerings and enhance the experience and outcomes for our patients.”

Mahrt-Smith notes in today’s health care climate midwifery care can also play a key role for many people who don’t have a family doctor.

“We know people are having issues getting access to a family doctor – either they had one and that person is no longer available to them through retirement or other reasons, they’re new to the city, or new to the country,” she says.

“So if we can intervene in that critical six-week period for moms and newborns to keep our finger on the pulse of what’s going on, we also buy ourselves a little bit of time of trying to think about ways in which we can connect people to primary care or other resources.”

Since its opening in late January, the clinic has been able to connect nearly 80 per cent of its patients who came in without a primary care provider to primary care.

Beginning in May, the clinic will also run on Saturdays, which provides more flexibility for parents and their newborns.

“My hope for the future is that we continue to grow the program to help us provide the very best possible care to those that have their babies at Unity Health,” Cicero says.

The Postpartum Midwifery Care Clinic was made possible by provincial government funding to increase access to pediatric services for children and youth in Toronto and the GTA.

By Danielle Pereira. Photos by Eduardo Lima.