Unity Health Toronto strengthens coordinated care for patients with high-risk pregnancies

Dr. Tony Barozzino and Dr. Tatiana Freire‑Lizama

Unity Health Toronto is making it easier for patients with high-risk pregnancies to get coordinated care by setting up a clear referral system between two of its sites: St. Michael’s Hospital and St. Joseph’s Health Centre.

This strengthened referral pathway also connects families to a broader range of Unity Health resources, including pre-pregnancy counselling, post-loss specialized support, antenatal consultation with neonatology and care within a network that includes two Level 2C NICUs. Pregnancy can be unpredictable and this coordinated care model will help ensure families receive the right level of support at the right time and place.

St. Joseph’s Health Centre provides local pregnancy and birth support in Toronto’s west end. Located only 20 minutes away, St. Michael’s Hospital offers specialized pregnancy care for complex cases across Toronto, supporting patients with a wide range of medical and mental health conditions such as Multiple Sclerosis, Cystic Fibrosis, addiction/substance usage disorders among other potential maternal health challenges.

“It’s a one‑stop shop. If a patient starts at St. Joseph’s or St. Michael’s, we can help manage their high‑risk pregnancy and stay closely connected with their hospital team and caregivers,” says Dr. Tatiana Freire‑Lizama, perinatologist at St. Michael’s Hospital

Freire-Lizama said this kind of hospital-based, team-driven approach isn’t common in the GTA. In many cases, patients with high-risk pregnancies need to see different specialists at separate centres, which can mean more appointments, more travel and less connected care. Something most pregnant mothers would prefer to avoid – especially if they’re already high risk.

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Dr. Tony Barozzino, Medical Director, Women’s and Children’s Health Program and Interim Chief of the Department of Pediatrics at St. Michael’s Hospital, says “This new care pathway strengthens how our teams stay connected, particularly through Epic, Unity Health’s electronic health record system. It also makes things easier for patients, because it links them to a wider range of services if their needs become more complex.”

In the past, referrals outside the network often meant transitioning to new teams and new care plans. The shared approach keeps both sites involved and allows Unity Health to care for patients in house. With a robust team of social workers, dietitians, lactation consultants, hospital-based midwives and other specialists working together across both sites, families receive seamless, wrap-around support throughout pregnancy and into the weeks and months after their baby is born.

St. Michael’s Hospital offers highly specialized, subspecialty services for patients with complex conditions such as Multiple Sclerosis, heart disease or autoimmune diseases such as Lupus that allows their obstetrical care to be easily coordinated with other specialists. “Because we work alongside our specialty clinical teams caring for patients’ underlying medical conditions, individuals who have may brain lesions (commonly seen in MS) or may have had heart surgery in the past can see us when they become pregnant,” said Freire-Lizama.

The team is also focused on making care easier to access. The interprofessional team works closely with patients to better understand what they may require and how to support families across the city.

Dr. Barozzino says, “Strengthening the care pathway between both hospitals,” he adds, “means more families can stay connected to the care teams who know them best, receive the right level of support throughout pregnancy and, ultimately, give their babies the best and smoothest possible start.”

“Every pregnancy journey is unique, and with expert care, even complex cases can lead to healthy babies,” said Freire-Lizama. “That’s why this work matters – because your family’s future starts here.”

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Stories like Bianca and Daniel Borg’s, who recently welcomed triplets, highlight what’s possible with coordinated high-risk pregnancy care. Through their experience, you’ll get a glimpse of how the dedicated team at Unity Health Toronto’s Maternal and Fetal Medicine clinic supports families through complex pregnancies, both before and after birth.

“In that moment, we knew we were in the right place,” Bianca says. “You could just tell the team was attentive and confident.”

By Jade Vyfhuis