East Toronto midwifery program serves vulnerable women

‘I would say it was the most wonderful experience.’: client




Shruti Madhiraju, right, with her husband Dilip Srikant and their infant daughter, Anaha. Madhiraju was a client of SRCHC’s MATCH midwifery program for the birth of her child. – Madhiraju/Srikant family photo


MATCH program midwife/co-lead Shezeen Suleman examines a client at the South Riverdale Community Health Centre. – SRCHC photo


Midwives Shezeen Suleman, left, and Jenna Bly co-lead SRCHC’s MATCH program. – Joanna Lavoie/Torstar


Midwives Shezeen Suleman, left, and Jenna Bly co-lead SRCHC’s MATCH program. – Joanna Lavoie/Torstar

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It doesn’t matter if you’re an immigrant to Canada, a person of colour, an individual without Ontario health insurance, someone who uses drugs, is poor, queer, trans, a single parent or homeless, you can still obtain the care of a midwife in east Toronto.

Last fall, the South Riverdale Community Health Centre (SRCHC) launched an innovative program called Midwifery and Toronto Community Health, MATCH for short, that focuses on breaking down barriers for those who have had trouble accessing or wouldn’t typically seek out midwifery services.

Based in the SRCHC’s main location in Leslieville at 955 Queen St. E., the program is run by four midwives who provide clients with complete care during pregnancy, childbirth and the postpartum period (including newborn care), as well as sexual and reproductive health care. Clients, who can also benefit from a full slate of programs and services at SRCHC, can choose to have their baby at Michael Garron Hospital, at the Toronto Birth Centre or at home.

“We offer the full-spectrum of pregnancy care. We also know not all pregnancies are wanted. We recognized that’s a reality, especially for vulnerable individuals. … We want people to come and get care in a dignified way,” said Shezeen Suleman, who co-leads the program with fellow midwife Jenna Bly.

First-time mom and newcomer Shruti Madhiraju is one of the 80 clients who benefited from the MATCH program during its inaugural year.

Last spring, Madhiraju’s family physician went on maternity leave just a few months before Madhiraju was due. She was offered the services of another doctor but decided to pursue a more natural birth. At the recommendation of some friends and acquaintances, Madhiraju sought out the services of a midwife to assist in the birth of her now 4½-month-old daughter, Anaha,

The MATCH program was the first clinic to respond to her query, and after meeting with Suleman, Madhiraju and her husband Dilip Srikant, who live downtown but within the SRCHC’s catchment area, went with the MATCH program.

“We didn’t know what to expect,” she said Madhiraju, who said she really appreciated the MATCH program’s diverse environment and inclusive approach.

“I would say it was the most wonderful experience. The kind of care we got from them was really amazing.”

Madhiraju, who is originally from India but has called Canada home for two years, said she was especially impressed by the 24-7 availability of the midwives, adding the time they took to care for her and her baby was “really reassuring.”

Jason Altenberg, SRCHC’s co-interim CEO, said the centre has had a decades-long relationship with midwives in east Toronto and it only made sense to incorporate this practice into the primary-care services and programs offered at the local community health centre.

But, doing that was a challenge, because there was no money available to hire midwives and operate such a program in-house.

“The funding models that existed didn’t allow midwives to be part of our interdisciplinary team,” he said, adding that, until recently, midwives operated only in practice groups and were paid based on the number of clients they served.

Two years ago, the Ontario Ministry of Health and Long-Term Care started accepting proposals for alternative payment models for midwives. South Riverdale Community Health Centre, whose mission is to improve the lives of people who face barriers to physical, mental, spiritual and social well-being, successfully made its case to become the first CHC in Ontario to offer in-house midwifery care by salaried midwives.

“This salaried model allows us to really do a different kind of work,” Bly said during MATCH’s one-year anniversary celebration on Nov. 14.

“We’re also able to devote more time to committee involvement and research work.”

She said being a salaried midwife has given her and her colleagues more time to devote to clients, especially those with more complex cases.

Altenberg said MATCH’s first year was focused on figuring out what the program would look like, developing relationships with the other programs and services at SRCHC and in the community, and determining who were the clients who would most benefit from the care of midwives.

Going into year 2, he said, the almost-full MATCH program is now “hitting its stride” and the team is excited to keep moving forward in the meaningful work they do through the development of even more partnerships, notably with Michael Garron Hospital, and initiatives that will better serve vulnerable populations.