Hospital Integration
Hospital integration of midwives is an important enabler of the midwifery model of care and is essential to providing choice of birthplace to midwifery clients. The ability to navigate and understand complex hospital systems allows for appropriate representation in hospital processes, enhances quality client care, strengthens interprofessional collaboration, and eases transitions between community and hospital.
Throughout the province, midwives are at different stages of integration within their privileging hospitals. Despite 85% of midwifery clients opting to give birth in hospitals, midwives can encounter barriers to full integration.
Barriers can include:
- Difficulty applying for and securing hospital privileges
- Caps on the number of midwives with privileges
- Caps on the number of midwifery-attended births
- Scope of practice restrictions
- Financial constraints and limited access to resources
In many cases, these challenges can stem from deeper issues within the hospital, arising from systemic, interprofessional or interpersonal conflicts and tensions. Tensions can often be directly tied to a lack of familiarity with or understanding of the midwifery model. AOM staff can offer support to address these challenges, including assisting midwives to identify helpful resources and develop effective advocacy strategies.
Head midwives act as leaders in hospitals where midwives work and often actively direct hospital integration work. They are responsible for the quality of midwifery practice and the provision of midwifery care within the hospital. Head midwives hold the dual role of representing midwifery interests in the hospital as well as representing the hospital's interest towards midwives. For more information about head midwife roles and responsibilities, see resources in the accordion below. If you are a head midwife or in a hospital leadership role, please contact policy@aom.on.ca to be added to the Head Midwife email listserv.
Since 2014, the AOM has recognized Ontario hospitals that have demonstrated excellence in successful midwifery integration. Read the criteria, nominate your hospital, and see past winners.
Visit the hospital integration resources page (member login required) for tools, knowledge, and best practices to foster effective and respectful collaboration within hospital teams. Want to share resources with the AOM, or looking for a particular document? Contact policy@aom.on.ca.
