Original Article

The Role of the Hospitalist Midwife at Oak Valley Health’s Alongside Midwifery Unit

Abigail Corbin*

Assistant Clinical Professor, Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario.


After many years of expansion, with limited evolution, Canadian midwifery is starting to see much needed waves of innovation. As midwives collaborate with health organizations such as hospitals and community health centres, their roles in client care and their impact on the broader healthcare landscape have expanded. The Hospitalist Midwife, an example of innovation, is a new and evolving role in the healthcare landscape within Canada.


Après de nombreuses années d’expansion avec une évolution limitée, la pratique sage-femme au Canada commence à connaître des vagues d’innovation bien nécessaires. Alors que les sages-femmes collaborent avec des organismes de santé comme des hôpitaux et des centres de santé communautaire, leurs rôles dans les soins à la clientèle et leur incidence sur le secteur plus vaste des soins de santé se sont élargis. Exemple d’innovation, la sage-femme exerçant en milieu hospitalier constitue un rôle nouveau et en pleine évolution au sein du paysage des soins de santé au Canada.

Key words: Innovation, midwifery, hospitalist midwife, hospitals, community health

Corresponding author: Abigail Corbin: [email protected]

Submitted: 14 November 2023; Accepted: 13 March 2024; Published: 11 April 2024

All articles published in DPG Open Access journals
This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/).

When the Alongside Midwifery Unit (AMU) at Oak Valley Health in Markham, Ontario, opened in 2018, a cornerstone of the new model was to staff the unit with “hospitalist” midwives. Hospitalist midwives were so-called because the term was familiar in healthcare. In essence, “hospitalists” provide care to hospital patients.1,2 At the AMU, one hospitalist midwife staffs the unit per 12-hour shift and is responsible for running the unit. Their duties include assessing midwifery clients, beginning induction of labours, facilitating consultations, acting as the second midwife (or primary care provider if their midwife does not make it), precepting students and more. The hospitalist midwife is also part of the more extensive childbirth program and will assist in the labour and delivery unit when able, and as needed.

When incorporating the hospitalist midwife into the hospital, there is a unique opportunity to develop midwives with advanced clinical skills.3 Hospitalist midwives in the Alongside Midwifery Unit (AMU) Centre of Excellence at Oak Valley Health are experts in leadership, research, best practice, and training. This editorial will describe how these roles developed in the AMU.


Hospitalist midwives use their expertise to expedite processes (such as admissions, transfers, and emergencies). They anticipate the needs of clients and community midwives. By navigating access to timely care and consultants, hospitalist midwives optimize care for clients, increasing flow in the unit. Because the hospitalist is in close contact with leadership across the childbirth program (such as the charge nurse or on-call obstetrician), their situational awareness optimizes their ability to access help when needed.

Advocacy happens when hospitalist midwives “use their knowledge, skill, and position to secure for clients the best treatment or position consistent with the constraints of the service.”4 The hospitalist midwife advocates for clients by promoting their access to physiological birth and client-centred care. Hospitalists facilitate creative solutions when needed to maximize client-centred care. This has included using the AMU space to accommodate adoptive parents or arranging postpartum consults in our triage area, avoiding the ED.

Hospitalists midwives advocate for midwives to practice to their full scope. They do this by creating AMU policies that support the fullest scope, participating in research demonstrating the benefits of full scope, and training future midwives to work to their fullest scope.


In an environment that promotes reflective culture and mutual respect, the presence of an experienced midwife on the AMU has many benefits. Hospitalists can use their experience and strong intrapartum skills to coach newer midwives in a safe learning environment. It can be overwhelming to consolidate your clinical skills while integrating into a hospital system. Positive experiences of coaching and mentorship play a crucial role in enabling new registrants to better assimilate into the hospital environment, offering long-lasting benefits beyond the first year.5

Notably, the AMU recognizes that coaching is not limited to hospitalist midwives. Each midwife in the unit has a strength to share. Successful coaching will build more resilient, self-compassionate and innovative midwives.6


There is abundant evidence pointing to the benefits of routine team debriefing. An effective team debrief increases shared understanding of roles, responsibilities, priorities, and areas for growth.7 On the AMU, we strive to include a pre-brief (bringing everyone onto the same page), and a team debrief with every birth. The hospitalist's role is facilitating and tracking learning opportunities so the whole team can learn together. The AMU's goals for the pre-brief and debrief conversations are to reflect on lessons learned, celebrate successes, and provide opportunities to safely address differences in practice (knowing that midwives have different styles and approaches). We know that holding space for these conversations can be challenging, but the positive outcomes of safer work environments and excellent client care are worth the work and time.


One of the AMU’s core goal is to train students and midwives. Hospitalists participate in and lead simulations and emergency training. The unit has training equipment and a dedicated learning space that students and staff use regularly. The AMU presents monthly rounds, leading the provision of up-to-date best practices.

Hospitalist midwives are preceptors for midwifery students utilizing their expertise in intrapartum care. The AMU has become an integral site for the Midwifery Education Programs. Students learn how to navigate inter and intraprofessional relationships, build clinical skills, and see an innovative way of providing midwifery care. Students participate in program-wide bed meetings, hospitalist meetings, and simulations with hospital staff. Many students coming out of their placement describes being inspired and hopeful.


Traditionally, in Canadian hospitals, leadership roles are limited to head or lead midwife. Even in well-integrated hospitals, one voice has a limited reach. Yet, midwifery leadership impacts client care and outcomes. As midwifery's involvement in strategic decisions increases, so does midwifery's influence on service delivery.8 Hospitalist midwives participate in leadership strategy meetings, quality care reviews, and operations meetings, providing expert opinions in operational decision-making. Hospitalists are encouraged to participate in hospital leadership development and are respected for their contributions to the hospital's culture.


The hospitalist midwife is a new and emerging role in Canadian midwifery. Hospitalist midwives hold many benefits, including optimal navigation and advocacy for clients, new midwives receive mentorship and positive coaching. The Midwifery Education Programs can build placements where students witness optimal integration and innovation firsthand. The role of the hospitalist midwife supports the growth of experienced midwives into leaders and coaches.


1. Cameron C, Sassi J, Malott AM. The Markham Stouffville Hospital Alongside Midwifery Unit: A Centre for Excellence for Normal Birth. CJMRP 2020 19(1):43–52.

2. Venes D. Taber's cyclopedic medical dictionary. FA Davis; 2017 Jan 25.

3. Goemaes R, Beeckman D, Goossens J, Shawe J, Verhaeghe S, Van Hecke A. Advance midwifery practice: An evolutionary concept analysis. Midwifery 2016;42:29–37. https://www.midwiferyjournal.com/article/S0266-6138(16)30148-6/pdf

4. Lipsky M. Street-level bureaucracy: Dilemmas of the individual in public services. New York: Russell Sage Foundation; 1980.

5. Sandor C, Murray-Davis B, Vanstone M, Bryant C. The Transition to Clinical Practice for New Registrant Midwives in Ontario, Canada. In: Gray M, Kitson-Reynolds E, Cummins A. (eds) Starting Life as a Midwife. Springer, Cham; 2019. 10.1007/978-3-319-93852-3_4

6. Wolever RQ, Moore MA, Jordan M. Coaching in Healthcare. The Sage Handbook of Coaching. 2017.

7. Lacerenza CN, Marlow SL, Tannenbaum SI, Salas E. Team development interventions: Evidence-based approaches for improving teamwork. Am Psychol 2018 May;73(4): 517.

8. Hewitt L, Dahlen HG, Hartz DL, Dadich A. Leadership and management in midwifery-led continuity of care models: A thematic and lexical analysis of a scoping review. Midwifery 2021 Jul 1;98:102986.


Abigail Corbin is the Patient Care Manager of Canada’s first Alongside Midwifery Unit and the Diabetes Programs at Oak Valley Health, Markham. Abigail is responsible for managing the Adult and Paediatric Diabetes Education Programs, hospitalist midwife team and the Midwifery Led Postpartum programs, which includes the Early Discharge Program and the Family and Baby Clinic. An experienced midwife with academic and research involvement, Abigail is an Instructor in both the undergraduate and graduate Midwifery programs at McMaster University, and a Fellow in the McMaster Midwifery Research Centre. Driven by a passion to develop midwifery leadership, Abigail is currently conducting groundbreaking research on the roles, barriers and enablers midwifery leaders experience. Profoundly committed to collaborative innovation, Abigail is an engaged leader who is invested in mentoring and building communities of practice. When not working, Abigail enjoys hiking with her family and creating linocut art. She remains grateful to her husband for his continued encouragement and sense of humour.