Parents, midwives mourn closure of family birth unit at Montreal's Notre-Dame Hospital

It cost $25 million to build, but barely a year after its opening and less than six months in operation, the family birth unit at Montreal's Notre-Dame Hospital is closed for good.

The CIUSSS du Centre-Sud-de-l'Île-de-Montréal, which oversees the hospital, announced the closure a week ago, blaming a lack of specialized obstetrics staff.

The loss is a "missed opportunity" and a blow for patients who would prefer to give birth outside of a traditional hospital setting, said Barbara Beccafico, a birth doula and board member with the Quebec Association of Doulas (AQD).

"The community was very saddened," said Beccafico. "We felt like it was a beautiful project that was stillborn."

The family birth unit emphasized physiological — or natural — medication-free births and collaborated with midwives, who shared their expertise and knowledge with the unit's nurses.

The unit was supposed to accommodate 1,500 births a year or 125 a month. In the end, only 46 children were born there.

In an email, Amaili Jetté, the president of the Regroupement les sages-femmes du Québec (RSFQ), a collective representing midwife groups, said it's important these kinds of collaborations continue in the future, while respecting each other's areas of competence and expertise.

"Physiological births are in demand, and it is vital that we continue to offer care and facilities that meet the needs of the population," said Jetté, adding that the island of Montreal currently has five birthing centres and one midwifery service.

Bridge between home and hospital

Shannon Godin had planned on delivering her son, Tomas, at Notre-Dame Hospital, which is close to her home.

The Notre-Dame unit was designed as a bridge between the experience of home births and that of hospital deliveries.

Unlike a traditional hospital setting, the family birth unit had large, private rooms equipped with bath tubs. Birthing balls, stools and other supports such as slings and ceiling bars were also available to help patients during delivery.

The patient would remain in the same room to recover rather than changing units, which Godin also liked.

But when the family birth unit was temporarily closed last summer, Godin began to search for another option.

A nurse herself, she said she isn't surprised the unit struggled to maintain staffing due to the nursing shortage throughout the health- care system. Even so, she admits it was "frustrating and disappointing" to have to start over and find a new place to give birth.

"It's too bad that they went ahead and built it when they didn't have the resources to actually run it," said Godin.

Needs have evolved

The Notre-Dame Hospital family birth unit has faced a lot of challenges.

Construction delays, recruitment difficulties and the COVID-19 pandemic postponed the project several times.

It finally opened in February 2024.

But by the summer, the unit had to temporarily suspend operations due to staffing difficulties, reduced availability of obstetricians and the arrival of the summer holiday period, said Marianne Paquette, a spokesperson for CIUSSS du Centre-Sud-de-l'Île-de-Montréal.

Last fall, the unit postponed its reopening indefinitely and an external consultant from the Health Ministry was called in to try to find a solution.

Despite several recruitment drives, "specialized labour in this field is scarce and we have not been able to fill a sufficient number of positions to ensure a safe reopening," said Paquette.

Paquette said the community's needs have also evolved since the project started seven years ago.

The regional health authority said other birthing centres in greater Montreal have the capacity to handle the demand, given that latest projections show the birth rate will continue to decline.

When Health Minister Christian Dubé was asked about the short-lived unit, he used it as an example to underline the importance of Santé Québec, the new Crown corporation responsible for the province's health-care system.

"There were a lot of projects that were looked [at] on a standalone basis by an establishment," said Dubé. "We cannot just spend money on a local basis without thinking globally."

But Beccafico said that decision is shortsighted.

Although they understand the province is always looking to get the most bang for its buck, they say more and more people are interested in giving birth outside of a traditional hospital setting.

"By shutting down this initiative, they are sending a clear message: budget priorities matter more than parents' choices," said Beccafico.

They believe the real issue is a lack of commitment, support and training for this birthing option, which in the end, could help save money.

Beccafico believes a patient-centric approach that focuses on natural births can help patients feel empowered and may even help lower the chances of postpartum depression.

The CIUSSS du Centre-Sud-de-l'Île-de-Montréal has met with all the employees and doctors about the closure.

Many of the unit's nurses and orderlies were already re-distributed to other birthing centres after Notre-Dame's unit closed last summer.