Happy Birthday

Project Toronto Birth Centre, Toronto, Ontario
Architect LGA Architectural Partners
Text Joanne Lam
Photos Ben Rahn/A-Frame

I am about to pop. Instead of lying in a hospital bed screaming, I am calmly pacing up and down Dundas Street East. When I stop and sit beside a planter to breathe through a contraction, curious glances come my way. I am in the midst of the revitalized Regent Park neighbourhood, where new buildings of various uses and heights line the street. At the base of a mid-rise, where you might expect to see a trendy restaurant, you are likely to be witnessing birth. Welcome to the Toronto Birth Centre, a project over 35 years in the making.

The two-storey facility faces Dundas Street East.
The two-storey facility faces Dundas Street East.

The Toronto Birth Centre (TBC) is a new option for expectant mothers, who, until this February, could only choose between home and hospital as a place for giving birth. As a building typology, birth centres may be located in old mansions, renovated houses, within hospitals, or they take the form of standalone centres.

A cedar-clad entrance welcomes expectant mothers.
A cedar-clad entrance welcomes expectant mothers.

Sara Wolfe, Toronto Birth Centre project co-lead and now the president of its board of directors, did not have a preconceived building type in mind when she took up the reins of the project in 2003 (picking up the pieces from an initiative dating back to the early 1980s but subsequently cancelled by the Harris government). Her starting point was advocating for a culturally safe place that welcomes everyone in Toronto, with emphasis on its most vulnerable and underserved clients—Aboriginals. The search for an appropriate space eventually led to an empty concrete shell on the ground and second floors of 230 Sackville, a Toronto Community Housing rental building designed by Wallman Architects. Although there was some initial hesitation from the Ministry of Health and Long-Term Care (MOHLTC), in the end, the site turned out to be brilliantly appropriate. It is accessible by public transit, close to hospitals, offers easy ground access, and even ties in to the revitalization—or rebirth, as it were—of a mixed-income neighbourhood. The clients hoped to open up the birth experience to the community, and chose LGA Architectural Partners to help them create a distinct typology for the TBC: a storefront birth centre.

The family waiting area and a communal kitchen provide domestic-style spaces  to celebrate the birth.
The family waiting area and a communal kitchen provide domestic-style spaces to celebrate the birth.

Behind the floor-to-ceiling glass façade, I share a light lunch with my midwife in the communal kitchen. The kitchen—along with a cedar-clad entrance, meeting room, and family gathering spaces—is designed as part of a public strata, organized along the street frontage. By now, the contractions are too frequent for me to go outside, so I lumber slowly up and down the corridor, which acts as a semi-private layer buffering the three private birth rooms. Lampshades made of porcelain casts of found birch, wallpaper with abstracted images of trees, and a fresh saturated colour palette surround me, cocooning me from the hustle and bustle outside. At the same time, seeing streetcars pass by allows me to remain part of the rhythm of the city, and puts me and my big belly on display for all to celebrate. With every laboured step, I am reaffirming and promoting the natural act of birth.

A freestanding tub is the focal point of each birthing suite. The washroom includes two entrances, creating a circulation loop around the room's wet zone.
A freestanding tub is the focal point of each birthing suite. The washroom includes two entrances, creating a circulation loop around the room’s wet zone.

As wave after wave of contractions becomes more intense, I enter the birth room named “Cedar.” A curtain separates a vestibule, allowing somebody to play music or drum without any visual connection. Alien probes and scary needles, strange monitors and ugly gowns are nowhere to be seen. Instead, a sparkling white deep soaker tub beckons, encouraging active birthing. With lights dimmed and facing the mural What We Teach Our Children by Métis artist Christi Belcourt, I lower myself into the tub, letting the warm water soothe the pain of each volcanic eruption in my belly. On the other side of the tub is a penthouse-scaled washroom with two points of access, forming a continuous circuit around the wet zone.

As the water cools, I make my way around the corner to the room’s most private point, the hospital-grade double bed. In a supported sitting position, I start to bear down. The room is spacious enough for large families to gather around, yet remains intimate for just me and my husband. Numerous 1:1 mock-ups and “a day in the life” exercises during the design process have obviously paid off. It feels like the right place to welcome my baby into the world. It feels like my place.

A wide corridor provides ample space for pacing.
A wide corridor provides ample space for pacing.

Although the TBC may be a novelty for Toronto, the concept of birth centres is certainly not new. Ontario has had a birth centre in a renovated house in Six Nations, serving Aboriginal clients since 1996. Quebec has the most birth centres in Canada: 13 in total, each with a midwifery practice located on site. Given the prevalence of these centres, it is small wonder that around 80 percent of Quebec women receiving a midwife’s care choose to give birth in them. Manitoba has a standalone publicly funded birth centre, while Alberta has two private ones located in houses. Saskatchewan has a midwifery-led birthing unit as part of a hospital outreach centre.

A view of the second-floor clinic.
A view of the second-floor clinic.

Currently, MOHLTC is funding and piloting the TBC and a second centre in Ottawa, studying the cost impact of moving low-risk births out of hospitals, and following health outcomes over an 18-month period. At the TBC, a midwifery practice shares the second floor with the centre’s offices, so regular pre- and post-natal care can occur at the same place as the birth. The effects of this coupling may reveal further benefits on how and where women give birth in the future.

The Toronto Birth Centre recently welcomed its 100th birth. At the celebration, a diverse group of mothers and fathers were busy bouncing their newborns. For my baby and me, it has been a privilege to share with this group such a profound life experience in this unique storefront.

Joanne Lam is a registered architect, writer, and proud mother of two based in Toronto.

Client Toronto Birth Centre Inc. | Architect Team Janna Levitt, Danny Bartman, James Mallinson, Antero Fonte, Kris Payne | Mechanical/Electrical Crossey Engineering | Interiors LGA Architectural Partners | Contractor TAPA Construction | Code David Hine Engineering | Project Managers MHPM | Area 13,000 ft2 | Budget $3.6 M | Completion January 2014