A recent field visit led by Rohan D’Souza gave McMaster’s first-year MSc Global Health students a closer look at how maternal-fetal medicine and maternity care are delivered in a tertiary-care setting.
Developed to support student learning in high-risk pregnancy care, the visit focused on how patient values are incorporated into obstetric decision-making. It also formed part of the students’ wider coursework in sexual and reproductive health, giving them practical context for a systems mapping assignment comparing how care is organized across different countries, communities, and models of practice.
D’Souza, Scientific Director of FLOURISH, opened the morning with a teaching session on maternity services, obstetrics and gynecology, maternal-fetal medicine, and the professional roles involved in caring for patients during pregnancy and birth. Drawing on his experience in Canada and internationally, he spoke about how decisions in high-risk pregnancy are shaped by evidence, health-system capacity, clinical judgement, and the values and priorities of the people receiving care.
“Students in global health are often asked to compare systems, policies, and models of care,” D’Souza said. “What I wanted them to see is that those comparisons become much more meaningful when they are connected to real clinical pathways and real decision-making. In maternal-fetal medicine, the question is never only what care is available. It is also how care is organized, how patients move through the system, and how their values are understood when decisions are complex.”
Students then took part in a clinical orientation to maternity-care services, including antenatal and maternal-fetal medicine clinics, ultrasound, labour and delivery, and inpatient wards. The route through the hospital was planned around available clinical areas and carried out in a way that protected patient privacy and avoided disruption to care. The visit was supported by Gizachew Abdissa Bulto, a FLOURISH graduate student and midwife by training who practised in Ethiopia before moving to McMaster to pursue a PhD in Global Health.
The clinical orientation gave students a more grounded way to think about the questions they were already exploring in their coursework, connecting their systems mapping work in sexual and reproductive health with the practical organization of maternity services. It also gave them space to ask how maternal and reproductive health systems respond to clinical need, patient experience, and social context.
For D’Souza, the value of the morning was in the exchange it created. Students brought perspectives shaped by different countries, professional backgrounds, and areas of interest, and used the visit to think more carefully about how care is organized and how decisions are made with patients and families.
“Those conversations are exactly where meaningful learning happens,” D’Souza said. “Students were not just observing a clinical environment. They were thinking about how care is organized, how decisions are made, and how different systems shape what patients and families experience. That is central to the work of FLOURISH, bringing research, clinical care, and education together to improve how pregnancy and postpartum care are understood and delivered.”
