Bringing together clinical insight, policy experience, and systems thinking to strengthen care.
Civitas Health Systems Consulting was founded to support organizations working to strengthen the systems that shape care for women, babies, families, communities, and care providers.
This work is grounded in more than twenty years of experience across clinical care, health policy, Indigenous midwifery systems, program development, strategy, and implementation.
About the Founder
Laya Bourguignon,
MHA, BHSc Midw., RM (NP)
Laya is a health systems strategist and former Registered Midwife with a deep commitment to strengthening maternal-newborn, perinatal, and midwifery systems.
Her career has moved between the point of care and the systems where decisions are made — from rural and remote clinical practice to provincial and federal policy, program, funding, and governance spaces.
This experience gives her a practical understanding of how policy, funding, workforce, geography, infrastructure, regulation, and service design affect what care is possible on the ground.
Clinical Roots
Laya’s systems work is grounded in clinical experience.
As a midwife, she provided care in rural and remote settings, including with coastal First Nations families required to leave their home communities to access maternity and health services. She also opened and operated a birth home for families displaced by birth-related evacuations.
These experiences shaped her understanding of how deeply systems decisions affect families, communities, and providers — particularly when care is distant, fragmented, under-resourced, or not designed around the realities of people’s lives.
They are also part of why Civitas focuses on the connection between policy and point of care.
“Throughout her time in clinical practice as a Registered Midwife, Laya was recognized as a highly skilled clinician and educator, collaborative leader, and compassionate care provider with a strong commitment to culturally safe maternal and newborn care. She demonstrated a particular ability to support families navigating layered care pathways, including rural and remote services, birth evacuation, interdisciplinary coordination, and access to care across multiple settings.
Her strength lies in combining clinical expertise with systems thinking, equity, and relationship-based practice. She understands that improving maternal and newborn outcomes requires trust, cultural safety, collaboration, and services designed around the realities of families, communities, and care providers.”
— Sheila Jager
Former Regional Director of Midwifery (retired), Vancouver Coastal Health
Systems, Policy & Leadership
Rooted in experience across clinical, organizational, provincial, and federal health system contexts, this work has spanned multiple levels of the health system.
Laya's experience includes federal and provincial health policy, maternal-newborn and midwifery systems development, program design, strategic planning, funding analysis, workforce planning, engagement, partner alignment, and implementation support.
As Manager of the Indigenous Midwifery Department at the Association of Ontario Midwives, the provincial association advancing midwifery in Ontario, she supported work to strengthen Indigenous midwifery systems across policy, funding, workforce, program development, and implementation.
This included supporting Indigenous midwifery-specific strategy, evidence-informed materials, funding and policy asks, engagement processes, and systems planning. Throughout this work, her role was to support Indigenous-led priorities and help strengthen the systems, processes, and conditions needed for those priorities to move forward.
“I invited Laya to deliver guest lectures for the Master of Health Systems Administration students at the Telfer School of Management, University of Ottawa, on Indigenous health jurisdiction within Canada’s political and health system context. Laya helps learners and leaders understand the complex relationships between policy, funding, clinical care, education, governance, and community realities, while encouraging thoughtful reflection on each person’s role and responsibility in advancing health systems change.
Based on the positive response, she was invited back over the three consecutive years I taught the course because of her ability to make cross-jurisdictional issues clear, engaging, thought-provoking and deeply relevant."
— Jim Lambley, Professor, Telfer School of Management, University of Ottawa
Working Across Contexts
Laya’s work is also informed by international and cross-cultural experience, including maternal health education and systems exposure in Uganda and Mexico, and experience working across diverse cultural, linguistic, and institutional contexts.
Fluent in English and French, with conversational Spanish, she brings a relational and adaptable approach to multicultural and international work.
She is particularly interested in supporting organizations working across complexity — where policy, service delivery, funding, workforce, culture, geography, and community priorities need to be brought into clearer alignment.
How This Shapes Civitas
Civitas was created to support thoughtful, practical, and relationship-based systems work.
Laya’s particular strength is translating between care and systems: helping decision-makers understand clinical and community realities, while supporting policies, programs, services, funding approaches, and implementation plans that are practical, respectful, and sustainable.
Her approach is grounded in listening, clarity, integrity, and collaboration. Rather than applying generic frameworks, she works with each client’s context, relationships, priorities, and constraints to develop strategies and supports that can be acted on and sustained.
At the heart of her work is a simple belief: better systems support better care, better care improves outcomes, and better outcomes create the conditions for lasting change.
Experience That Shapes the Work
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Maternal-Newborn & Perinatal Health Strategy
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Midwifery Systems Development
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Rural and Remote Maternity Care
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Indigenous Midwifery & Maternal-Newborn Health Systems and Policy
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Birth Evacuation and Access-to-Care Challenges
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Federal & Provincial Health Policy
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Program Development and Implementation
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Workforce Planning and Systems Design
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Funding Strategy and Decision-Support Materials
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Engagement, Facilitation, and Partner Alignment
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International and Cross-Cultural Maternal Health Work
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Teaching, Guest Lecturing & Capacity Building
Let’s Work Together
Systems change is most meaningful when it is grounded in the realities of care.
If you are working to strengthen maternal-newborn, perinatal, or midwifery systems, Civitas can help bring clinical insight, policy experience, systems thinking, and practical implementation support to the work.