title: The attitudes of Canadian maternity care practitioners towards labour and birth: many differences but important similarities.
abstract: OBJECTIVE
  Collaborative, interdisciplinary care models have the potential to improve maternity care. Differing attitudes of maternity care providers may impede this process. We sought to examine the attitudes of Canadian maternity care practitioners towards labour and birth.
  
  
  METHODS
  We performed a cross-sectional web- and paper-based survey of 549 obstetricians, 897 family physicians (400 antepartum only, 497 intrapartum), 545 nurses, 400 midwives, and 192 doulas.
  
  
  RESULTS
  Participants responded to 43 Likert-type attitudinal questions. Nine themes were identified: electronic fetal monitoring, epidural analgesia, episiotomy, doula roles, Caesarean section benefits, factors decreasing Caesarean section rates, maternal choice, fear of vaginal birth, and safety of birth mode and place. Obstetrician scores reflected positive attitudes towards use of technology, in contrast to midwives' and doulas' scores. Family physicians providing only antenatal care had attitudinal scores similar to obstetricians; family physicians practising intrapartum care and nurses had intermediate scores on technology. Obstetricians' scores indicated that they had the least positive attitudes towards home birth, women's roles in their own births, and doula care, and they were the most concerned about the consequences of vaginal birth. Midwives' and doulas' scores reflected opposing views on these issues. Although 71% of obstetricians supported regulated midwifery, 88.9% were against home birth. Substantial numbers of each group held attitudes similar to dominant attitudes from other disciplines.
  
  
  CONCLUSIONS
  To develop effective team practice, efforts to reconcile differing attitudes towards labour and birth are needed. However, the overlap in attitudes between disciplines holds promise for a basis upon which to begin shared problem solving and collaboration.
authors: Developmental Neuroscience and Child Health, Child and Family Research Institute, University of British Columbia, Vancouver BC; Department of Family Practice, University of British Columbia, Vancouver BC; Department of Pediatrics, University of British Columbia, Vancouver BC.
authors: Michael C
authors: MC
authors: Klein
authors: Developmental Neuroscience and Child Health, Child and Family Research Institute, University of British Columbia, Vancouver BC; Department of Family Practice, University of British Columbia, Vancouver BC.
authors: Janusz
authors: J
authors: Kaczorowski
authors: School of Nursing, University of British Columbia, Vancouver BC.
authors: Wendy A
authors: WA
authors: Hall
authors: Department of Obstetrics and Gynecology, Université de Montréal, Montreal QC.
authors: William
authors: W
authors: Fraser
authors: Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC.
authors: Robert M
authors: RM
authors: Liston
authors: Ministry of Health and Long Term Care, Government of Ontario, Toronto ON.
authors: Sahba
authors: S
authors: Eftekhary
authors: Developmental Neuroscience and Child Health, Child and Family Research Institute, University of British Columbia, Vancouver BC; Department of Statistics, University of British Columbia, Vancouver BC.
authors: Rollin
authors: R
authors: Brant
authors: Developmental Neuroscience and Child Health, Child and Family Research Institute, University of British Columbia, Vancouver BC; Department of Pediatrics, University of British Columbia, Vancouver BC.
authors: Louise C
authors: LC
authors: Mâsse
authors: Department of Political Science, University of British Columbia, Vancouver BC.
authors: Jessica
authors: J
authors: Rosinski
authors: School of Population and Public Health, University of British Columbia, Vancouver BC.
authors: Azar
authors: A
authors: Mehrabadi
authors: Developmental Neuroscience and Child Health, Child and Family Research Institute, University of British Columbia, Vancouver BC.
authors: Nazli
authors: N
authors: Baradaran
authors: Developmental Neuroscience and Child Health, Child and Family Research Institute, University of British Columbia, Vancouver BC.
authors: Jocelyn
authors: J
authors: Tomkinson
authors: Hamilton Health Sciences, Hamilton ON.
authors: Sharon
authors: S
authors: Dore
authors: Midwifery Education Program, Department of Family Practice, McMaster University, Hamilton ON.
authors: Patricia C
authors: PC
authors: McNiven
authors: Department of Midwifery, BC Women's Hospital and Health Centre and St. Paul's Hospital, Vancouver BC.
authors: Lee
authors: L
authors: Saxell
authors: Perinatal Program, Faculty of Health Sciences, Douglas College, New Westminster BC.
authors: Kathie
authors: K
authors: Lindstrom
authors: South Community Birth Program, Vancouver BC.
authors: Jalana
authors: J
authors: Grant
authors: Midwifery Education Program, Ryerson University, Toronto ON.
authors: Aoife
authors: A
authors: Chamberlaine
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002170:Canada; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data; D006801:Humans; D007743:Labor, Obstetric; D008297:Male; D008875:Middle Aged; D036801:Parturition; D011247:Pregnancy; D011795:Surveys and Questionnaires