Models of organization of maternity care by midwives in Canada: a descriptive review.
Most provinces in Canada now offer regulated midwifery, but the way services are delivered across the country varies. The Canadian Midwifery Regulators Consortium has identified a need to examine the different ways in which care is being organized; this is to determine what elements are essential to maintain and where flexibility is desirable, in order to promote growth of the profession and maximize the contribution of midwifery to the provision of services. In April 2012 a planning meeting (funded by Canadian Institutes of Health Research) brought together midwifery leaders, researchers, regulators, and lead clinicians of several maternity service programs across Canada. The various approaches to organizing care were discussed and three of the programs presented were selected for this descriptive review because of their unique approaches and ability to respond to the needs of communities and of care providers within those communities who strive to deliver sustainable maternity care. The programs include an interprofessional group-care approach in British Columbia, an expanded scope of practice in an underserved community in the Northwest Territories, and an interprofessional collaboration of primary maternity caregivers in Nova Scotia. Each is discussed in terms of the population served, the program itself, and the fit of that microsystem within the larger health care system. The organization of maternity care must address the needs of communities and providers alike to make the greatest contribution. Through collaborative and creative organizational approaches, midwives have an opportunity to contribute in a meaningful way and increase their impact on the provision of services.
Midwifery Education Program, McMaster University, Hamilton ON.
Anne M
AM
Malott
Midwifery Education Program, McMaster University, Hamilton ON.
Karyn
K
Kaufman
Department of Obstetrics and Gynecology, McMaster University, Hamilton ON.
Julia
J
Thorpe
South Community Birth Program, Vancouver BC.
Lee
L
Saxell
Midwifery Program, Fort Smith Health and Social Services Authority, Fort Smith NT.
Gisela
G
Becker
Midwifery Program, Fort Smith Health and Social Services Authority, Fort Smith NT.
Leslie
L
Paulette
Guysborough Antigonish Strait Health Authority District Collaborative Care Maternity Program, Guysborough NS.
Amanda
A
Ashe
Midwifery Regulatory Council of Nova Scotia, Halifax NS.
Kerstin
K
Martin
College of Midwives of British Columbia, Vancouver BC.
Leanne
L
Yeates
Department of Obstetrics and Gynecology, McMaster University, Hamilton ON.
Eileen K
EK
Hutton
D002170:Canada; D003299:Cooperative Behavior; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000379:methods / Q000458:organization & administration*; D008880:Midwifery / Q000458:organization & administration; D011247:Pregnancy