Northern Ontario's Obstetrical Services in 2020: A developing rural maternity care desert

Orrantia, Eliseo; Hutten‐Czapski, Peter; Mercier, Mathieu; Fageria, Samarth

doi:10.4103/cjrm.cjrm_4_21

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…Under-resourcing of rural obstetric services has been noted in the literature (3). Funding for RSON interventions include the potential to direct funds to capital costs including space renovations or rebuilds, something noted as necessary by many participants in this study.…”

Section: Discussionmentioning

confidence: 84%

System Interventions to Support Rural Access to Maternity Care: An Analysis of the Rural Surgical Obstetrical Networks program

Kornelsen

Lin

Williams³

et al. 2023

Preprint

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Background: The Rural Surgical Obstetrical Networks (RSON) project was developed in response to the persistent attrition of rural maternity services across Canada over the past two decades. While other research has demonstrated the adverse health and psychosocial consequences of losing local maternity services, this paper explores the impact of a program designed to increase the sustainability of rural services themselves, through the funding of four “pillars”: increased scope and volume, clinical coaching, continuous quality improvement (CQI) and remote presence technology. Methods: We conducted in-depth, qualitative research interviews with rural health care providers and administrators in eight rural communities across British Columbia to understand the impact of the RSON program on maternity services. Researchers used thematic analysis to generate common themes across the dataset and interpret findings. Findings: Participants articulated six themes regarding the sustainability of maternity care as actualized through the RSON project: safety and quality through quality improvement opportunities, improved access to care through increased surgical volume and OR backup, optimized team function through innovative models of care, improved infrastructure, local innovation surrounding workforce shortages, and locally tailored funding models. Conclusion: Rural maternity sites benefited from the funding offered through the RSON pillars, as demonstrated by larger volumes of local deliveries, nearly unanimous positive accounts of the interventions by health care providers, and evidence of staffing stability during the study time frame. As such, the interventions provided through the Rural Surgical Obstetrical Networks project as well as study findings on the common themes of sustainable maternity care should be considered when planning core rural health services funding schemes.

show abstract

Section: Discussionmentioning

confidence: 84%

System Interventions to Support Rural Access to Maternity Care: An Analysis of the Rural Surgical Obstetrical Networks program

Kornelsen

Lin

Williams³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Under-resourcing of rural obstetric services has been noted in the literature [ 3 ]. Although initially, funding for physical infrastructure and technology was not included in the RSON funding model, in some cases, funding was flexible enough to accommodate these needs.…”

Section: Discussionmentioning

confidence: 99%

“…There has been extensive research in the past two decades on the attrition of rural maternity services in Canada [ 1 – 3 ] and internationally [ 4 , 5 ] alongside documentation of the adverse health and social consequences of losing local services [ 6 – 8 ]. Less attention, however, has been paid to evidence to support interventions to stabilize these services, and less still to evaluations of such interventions.…”

Section: Introductionmentioning

confidence: 99%

System interventions to support rural access to maternity care: an analysis of the rural surgical obstetrical networks program

Kornelsen,

Lin,

Williams

et al. 2023

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background The Rural Surgical Obstetrical Networks (RSON) project was developed in response to the persistent attrition of rural maternity services across Canada over the past two decades. While other research has demonstrated the adverse health and psychosocial consequences of losing local maternity services, this paper explores the impact of a program designed to increase the sustainability of rural services themselves, through the funding of four “pillars”: increased scope and volume, clinical coaching, continuous quality improvement (CQI) and remote presence technology. Methods We conducted in-depth, qualitative research interviews with rural health care providers and administrators in eight rural communities across British Columbia to understand the impact of the RSON program on maternity services. Researchers used thematic analysis to generate common themes across the dataset and interpret findings. Findings Participants articulated six themes regarding the sustainability of maternity care as actualized through the RSON project: safety and quality through quality improvement opportunities, improved access to care through increased surgical volume and OR backup, optimized team function through innovative models of care, improved infrastructure, local innovation surrounding workforce shortages, and locally tailored funding models. Conclusion Rural maternity sites benefited from the funding offered through the RSON pillars, as demonstrated by larger volumes of local deliveries, nearly unanimous positive accounts of the interventions by health care providers, and evidence of staffing stability during the study time frame. As such, the interventions provided through the Rural Surgical Obstetrical Networks project as well as study findings on the common themes of sustainable maternity care should be considered when planning core rural health services funding schemes.

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Surviving in the midst of ‘Nowhere’: Disrupting the conceptualisation of a maternity care desert

Archer

2024

Sociology Health & Illness

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The conceptualisation of ‘care deserts’ has gained increased public attention in recent years. This paper engages a reproductive justice framework to investigate the (mis)alignment of a maternity care desert within a predominantly Black rural community in the United States. I draw on a case study of Gadsden County, Florida—a community that is perceived by its members to be a maternity care desert but that is not technically defined as one—to demonstrate how Black birthing people are cultivating a reproductive liberatory consciousness. Semi‐structured interviews with birthing persons and reproductive health experts reveal three overarching processes—naming barriers to health equity, resisting health inequity and cultivating health equity—that characterise a reproductive liberatory consciousness, which I identify as an analytical tool to outline how local social actors are identifying structural constraints as well as developing strategies of communal care and resistance. This work contributes to sociological research on reproductive justice and health equity by exploring the limitations of ‘desert’ frameworks. Pointing to the need to carefully consider the mechanisms that actively disrupt and potentially transform spatial stratifications and inequities, this paper advances a new understanding of birthing space that captures the layered movements of those living within a perceived maternity care desert.

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Northern Ontario's Obstetrical Services in 2020: A developing rural maternity care desert

Cited by 4 publications

References 12 publications

System Interventions to Support Rural Access to Maternity Care: An Analysis of the Rural Surgical Obstetrical Networks program

System Interventions to Support Rural Access to Maternity Care: An Analysis of the Rural Surgical Obstetrical Networks program

System interventions to support rural access to maternity care: an analysis of the rural surgical obstetrical networks program

Surviving in the midst of ‘Nowhere’: Disrupting the conceptualisation of a maternity care desert

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