What accounts for physician opinions about midwifery in Canada?

Blais, Régis; Lambert, Jean; Maheux, Brigitte

doi:10.1016/s0091-2182(99)00061-0

Cited by 10 publications

(8 citation statements)

References 17 publications

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“…The overall response rate of 37% is somewhat lower than observed in surveys of professionals and managers (Blais et al 1999; Gilbert et al 2006; Haley et al 2000; Maheux et al 2006; Makni et al 2002; National Physician Survey 2007; O'Loughlin et al 2007; Richard et al 2005; Sicotte et al 2002; Tremblay et al 2009). However, if we exclude nurses, the combined response rate for the other groups falls within the range generally observed.…”

Section: Resultsmentioning

confidence: 74%

Stakeholder Views on Solutions to Improve Health System Performance

Brousselle

Contandriopoulos

Haggerty

et al. 2018

hcpol

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Overall response rate was 37%. There was considerable consensus on identified solutions to improve the healthcare system. Resistance was observed in two major areas: information systems and changes directly affecting doctors' practice. The groups' positions cannot explain the inability to implement important characteristics of high-performing systems. The findings raise new questions on the actual sources of resistance.

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Section: Resultsmentioning

confidence: 74%

Stakeholder Views on Solutions to Improve Health System Performance

Brousselle

Contandriopoulos

Haggerty

et al. 2018

hcpol

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“…This is particularly true for individuals of lower SES, who are more likely to have low levels of health literacy [51–54], lower levels of engagement [55], greater trust in physician expertise [50, 56], and less involvement in decision-making [55]. Our study does not allow us to make any broad conclusions regarding family physicians’ knowledge and attitudes towards midwifery care; however, previous research has found a lack of understanding and trust in the education and scope of practice of midwives [57–59]. With 57% of participants with family physicians in our study reporting that their family physician didn’t even raise the option of midwifery, our findings suggest that some family physicians are uninclined to refer patients to midwives.…”

Section: Discussionmentioning

confidence: 99%

Access to midwifery care for people of low socio-economic status: a qualitative descriptive study

Darling

Grenier

Nussey

et al. 2019

BMC Pregnancy Childbirth

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BackgroundDespite public funding of midwifery care, people of low-socioeconomic status are less likely to access midwifery care in Ontario, Canada, but little is known about barriers that they experience in accessing midwifery care. The purpose of this study was to examine the barriers and facilitators to accessing midwifery care experienced by people of low-socioeconomic status.MethodsA qualitative descriptive study design was used. Semi-structured interviews were conducted with 30 pregnant and post-partum people of low-socioeconomic status in Hamilton, Ontario from January to May 2018. Transcribed interviews were coded using open coding techniques and thematically analyzed.ResultsWe interviewed 13 midwifery care recipients and 17 participants who had never received care from midwives. Four themes arose from the interviews: “I had no idea…”, “Babies are born in hospitals”, “Physicians as gateways into prenatal care”, and “Why change a good thing?”. Participants who had not experienced midwifery care had minimal knowledge of midwifery and often had misconceptions about midwives’ scope of practice and education. Prevailing beliefs about pregnancy and birth, particularly concerns about safety, drove participants to seek care from a physician. Physicians are the entry point into the health care system for many, yet few participants received information about midwifery care from physicians. Participants who had experienced midwifery care found it to be an appropriate match for the needs of people of low socioeconomic status. Word of mouth was a primary source of information about midwifery and the most common reason for people unfamiliar with midwifery to seek midwifery care.ConclusionsAccess to midwifery care is constrained for people of low-socioeconomic status because lack of awareness about midwifery limits the approachability of these services, and because information about midwifery care is often not provided by physicians when pregnant people first contact the health care system. For people of low-socioeconomic status, inequitable access to midwifery care may be exacerbated by lack of knowledge about midwifery within social networks and a tendency to move passively through the health care system which traditionally favours physician care. Targeted efforts to address this issue are necessary to reduce disparities in access to midwifery care.

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“…From previous literature, we have some knowledge of diversity of the attitudes, practice and collaboration of maternity care professionals. We still need to develop a better understanding of this collaboration in order to become aware of potential barriers to this collaboration [ 1 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Understanding factors affecting collaboration between midwives and other health care professionals in a birth center and its affiliated Quebec hospital: a case study

Behruzi

Klam

Dehertog

et al. 2017

BMC Pregnancy Childbirth

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BackgroundA better understanding of the processes of collaboration between midwives who work in the birthing centers, and hospital-based obstetricians, family physicians and nurses may promote cooperation among professionals providing maternity care in both institutions. The aim of this research was to explore the barriers and facilitators of the interprofessional and interorganizational collaboration between midwives in birthing centers and other health care professionals in hospitals in Quebec.MethodsA case study design was adopted. Data were collected through semi-structured interviews with midwives, multidisciplinary professionals and administrators, through direct observation of activities in maternity units and field notes, and a variety of organizational and policy documents and archives. A qualitative thematic analysis method was used for analyzing transcribed verbatim.ResultsThe study suggests the close intertwinement between interactional, organizational and systemic factors in regard to barriers and opportunities for collaboration between midwives in birthing centers, and physicians and nurses in hospitals in Quebec. At interactional level, our findings show a conflict in scope of midwifery practice, myth about midwives, pre-judgment, and lack of communication skills between health care providers in the studied birthing center and hospital. At the organizational level, this investigation shows that although midwives have complete access to the hospital with which a formal agreement was signed, they were not integrated in hospital because of lack of interest of midwives and differences in philosophy and scope of practice among healthcare professionals as well as the culture of organizations. At a systemic level, in spite of excessive demand for midwifery care, there are not enough midwives to cover these demands.ConclusionMaternity care professionals require taking a collaborative approach in working and the boundaries of responsibility need to be redrawn. The inter-professional collaborative work between midwives and other maternity care professionals is crucial to improve access and women’s choices for maternity care in Canada. Although having collaborative and multidisciplinary teamwork is a goal of maternity care systems, it is hard to achieve.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-017-1381-x) contains supplementary material, which is available to authorized users.

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What accounts for physician opinions about midwifery in Canada?

Cited by 10 publications

References 17 publications

Stakeholder Views on Solutions to Improve Health System Performance

Stakeholder Views on Solutions to Improve Health System Performance

Access to midwifery care for people of low socio-economic status: a qualitative descriptive study

Understanding factors affecting collaboration between midwives and other health care professionals in a birth center and its affiliated Quebec hospital: a case study

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