must also be willing to evaluate critically the practices of certified nurse midwives, who might have an even lower rate of intervention in maternity care while they maintain equally high quality.IS Finally, because today's medical environment, despite its shortcomings, has a greater emphasis on cost-effective care, family physicians might have their greatest opportunity to promote the lowinter...

The shortage of maternity care providers in Canada has been documented largely from the perspective of physicians. Women in rural communities, however, have much to contribute to this discussion. Exploratory research in 3 rural communities in south central Ontario eliciting the perspectives of 36 birthing women has affirmed the need for integrated models of maternity care. Rural women seek care...

In many countries rural maternity care is under threat. Consequently rural pregnant women will have to travel further to attend larger maternity units to receive care and deliver their babies. This trend is not dissimilar from the disappearance of other rural services, such as village shops, banks, post offices and bus services. We use a comparative approach to draw an analogy with large-scale ...

BACKGROUND Understanding women's experiences and perspectives of antenatal care services is particularly critical for enhancing effectiveness of services delivery and addressing women's needs and expectations. As part of a comprehensive assessment of the maternity care services in Iraq, this study aimed to explore the views and experiences of antenatal care in a sample of women. METHODS This ...

Although policies and programs exist to promote safe motherhood in sub-Saharan Africa, maternal health has not improved and may be deteriorating in some countries. Part of the explanation may be the adverse effects of HIV/AIDS on maternity care. We conducted a study in Kisumu, Kenya to explore how fears related to HIV/AIDS affect women's uptake and health workers' provision of labor and deliver...

At present there is under utilization of maternity service provision in Nigeria, with only a third of childbearing women electing to deliver in healthcare facilities. This is relevant since Nigeria's maternal mortality rate is second highest in the world and is estimated at 1,100 per 100,000 live births. To date, studies have sought cause and effect and have neglected the opinion of the people ...

OBJECTIVE To explore the independent effects of gestational diabetes mellitus (GDM) on maternity care and costs. RESEARCH DESIGN AND METHODS Estimates for maternity care resource activity and costs for 4,372 women, of whom 354 (8.1%) were diagnosed with GDM, were generated from data from the Atlantic Diabetes in Pregnancy (ATLANTIC DIP) database. Multivariate regression analysis was applied t...

For 22 years I delivered babies as a family physician—22 years of wearing a pager 24 hours a day, 7 days a week. It was amazingly invigorating and inspiring, and at times onerous and overwhelming. September is the perfect time to talk about delivering babies—9 months after New Year’s, it is always a busy month in labour and delivery. This is a National Physician Survey (NPS) year, and one of th...

OBJECTIVE To determine the level of near-miss maternal mortality and morbidity due to severe obstetrical complications or maternal disease in a tertiary maternity hospital. DESIGN Retrospective review. SETTING A free-standing maternity hospital delivering 5500 infants per year. METHODS The information coded in the perinatal database concerning women who had required transfer for critical ...

The impact of rapid increase in institutional birth rate in Nepal on women's satisfaction and planned future utilization of services is less well known. This study aimed to measure women's satisfaction with maternity care and its correlation with intended future utilisation. Data came from a nationally representative facility-based survey conducted across 13 districts in Nepal and included clie...