Providing a Birth Support Program for Women of the North Island Region, Vancouver Island An Aboriginal Midwifery Demonstration Project (original) (raw)
The Centre for Rural Health Research (CRHR) was formed in 2005 in response to the need for evidence to develop policies and inform decision making in the area of rural health. This mandate is based on an understanding of the known health inequities between rural and urban residents arising in part from the difference between their respective health needs and service delivery context. Under the direction of Drs Stefan Grzybowski (a rural family physician) and Jude Kornelsen (a medical sociologist who specializes in maternity care), the CRHR is supported by both the Vancouver Coastal Health Research Institute and the Department of Family Practice at the University of British Columbia, and receives project funding predominantly from the Canadian Institutes of Health Research (CIHR). To date the program of research has focused primarily on rural maternity care and developing strategic approaches to planning sustainable rural maternity services in British Columbia. Please see www.ruralmatresearch.net for a complete list of projects and recent publications.
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Health Policy, 2009
Objectives: To develop and apply a population isolation model to define the appropriate level of maternity service for rural communities in British Columbia, Canada. Methods: Iterative, mathematical model development supported by extensive multimethods research in 23 rural and isolated communities in British Columbia, Canada, which were selected for representative variance in population demographics and isolation. Main outcome measure was the Rural Birth Index (RBI) score for 42 communities in rural British Columbia. Results: In rural communities with 1 h catchment populations of under 25,000 the RBI score matched the existing level of service in 33 of 42 (79%) communities. Inappropriate service for the rural population was postulated and supported by qualitative data available on 6 of the remaining 9 communities. Conclusions: The RBI is a potentially pragmatic tool in British Columbia to help policy makers define the appropriate level of maternity service for a given rural population. The conceptual structure of the model has broad applicability to health service planning problems in other jurisdictions.
A Systematic Approach to Rural Service Planning – The Rural Birth Index (RBI)
The Issues in Rural Maternity Care policy brief series addresses current issues in the provision of maternity care in British Columbia and provides timely recommendations for improving the quality and safety of rural intrapartum care. Targeted at policy makers and maternity care providers, it is produced by the Rural Maternity Care New Emerging Team (RM-NET).
Health policy: outcomes for rural residents' access to maternity care
2009
Regular health care during pregnancy, birthing and the postnatal period is recommended for improving maternal and neonatal outcomes and accessing such care has become a common expectation for Australian families. Studies have highlighted the relative safety of birthing ...
Local birthing services for rural women: Adaptation of a rural New South Wales maternity service
Australian Journal of Rural Health, 2016
Objective: To describe the outcomes of a public hospital maternity unit in rural New South Wales (NSW) following the adaptation of the service from an obstetrician and general practitioner-obstetrician (GPO)-led birthing service to a low-risk midwifery group practice (MGP) model of care with a planned caesarean section service (PCS). Design: A retrospective descriptive study using quantitative methodology. Setting: Maternity unit in a small public hospital in rural New South Wales, Australia. Participants: Data were extracted from the wardbased birth register for 1172 births at the service between July 2007 and June 2012. Main outcome measures: Birth numbers, maternal characteristics, labour, birthing and neonatal outcomes. Results: There were 750 births over 29 months in GPO and 277 and 145 births over 31 months in MGP and PCS, respectively, totalling 422 births following the change in model of care. The GPO had 553 (73.7%) vaginal births and 197 (26.3%) caesarean section (CS) births (139 planned and 58 unplanned). There were almost universal normal vaginal births in MGP (>99% or 276). For normal vaginal births, more women in MGP had no analgesia (45.3% versus 25.1%) or non-invasive analgesia (47.9% versus 38.6%) and episiotomy was less common in MGP than GPO (1.9% versus 3.4%). Neonatal outcomes were similar for both groups with no difference between Apgar scores at 5 min, neonatal resuscitations or transfer to high-level special care nurseries. Conclusion: This study demonstrates how a rural maternity service maintained quality care outcomes for low-risk women following the adaptation from a GPO to an MGP service.
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