• Maria De Koninck PhD,

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    • Maria De Koninck received a PhD in sociology and is currently a professor in the Department of Social and Preventive Medicine at the Faculty of Medicine of the Université Laval, Québec, Canada. Dr. De Koninck was the first Chair of Women's Studies at Laval University from 1988 to 1992. Her research interests include women's health and reproductive health.

  • Régis Blais PhD,

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    • Régis Blais received a PhD in psychology and is currently a professor in the Department of Health Administration and member of the Interdisciplinary Health Research Group at the Faculty of Medicine of the University of Montréal.

  • Pierre Joubert MSc,

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    • Pierre Joubert is currently Director of the Evaluation, Research and Innovation Branch of the Québec Department of Health and Social Services and an associate professor in the Department of Social and Preventive Medicine at the Faculty of Medicine of the Université. Dr. Joubert holds a master's degree in anthropology and a doctoral degree in political science.

  • Claude Gagnon MA,

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    • Claude Gagnon is a research officer at the Public Health Center of Québec. His main fields of study are the organization and evaluation of client satisfaction with health services and social support networks. He holds a master's degree in sociology.

  • L'équipe d'évaluation des projets-pilotes sages-femmes

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    • Members of l'équipe d'évaluation des projets-pilotes sages-femmes included, in addition to De Koninck, Blais, Joubert, and Gagnon: Johanne Collin, PhD, André-Pierre Contandriopoulos, PhD, Andrée Demers, PhD, William Fraser, MD, Deena White, PhD, Francine Desbiens, MSc, Marie Hatem-Asmar, PhD, Isabelle Krauss, MSc, and Daniel Reinharz, PhD.

Département de médecine sociale et préventive Pavillon de l'Est, Université Laval Ste-Foy, Québec, Canada G1K 7P4.


In 1990, the province of Québec, Canada, adopted a law that authorized the evaluation of the practice of midwifery through pilot projects before its legalization. A key objective of this evaluation, as defined by the law, was the documentation of women's assessment of maternity care, especially with regard to humanization and continuity of care. Two to 3 months after birth, 933 midwifery clients and 1,000 physicians' clients, matched on several characteristics, responded to a mailed questionnaire (response rates were 93% and 76%, respectively). Results showed that women from both groups were generally satisfied with the care they received, although women who received midwifery care were assessed as more positive on every issue surveyed. Objective measures supported impressions that were also confirmed through qualitative data analysis: midwifery clients had a greater number of and longer prenatal visits, their care was perceived to be more personalized, and a greater number of midwives' clients breastfed their infants. However, the interpretation of these results must take into account that the two groups had different personal expectations and values with regard to health and health care. These findings are enlightening in evaluating women's needs, expectations, and satisfaction with health care services and should be included in future development of maternity care, including midwifery services, in Québec and other locations.