PREFACE: This “In the Literature” column has a different genesis from previous columns. It emanates from a discussion that began on the Maternity Care Discussion Group (MCDG), an online group of more than 600 family physicians, obstetricians, midwives, nurses, and doulas that has been hosted on the College of Family Physicians of Canada website for 20 years. Although mainly a Canadian list, international participants are welcome to join in the struggle to improve maternity care and support those who provide it. To join the MCDG List, send an e-mail to