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The Experience of Pregnancy and Birth with Midwives: Results from the Canadian Maternity Experiences Survey

Authors

  • Beverley O’Brien RM, RN, PhD,

    1. Beverley O’Brien is a Professor at the Faculty of Nursing, University of Alberta, Edmonton, Alberta; Beverley Chalmers is an International Perinatal Health Consultant, Department of Obstetrics and Gynaecology and Affiliate Investigator, Ottawa Health Research Institute, University of Ottawa, Ottawa; Deshayne Fell is an Epidemiologist at the Better Outcomes Registry & Network (BORN), Ottawa, Ontario; Maureen Heaman is a Professor and CIHR Chair in Gender and Health, Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba; Elizabeth Darling is an Assistant Professor in the Midwifery Education Program, Laurentian University, Sudbury, Ontario; and Pearl Herbert is an Associate Professor (retired), School of Nursing, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada.
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  • Beverley Chalmers DS (Med), PhD,

    1. Beverley O’Brien is a Professor at the Faculty of Nursing, University of Alberta, Edmonton, Alberta; Beverley Chalmers is an International Perinatal Health Consultant, Department of Obstetrics and Gynaecology and Affiliate Investigator, Ottawa Health Research Institute, University of Ottawa, Ottawa; Deshayne Fell is an Epidemiologist at the Better Outcomes Registry & Network (BORN), Ottawa, Ontario; Maureen Heaman is a Professor and CIHR Chair in Gender and Health, Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba; Elizabeth Darling is an Assistant Professor in the Midwifery Education Program, Laurentian University, Sudbury, Ontario; and Pearl Herbert is an Associate Professor (retired), School of Nursing, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada.
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  • Deshayne Fell MSc,

    1. Beverley O’Brien is a Professor at the Faculty of Nursing, University of Alberta, Edmonton, Alberta; Beverley Chalmers is an International Perinatal Health Consultant, Department of Obstetrics and Gynaecology and Affiliate Investigator, Ottawa Health Research Institute, University of Ottawa, Ottawa; Deshayne Fell is an Epidemiologist at the Better Outcomes Registry & Network (BORN), Ottawa, Ontario; Maureen Heaman is a Professor and CIHR Chair in Gender and Health, Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba; Elizabeth Darling is an Assistant Professor in the Midwifery Education Program, Laurentian University, Sudbury, Ontario; and Pearl Herbert is an Associate Professor (retired), School of Nursing, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada.
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  • Maureen Heaman RN, MN, PhD,

    1. Beverley O’Brien is a Professor at the Faculty of Nursing, University of Alberta, Edmonton, Alberta; Beverley Chalmers is an International Perinatal Health Consultant, Department of Obstetrics and Gynaecology and Affiliate Investigator, Ottawa Health Research Institute, University of Ottawa, Ottawa; Deshayne Fell is an Epidemiologist at the Better Outcomes Registry & Network (BORN), Ottawa, Ontario; Maureen Heaman is a Professor and CIHR Chair in Gender and Health, Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba; Elizabeth Darling is an Assistant Professor in the Midwifery Education Program, Laurentian University, Sudbury, Ontario; and Pearl Herbert is an Associate Professor (retired), School of Nursing, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada.
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  • Elizabeth K. Darling RM, MSc,

    1. Beverley O’Brien is a Professor at the Faculty of Nursing, University of Alberta, Edmonton, Alberta; Beverley Chalmers is an International Perinatal Health Consultant, Department of Obstetrics and Gynaecology and Affiliate Investigator, Ottawa Health Research Institute, University of Ottawa, Ottawa; Deshayne Fell is an Epidemiologist at the Better Outcomes Registry & Network (BORN), Ottawa, Ontario; Maureen Heaman is a Professor and CIHR Chair in Gender and Health, Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba; Elizabeth Darling is an Assistant Professor in the Midwifery Education Program, Laurentian University, Sudbury, Ontario; and Pearl Herbert is an Associate Professor (retired), School of Nursing, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada.
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  • Pearl Herbert BN, BEd, MSc

    1. Beverley O’Brien is a Professor at the Faculty of Nursing, University of Alberta, Edmonton, Alberta; Beverley Chalmers is an International Perinatal Health Consultant, Department of Obstetrics and Gynaecology and Affiliate Investigator, Ottawa Health Research Institute, University of Ottawa, Ottawa; Deshayne Fell is an Epidemiologist at the Better Outcomes Registry & Network (BORN), Ottawa, Ontario; Maureen Heaman is a Professor and CIHR Chair in Gender and Health, Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba; Elizabeth Darling is an Assistant Professor in the Midwifery Education Program, Laurentian University, Sudbury, Ontario; and Pearl Herbert is an Associate Professor (retired), School of Nursing, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada.
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  • All authors are members of the Maternity Experiences Study Group of the Canadian Perinatal Surveillance System, Public Health Agency of Canada, Ottawa, Ontario, Canada (http//http://www.publichealth.gc.ca/MES).

Address correspondence to Beverley O’Brien, RM, RN, PhD, UEC 7-50C, Faculty of Nursing, University of Alberta, 3rd Floor, Clinical Sciences Building, Edmonton, Alberta T6G 2G3, Canada.

Abstract

Abstract:  Background:  In Canada maternity care is publicly funded, and although women may choose their care providers, choices may be limited. The purpose of this study was to compare perceptions of maternity outcomes and experiences of those who received care from midwives with those who received care from other providers.

Methods:  Based on the 2006 Canadian census, a random sample of women (= 6,421) who had recently given birth in Canada completed a computer-assisted telephone interview for the Maternity Experiences Survey. The sample was stratified according to province or territory where birth occurred, age, rural or urban residence, and presence of other children in the home. Those who were 15 years of age and older, gave birth to a singleton baby, and were living with their infant were eligible for inclusion.

Results:  Women whose primary prenatal providers were midwives had fewer ultrasounds and were more likely to attend prenatal classes and have at least five or more prenatal visits. They were also more likely to rate satisfaction with their maternity experience as “very positive” and be satisfied with information provided on a variety of pregnancy and birth topics if their primary prenatal provider was a midwife. They were almost half as likely to experience induction and 7.33 times more likely to experience a medication-free delivery. They were more likely to initiate and maintain breastfeeding at 3 and 6 months.

Conclusions:  Evidence shows that midwifery outcomes and levels of satisfaction meet or exceed Canadian maternity care standards. Facilitation of the continuing integration of midwives as autonomous practitioners throughout Canada is recommended. (BIRTH 38:3 September 2011)

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