Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Aug 8;63(5):541-549.
doi: 10.1111/jmwh.12883. Online ahead of print.

The Integration of Ontario Birth Centers into Existing Maternal-Newborn Services: Health Care Provider Experiences

Jessica Reszel, Dana Sidney, Wendy E Peterson, Elizabeth K Darling, Vicki Van Wagner, Bobbi Soderstrom, Judy Rogers, Erin Graves, Bushra Khan, Ann E Sprague

The Integration of Ontario Birth Centers into Existing Maternal-Newborn Services: Health Care Provider Experiences

Jessica Reszel et al. J Midwifery Womens Health. .

Abstract

Introduction: In 2014, 2 freestanding, midwifery-led birth centers opened in Ontario, Canada. The purpose of this study was to qualitatively investigate the integration of the birth centers into the local, preexisting intrapartum systems from the perspective of health care providers and managerial staff.

Methods: Focus groups or interviews were conducted with health care providers (paramedics, midwives, nurses, physicians) and managerial staff who had experienced urgent and/or nonurgent maternal or newborn transports from a birth center to one of 4 hospitals in Ottawa or Toronto. A descriptive qualitative approach to data analysis was undertaken.

Results: Twenty-four health care providers and managerial staff participated in a focus group or interview. Participants described positive experiences transporting women and/or newborns from the birth centers to hospitals; these positive experiences were attributed to the collaborative planning, training, and communication that occurred prior to opening the birth centers. The degree of integration was dependent on hospital-specific characteristics such as history, culture, and the presence or absence of midwifery privileging. Participants described the need for only minor improvements to administrative processes as well as the challenge of keeping large numbers of staff updated with respect to urgent transport policies. Planning and opening of the birth centers was seen as a driving force in further integrating midwifery care and improving interprofessional practice.

Discussion: The collaborative approach for the planning and implementation of the birth centers was a key factor in the successful integration into the existing maternal-newborn system and contributed to improving integrated professional practice among midwives, paramedics, nurses, and physicians. This approach may be used as a template for the integration of other new independent health care facilities and programs into the existing health care system.

Keywords: birthing centers; health services research; midwifery.

PubMed Disclaimer

References

    1. Canadian Association of Midwives . Midwifery across Canada ‐ Ontario. Canadian Association of Midwives website. https://canadianmidwives.org/midwifery-across-canada/#1464901112890-3126.... Published 2017. Accessed March 1, 2018.
    1. de Jonge A, Geerts CC, van der Goes BY, Mol BW, Buitendijk SE, Nijhuis JG. Perinatal mortality and morbidity up to 28 days after birth among 743 070 low‐risk planned home and hospital births: a cohort study based on three merged national perinatal databases. BJOG. 2015;122(5):720‐728. - PubMed
    1. Rowe RE, Townend J, Brocklehurst P, et al. Duration and urgency of transfer in births planned at home and in freestanding midwifery units in England: secondary analysis of the birthplace national prospective cohort study. BMC Pregnancy Childbirth. 2013;13:224. - PMC - PubMed
    1. Li Y, Townend J, Rowe R, Knight M, Brocklehurst P, Hollowell J. The effect of maternal age and planned place of birth on intrapartum outcomes in healthy women with straightforward pregnancies: secondary analysis of the Birthplace national prospective cohort study. BMJ Open. 2014;4(1):e004026. - PMC - PubMed
    1. Stapleton SR, Osborne C, Illuzzi J. Outcomes of care in birth centers: demonstration of a durable model. J Midwifery Womens Health. 2013;58(1):3‐14. - PubMed

LinkOut - more resources