Grant: Operating Grant

In Canada today, there is a serious shortage of doctors and midwives who can take care of mothers and babies, and regional inequities in available birth settings. A woman's choice of birth site assumes she has a range of options and access to qualified providers. The attitudes of medical providers towards maternity care options have been shown to influence the nature of informed decision-making discussions, and patient choice. This study examines the attitudes of doctors and midwives towards practice in the home, and personal and professional experiences that predict those attitudes. Women who live in cities are faced with the prospect of hospitals that do not have enough beds or staff to care for them during pregnancy and birth and a limited choice of maternity care providers. Women in rural, remote, and First Nations communities often must leave their homes and families for several weeks before and after birth, to travel to centers where doctors or midwives are available. Building and staffing enough hospitals to meet the need will take significant time and money. The available research shows that healthy women can can safely plan home births if doctors or midwives provide prenatal and delivery care, and help families make informed decisions about which women and babies will benefit from hospital services. Currently, however, there are not enough maternity providers in Canada who are willing or able to provide home based care, so most women cannot choose this option. The information will help to guide health planning, development of new funding models, and educational programs that will enable physicians and midwives to work together to provide optimal maternity services in all settings.