Grant: Project Grant

Person-centred care values the preferences and cultures of patients, supports informed decision-making, and is linked to improved outcomes and reduced healthcare costs. By contrast, lack of involvement in decision-making and mistreatment during the course of pregnancy and birth can lead to several adverse outcomes, including impacts on mental health and parenting success. In Canada very little is known about whether childbearing women are encouraged to lead decisions about their care, if they feel pressured or coerced into accepting interventions or tests, or if they feel their preferences for care are respected by care providers. Patients who experience mental illness, poverty, lifestyle, immigrant status, or other vulnerabilities during pregnancy may face barriers to access to their preferred modes of care. Our team includes consumers, researchers, clinician leaders and community partners. We will use a community-led process to design a study that focuses on the World Health Organization standards for high quality, respectful maternity care: "safe, effective, equitable and person-centred care". Using a patient-designed survey instrument we will examine experience and outcomes of maternity care across diverse communities in Canada. Our previous studies, Changing Childbirth in BC and Giving Voice to Mothers: US, used best practices for patient-oriented research. We will recruit a broad sample of people who had care during a pregnancy in the last 5 years, using community networks, social media, and Survey Cafés at locations where members from targeted communities access services, with peer assistance for data-entry. We will support communities to interpret results and tell the story to clinicians, hospitals, and government. Our study will raise awareness about options and rights in maternity care, improve health professional education, and lead to data-driven policies to improve health outcomes and to lower costs associated with the quality of maternity care.