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The Integration of Ontario Birth Centers into Existing Maternal‐Newborn Services: Health Care Provider Experiences
Author(s) -
Reszel Jessica,
Sidney Dana,
Peterson Wendy E.,
Darling Elizabeth K.,
Wagner Vicki,
Soderstrom Bobbi,
Rogers Judy,
Graves Erin,
Khan Bushra,
Sprague Ann E.
Publication year - 2018
Publication title -
journal of midwifery and women's health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.543
H-Index - 62
eISSN - 1542-2011
pISSN - 1526-9523
DOI - 10.1111/jmwh.12883
Subject(s) - focus group , nursing , health care , medicine , qualitative research , family medicine , obstetrics , business , political science , sociology , social science , marketing , law
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.