Prenatal Screening in Canadian and United States Midwifery Practices: An Exploratory Study
Jude A. Kornelsen, PhD Lee W. Saxell, MA, RM
Canada is currently facing a shortage of physicians providing maternity care in both urban centres and rural environments. Although midwives have been regulated in five Canadian provinces, they are currently unable to meet the needs of a diversity of childbearing women. An expanded scope of practice may address some of the current obstacles to the provision of care. A 145-item questionnaire on current practice issues faced by midwives in British Columbia was administered to all registered midwives in the province in March 2002 (n=65). Thirty-five questionnaires were returned for a response rate of 54%. One component of the questionnaire focused on respondents' views of an expanded scope of practice. Out of a possible 32 items, the majority of respondents advocated including an additional 17 items into their current scope of practice. Desired functions included increased prescribing authority and an increase in some technical skills. Conversely, the majority of respondents were not interested in including15 additional items including gynecological surgery and advanced procedures. In order to be a viable long-term contributor to maternity care in Canada, midwives must engage in a dialogue with each other over future directions for their profession, begin consultations with other players in maternity care, and develop a mechanism for evaluating any changes to their scope of practice. The results of this study indicate an interest on the part of some midwives to increase their scope of practice. However, findings may not be representative of the opinions and attitudes of all registered midwives in British Columbia. More research is needed into the nature and implications of such changes.
midwifery, scope of practice, interprofessional relationships