Maternity Care Collaboration in Ontario: The Perspectives of Obstetricians and Midwives

Abstract

Introduction:

Interprofessional collaborative care is the gold standard in maternity care and has been proposed as the best way to manage the impending maternity care crisis in Ontario. This thesis researched the benefits and barriers to interprofessional collaboration from the perspectives of obstetricians and midwives. The goal was to understand how obstetricians and midwives view collaborative practice, how the different professions perceive collaboration, and to explore the attitudes and perceptions regarding collaboration of clinicians practicing in each discipline.

Methods:

This study adopted a mixed methods design. A province-wide survey was distributed to actively practicing obstetricians and midwives in Ontario. Following completion of the survey, participants were invited to contribute further opinions and perceptions in semi-structured interviews, conducted using a grounded theory approach.

Results:

Quantitative and qualitative data revealed three key findings. First, when comparing the opinions of obstetricians and midwives, scope of practice was viewed as a contentious issue with fee structures and turf protection being contributory factors. Second, the definition of interprofessional collaboration, and its application to clinical practice, varied by profession, and was viewed as a barrier to effective communication between disciplines. Finally, philosophy of care, particularly surrounding the provision of homebirth and women-centered care, varied starkly across the disciplines.

Conclusion:

Members of each profession need to develop strategies to ensure mutual respect is given in cases of philosophical and scope differences, an essential component to successful implementation of collaborative initiatives. Governing bodies and professional associations of each discipline need to strive for mutual agreement on appropriate scope of practice to ensure buy-in from members of each profession.