Comparing birth experiences and satisfaction with midwifery care before and after the implementation of Canada's first Alongside Midwifery Unit (AMU).

Background: Globally, midwifery-led birthing units are associated with favourable clinical outcomes and positive birth experiences. As part of our evaluation of Canada's first Alongside Midwifery Unit (AMU) at Markham Stouffville Hospital, we sought to explore and compare birth experiences and satisfaction among midwifery clients who gave birth on the AMU with midwifery clients who gave birth on the traditional obstetric unit prior to AMU implementation.

Methods: We conducted a structured, online, cross-sectional survey of midwifery clients in the six months before, and up to 18 months after, opening of the AMU at Markham Stouffville Hospital, Ontario Canada.

Canadian midwives' perspectives on the clinical impacts of point of care ultrasound in obstetrical care: A concurrent mixed-methods study.

Introduction: Point of Care Ultrasound (POCUS) is used globally in obstetrics to conduct real time bedside ultrasound scans to answer a clinical question, and it may be conducted by a non-sonography healthcare practitioner. The College of Midwives of Ontario expanded the scope of practice in 2018 to allow registered midwives to perform POCUS during clinical assessments. In response, a POCUS training curriculum for practicing midwives was developed.

Mediating expectations and experiences that influence birth experiences in Canada's first Alongside Midwifery Unit.

Background: Globally, midwifery-led birthing units are associated with excellent maternal and neonatal outcomes, and positive childbirth experiences. However, little is known about what aspects of midwife-led units contribute to favorable experiences and overall satisfaction. Our aim was to explore and describe midwifery service user experiences at Canada's first Alongside Midwifery Unit (AMU).

Making Space for Midwifery in a Hospital: Exploring the Built Birth Environment of Canada's First Alongside Midwifery Unit.

Background: Canada's first alongside midwifery unit (AMU) was intentionally informed by evidence-based birth environment design principals, building on the growing evidence that the built environment can shape experiences, satisfaction, and birth outcomes.

Objectives: To assess the impact of the built environment of the AMU for both service users and midwives. This study aimed to explore the meanings that individuals attribute to the built environment and how the built environment impacted people's experiences.

Promoting safety and role clarity among health professionals on Canada's First Alongside Midwifery Unit (AMU): A mixed-methods evaluation.

Objective: Globally, midwife-led units are associated with improved clinical outcomes and childbirth satisfaction, but little is known about the impact of the model on health professionals themselves and interprofessional collaboration. The aim of this research was to describe the experiences of health professionals providing care in Canada's first Alongside Midwifery Unit.

Design: A mixed-methods evaluation exploring healthcare provider's experiences using an online survey and qualitative semi-structured interviews and focus groups.

Lessons learned from the implementation of Canada's first alongside midwifery unit: A qualitative explanatory study.

Background: In July 2018, Canada's first midwife-led alongside midwifery unit (AMU) opened at Markham Stouffville Hospital (MSH) in Markham, Ontario. Our objectives were to examine how the conditions at MSH made it possible for the hospital to create the first AMU in Canada and to identify lessons to inform spread by examining how characteristics of the intervention, the inner and outer settings, the individuals involved, and the processes used influenced the MSH-AMU implementation process.

Methods: We conducted key informant interviews and document analysis using Yin's research methods.

A Survey of University Students' Preferences for Midwifery Care and Community Birth Options in 8 High-Income Countries.

Introduction: Midwifery care is associated with positive birth outcomes, access to community birth options, and judicious use of interventions. The aim of this study was to characterize and compare maternity care preferences of university students across a range of maternity care systems and to explore whether preferences align with evidence-based recommendations and options available.

Methods: A cross-sectional, web-based survey was completed in 2014 and 2015 by a convenience sample of university students in 8 high-income countries across 4 continents (N = 4569).

A cross-country survey of attitudes toward childbirth technologies and interventions among university students.

Problem & Aim: Cultural beliefs that equate birth technology with progress, safety and convenience contribute to widespread acceptance of childbirth technology and interventions. Little is known about attitudes towards childbirth technology and interventions among the next generation of maternity care users and whether attitudes vary by country, age, gender, childbirth fear, and other factors.

Methods: Data were collected via online survey in eight countries.

A scoping review of how new midwifery practitioners transition to practice in Australia, New Zealand, Canada, United Kingdom and The Netherlands.

Background: contemporary knowledge related to the experiences of new midwifery practitioners is limited to countries that run hospital-based transition to practice programmes within an employment contract arrangement, such as the United Kingdom, and Australia. Less is known of the experiences of New Midwifery Practitioners (NMPs) who transition into autonomous private practice in New Zealand, Canada and the Netherlands.

Purpose: the purpose of this paper is to report on a scoping review of the way NMPs are transitioned to practice in the first year of registered practice across the selected countries.

Cross-cultural development and psychometric evaluation of a measure to assess fear of childbirth prior to pregnancy.

Background: Assessment of childbirth fear, in advance of pregnancy, and early identification of modifiable factors contributing to fear can inform public health initiatives and/or school-based educational programming for the next generation of maternity care consumers. We developed and evaluated a short fear of birth scale that incorporates the most common dimensions of fear reported by men and women prior to pregnancy, fear of: labour pain, being out of control and unable to cope with labour and birth, complications, and irreversible physical damage.

Methods: University students in six countries (Australia, Canada, England, Germany, Iceland, and the United States, n = 2240) participated in an online survey to assess their fears and attitudes about birth.

Models of organization of maternity care by midwives in Canada: a descriptive review.

Most provinces in Canada now offer regulated midwifery, but the way services are delivered across the country varies. The Canadian Midwifery Regulators Consortium has identified a need to examine the different ways in which care is being organized; this is to determine what elements are essential to maintain and where flexibility is desirable, in order to promote growth of the profession and maximize the contribution of midwifery to the provision of services. In April 2012 a planning meeting (funded by Canadian Institutes of Health Research) brought together midwifery leaders, researchers, regulators, and lead clinicians of several maternity service programs across Canada.

Why home birth? A qualitative study exploring women's decision making about place of birth in two Canadian provinces.

Objective: the aim of this study was to increase our understanding of why Canadian women choose to give birth at home. Despite on-going debate regarding the safety of home birth, a small number of Canadian women choose home as a place to give birth. The factors influencing a woman's decision to plan a home birth remain poorly understood.

Women's experiences of participating in the early external cephalic version 2 trial.

Background: The international, multicenter External Cephalic Version 2 (ECV2) Trial compared early external cephalic version at 34(0/7) to 35(6/7) weeks with that at greater than 37 weeks. A total of 1,543 women were randomized from 68 centers in 21 countries. The goal of this component of the trial was to understand women's views about participation in a research trial and timing of external cephalic version.

Comparison of midwifery, family medicine, and obstetric patients' understanding of weight gain during pregnancy: a minority of women report correct counselling.

Objective: We hypothesized that differences in models of care between health care providers would result in variations in patients' reports of counselling. Our objective was to compare what women reported being advised about weight gain during pregnancy and the risks of inappropriate weight gain according to their type of health care provider.

Methods: A cross-sectional survey was conducted using a self-administered questionnaire at obstetric, midwifery, and family medicine clinics in Hamilton, Ontario.

Midwifery care in eight industrialized countries: how does Canadian midwifery compare?

Objectives: Much has been written about the status of midwifery in developing countries, yet there is limited knowledge and analysis of the role of midwifery in the provision of maternity care in the developed world. The purpose of this study was to better understand how midwifery in Canada compares with midwifery in other developed countries with particular attention to educational preparation, scope of practice, and the contribution of midwives to the overall provision of maternity care.

Methods: Eight countries were selected on the basis of comparably low maternal mortality rates (defined as < 10/100,000 live births).