Maternal and Newborn Outcomes in a Rural Midwifery-Led Maternity Service in British Columbia: A Retrospective Chart Review

Jude Kornelsen, PhD, and Maggie Ramsey, RN, RM

ABSTRACT
Background: Maternity services in rural British Columbia have undergone significant changes in the past decade, most notably marked by service closures in over 20 rural services. A potential solution to this rural maternity service delivery challenge is a shift towards midwife-led or interprofessional models of maternity care. However, little is known about the safety of such services, particularly in Canada.
Methods: A five-year retrospective chart audit of a midwifery-led practice in British Columbia. Findings are compared to recently published outcomes of all primary care rural maternity services in British Columbia.
Findings: The practice cared for 71.9% of the population and had lower rates of cesarean section, induction, and episiotomy when compared to provincial averages. When compared to published data on outcomes of other primary care maternity services in British Columbia, women in the case study practice were less likely to have an intrapartum cesarean section, induction or augmentation of labour, episiotomy, or epidural. They were more likely to have an assisted delivery and an elective cesarean section. The practice had a 36% transfer rate.
Conclusion: This case study midwifery service is able to meet the maternity care needs of the community in a safe and effective way, facilitating local birth for low-risk women.

KEYWORDS
rural maternity care, midwifery, retrospective chart review

This article has been peer reviewed