Toward Equity in Access to Midwifery in Saskatchewan: Key Informants’ Perspectives

Lori Hanson, MSc, PhD, and Daphne McRae, BA

ABSTRACT
In this article, we report on the second phase of our exploratory research into issues related to equity in access to midwifery in Saskatchewan. This phase of the research project aimed to explore equity in access to midwifery as understood and experienced by key stakeholders involved in the early stages of midwifery implementation in Saskatchewan. A total of 19 interviews were conducted with participants from Saskatchewan Health, the Midwifery Transitional Council, and Saskatoon’s Regional Midwifery Operations Committee, as well as practitioners, primary health care managers, directors from select regional health authorities, and Saskatchewan midwives. Additionally, all available midwifery policy documents and relevant Primary Health Care and Health Human Resource documents complemented the qualitative analysis. Initial thematic analysis led to five policy recommendations: (1) develop a provincial definition of “priority population” for midwifery clients, (2) establish a midwifery health human resource plan, (3) identify provincial midwifery research priorities, (4) facilitate growth in interprofessional relationships, and (5) develop a provincial “road map” for implementation. A secondary analysis of participants’ responses revealed concern over the poor public education about midwifery services and lack of provincial government prioritization, as well as varied perceptions of the concept of “equity.” We conclude that although general commitments to equity in midwifery service and access are enshrined in Saskatchewan’s health care policies and midwifery regulations, insider perspectives suggest that significant yet modifiable barriers to equity in access to care currently exist.

KEYWORDS
midwifery, midwives, health services accessibility, equity, delivery of health care

This article has been peer reviewed