ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2023
Perinatal outcomes of midwife-led care, stratified by medical risk: a retrospective cohort study from British Columbia (2008-2018).
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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19 citing papers in PubMed, 28 citations in OpenAlex.
- Spatial and Temporal Trends of Access to Birthing Hospitals in Illinois, 2016-2021.Preventing chronic disease · 2026Article
- Improving Effective Prenatal Care for New Obstetric Patients Using a Standardized Intake Template and Pregnancy Risk Calculator.Global journal on quality and safety in healthcare · 2026Article
- Maternity Care Deserts: An Urgent Public Health Problem in Need of Financial Solutions.Maternal and child health journal · 2025Article
- Barriers to Rural Midwifery: An Integrative Review.Journal of advanced nursing · 2025Review
- Article
- Perinatal outcomes following nonadherence to guideline-based screening for gestational diabetes: A population-based cohort study.Acta obstetricia et gynecologica Scandinavica · 2025Article
- Effect of midwife-led continuity of care combined with individualized breast management on postpartum recovery and lactation function in women undergoing cesarean section.Frontiers in medicine · 2025Article
- Maternal and neonatal outcomes of childbirth care in a Freestanding Birth Centre.Revista latino-americana de enfermagem · 2025Observational
- The effect of midwifery-led continuum of care to improve maternal and newborn outcomes in the Sidama region, Ethiopia: A non-randomized control trial study.SAGE open medicine · 2025Article
- Exploring the landscape of Canadian midwifery research: strengths, gaps and priorities - results of a scoping review.BMJ open · 2024Article
- Midwife-Led Versus Obstetrician-Led Perinatal Care for Low-Risk Pregnancy: A Systematic Review and Meta-Analysis of 1.4 Million Pregnancies.Journal of clinical medicine · 2024Review
- Community level factors and racial inequities in delivery hospitalizations involving severe maternal morbidity in the United States, 2016-2019.Scientific reports · 2024Article
- Evaluating rural health outcomes: A methodological approach using population-level data.Health care science · 2024Article
- Navigating geographical disparities: access to obstetric hospitals in maternity care deserts and across the United States.BMC pregnancy and childbirth · 2024Article
- Woman-Centered Care: Standardized Outcomes Measure.Medicina (Kaunas, Lithuania) · 2023Article
- Article
- Pitfalls of analyzing perinatal outcomes by health care provider.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Article
- Integration of midwifery care in Canada.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Article
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAnecdotal evidence suggests that the profile of midwifery clients in British Columbia has changed over the past 20 years and that midwives are increasingly caring for clients with moderate to high medical risk. We sought to compare perinatal outcomes with a registered midwife as the most responsible provider (MRP) versus outcomes among clients with physicians as their MRP across medical risk strata.
methodsThis retrospective cohort study (2008-2018) used data from the BC Perinatal Data Registry. We included all births that had a family physician, obstetrician or midwife listed as the MRP (
resultsThe adjusted absolute and relative risks of adverse neonatal outcomes were consistently lower among those who chose midwifery care across medical risk strata, compared with clients who had a physician as MRP. Midwifery clients experienced higher rates of spontaneous vaginal births, vaginal births after cesarean delivery and breastfeeding initiation, and lower rates of cesarean deliveries and instrumental births, with no increase in adverse neonatal outcomes. We observed an increased risk of oxytocin induction among high-risk birthers with a midwife versus an obstetrician as MRP.
interpretationOur findings suggest that compared with other providers in BC, midwives provide safe primary care for clients with varied levels of medical risk. Future research might examine how different practice and remuneration models affect clinical outcomes, client and provider experiences, and costs to the health care system.
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