PRENATAL SCREENING IN CANADIAN AND UNITED STATES MIDWIFERY PRACTICES: AN EXPLORATORY STUDY

Abstract

Midwifery practice in Canada and the United States (U.S.) developed along similar philosophical principles, but different practice models have evolved. Within these two frameworks of midwifery practice, this retrospective, exploratory study investigated the prenatal screening tests that often pose decision-making dilemmas for both clients and midwives. Women in the U.S. (n=60) were more likely to have four of the five prenatal screening tests than Canadian women (n=56). U.S. midwifery clients (n=60) more frequently received the genetic screen (p=0.029), HIV (p=0.0005), ultrasound (p=0.0005) and serum glucose screen (p=0.0005). Canadian midwifery clients (n=56) were more likely to receivehte Group BStreptococcus screen (p=0.004) than their US.. counterparts. In addition, hte mean number of ultrasounds performed during pregnancy was significantly higher for U.S. women than Canadian women (p=0.001). Women with any post-secondary education were more likely to choose to have the glucose screen (p=0.017) and primiparous women were more likely to have an ultrasound (p=0.020) and the glucose screen (p=0.038). Factors that may influence which tests women receive are discussed ni relation to the philosophic framework of midwifery practice in Canada and the U.S.