Toward Equity in Access to Midwifery: A Scan of Five Canadian Provinces

Abstract

This research project was created to support equitable access to midwifery care for the diverse populations of Saskatchewan women. Given the ongoing implementation and expansion of midwifery across diverse mixes of rural, urban, and aboriginal communities in the health regions of the province, we asked: How can midwifery care be implemented in an equitable and accessible way in Saskatchewan? The first phase of this research explored experiences with midwifery implementation around issues of accessibility through an environmental scan of five Canadian provinces (British Columbia, Manitoba, Ontario, Northwest Territories, and Nova Scotia). By analyzing policy and regulatory documents together with primary data generated through key informant interviews, we discovered an interesting compendium of provincial activities and policies in support of equity to access midwifery. We also identified several important areas in need of strengthening. In this article, we present a brief description of the best practices identified by each province, followed by an exploratory analysis of key thematic issues that are significant in creating equitable access to the full scope of midwifery care. These included funding models, interprofessional relationships, choice of birthplace and second attendants, risk designation, geographic dispersal, community integration, and midwifery human resources.