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Barriers to Rural Midwifery: An Integrative Review.

Madison Friesen¹, Viviane Josewski², Caroline Sanders²

¹School of Nursing, University of Northern British Columbia, Northern Health, Prince George, British Columbia, Canada.

Journal of Advanced Nursing

|January 2, 2025

Summary

Rural midwives face isolation, financial insecurity, and professional challenges. Addressing these multi-level barriers requires increased representation and supportive policies to improve rural maternity care.

Keywords:

midwifery midwifery integration midwifery sustainability rural health rural health access

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Area of Science:

Rural Health
Midwifery Practice
Healthcare Systems

Background:

Midwifery is crucial for rural maternity care.
Rural areas face unique healthcare access challenges.
Understanding midwife barriers is key to improving care.

Purpose of the Study:

To identify barriers rural midwives encounter.
To explore factors affecting rural midwifery practice.

Main Methods:

Integrative review utilizing Ecological Systems Theory.
Searches conducted in CINAHL, MEDLINE, Science Direct, and Google Scholar.
Thematic analysis of 14 included articles (1990-2023).

Main Results:

Micro-level barriers: isolation, financial insecurity, work-life balance issues.
Meso-level barriers: interprofessional discord, continuing education access.
Macro-level barriers: lack of representation, medical dominance, policy issues.

Conclusions:

Rural midwives face complex, multi-level challenges.
Solutions require increased midwifery representation in planning.
Policy reform and rural-specific healthcare models are essential.