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Midwifery defined by physicians, nurses and midwives: the birth of a consensus?
1Département d'administration de la santé, Université de Montréal, Que.
Objective:
To describe the form of midwifery practice preferred by physicians practising obstetrics, nurses providing maternity care and midwives.
Design:
Mail survey conducted in 1991.
Setting:
Province of Quebec.
Participants:
A systematic random sample of 844 physicians, 808 nurses and 92 midwives; 597, 723 and 92 respectively completed the questionnaire, for an overall response rate of 80%.
Main Outcome Measures:
Midwife training options, range of responsibilities, location of midwifery care, relationship to other maternity care providers and degree of autonomy.
Results:
Most of the physicians, nurses and midwives surveyed agreed that if midwifery was legalized, midwives should have a university degree, provide basic care to women with normal pregnancy and delivery, provide prenatal and postnatal care in hospitals and community health centres, perform delivery in hospitals and work in close collaboration with the other maternity care professionals. Disagreement existed concerning the level of university training required, the need for training in nursing first, the scope of medical intervention performed by midwives, out-of-hospital delivery, the autonomy of midwives and control over their practice.
Conclusion:
Some consensus on midwifery practice exists between physicians, nurses and midwives. In jurisdictions where opposition to midwives is strong, such consensus could serve as the starting point for the introduction of midwifery.