The role of risk theory in rural maternity services planning

British Columbia, like the rest of Canada, has seen the closure of many rural maternity services over the past 15 years, many due to the lack of local cesarean section capacity. Although it is very stressful for care providers to offer services in the absence of local surgical backup, very little is know about population health outcomes when birthing occurs at a distance from cesarean section capability. We do know that primary care services can support between 30 – 50% of the local birthing population (the rest will need to leave due to risk factors that warrant a higher level of care or choose to leave in case more care is needed). The negotiation between who stays in the community and who leaves, however, is a difficult one, particularly since there is often a different understanding of “risk” for each player involved. A recent paper written by the Centre for Rural Health has looked at the theoretical literature on risk to try to understand the chasm between what is sometimes call “social” and “scientific” concepts of risk (or ‘expert’ and ‘laypersons’ interpretation of risk). To read the full article, follow this link.

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