New paper on the outcomes of a rural midwifery service in BC

A new paper from Dr. Jude Kornelsen and Maggie Ramsay, a registered midwife on Salt Spring Island, shows the value and safety of the Salt Spring Midwifery Practice through a retrospective chart audit. Salt Spring Island is a relatively advantaged rural community, but still faces the challenge of isolation in providing primary maternity care.

Fulford Harbour Ferry Landing

Fulford Harbour on Salt Spring Island’s southern coast is the landing place of BC Ferries, connecting the small Island to Swartz Bay outside of Victoria.

The low rate of intrapartum transfer indicates a successful screening protocol… the cornerstone of good maternal and newborn outcomes in rural settings.”

The authors found that nearly 72% of the births from the local health area were cared for through the Salt Spring Midwifery Practice, with 65% of those giving birth on the Island. Intrapartum transfer was rare, with most transfers taking place pre-labour for planned surgical intervention. For those in the care of Salt Spring Midwifery Practice, rates of intervention and c-section were far below provincial averages. In fact, over 75% of women had a spontaneous vaginal delivery, compared to a provincial average of just over 60%. And just 7.6% of women had an unplanned intrapartum c-section compared to a provincial rate of 18.1%.

“Primary maternity care in isolated, rural settings demands an approach different from care in tertiary settings or even care in rural settings with access to cesarean sections. Key attributes include appropriate risk screening for local delivery, anticipatory thinking during labour, and established relationships with referral colleagues.”

Of the 196 registered midwives in BC in 2013, 30% identified as rural practitioners.

You can find the new paper on our Publications page.

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