Using data from BC, Alberta and Nova Scotia, a Canadian study published this week demonstrates that those women without local access to maternity and birth services have worsened outcomes, including higher rates of perinatal death and a greater likelihood of premature birth. At the same time, a variety of rural maternity care models with and without local surgical capacity were shown to have positive outcomes for local women, including primary maternity services and surgery-capable services staffed by general practitioners with enhanced skills, general surgeons or mixed generalist and specialist models.
Lead author and Co-Director of the Centre for Rural Health Research Stefan Grzybowski writes, “[This study] raises the question of whether centralization of maternity services in rural referral centres is ultimately an effective strategy for achieving best perinatal outcomes for rural families. Communities that provide local elective intrapartum services without local access to Cesarean Section are able to achieve better outcomes than communities without local services.”
This study provides further evidence that existing rural maternity services should be supported to avoid closure, and efforts should be made to reverse the trend of closures across rural Canada.
The full article has open access on BMC here (www.biomedcentral.com/1472-6963/15/410).
Grzybowksi, Fahey, Lai, Zhang, Aelicks, Leung, Stoll and Attenborough. “The safety of Canadian rural maternity services: a multi-jurisdictional cohort analysis.” BMC Health Services Research. 2015. 15.410. doi:10.1186/s12913-015-1034-6