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Rural Women's and Care Providers' Experiences of Maternity Care 2009

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Rural Maternity Care - MURC 2009 Hardy Wijaya.ppt
Rural Maternity Care - MURC 2009 Hardy Wijaya.ppt [ 2.64MB ]
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 Rural Women’s and Care Providers’ Experiences of Maternity Care Hardy Wijaya CRHR  Centre for Rural Health Research • Collaborative Team – Academic and community-based researchers – Policy makers – Administrators – Key stakeholdes Team arriving at Bella Coola  Centre for Rural Health Research Rural Women’s & Care Providers Experiences of Maternity Care Fetal Fibronectin Testing at Term Stress and Pregnancy Inter-professional Collaboration Study GP Surgeon Project Referral Hospital Project Rural Birth Index (RBI) Project PROJECTS  Centre for Rural Health Research Rural Women’s & Care Providers Experiences of Maternity Care Fetal Fibronectin Testing at Term Stress and Pregnancy Inter-professional Collaboration Study GP Surgeon Project Referral Hospital Project Rural Birth Index (RBI) Project PROJECTS  • By the end of presentation, audience could hopefully… 1. Be informed about rural maternity ‘crisis’ in BC 2. Appreciate the challenges faced by women in rural BC 3. Appreciate the difficulties faced by local leaders and care providers  INTRODUCTION • Rural maternity care services are in decline in Canada • In BC, over 20 closures since 2000 Nakusp  INTRODUCTION • For the women… have to travel outside of their communities to access intrapartum and/or prenatal services. • For care providers… feel unsupported? sense of loss? How is the change being experienced by the women and the care providers?  METHODS • Approach: qualitative, community based – Focus group / group interview – One-on-one interview Sparwood Haida Gwaii Alert Bay North Island • Sites:  METHODS Women Care Providers, Local Leaders, Administrators Group interview (25 participants) Group interview (5 participants) One-on-one unstructured (20 participants) One-on-one semi-structured (30 participants) • Participants:  METHODS • Analysis: – Transcribing (audio  text) – Coding into “themes” – QSR NU*DIST software  • Comfort of Local Birth • Positive Community Experience Women’s Experience of Maternity Care Importance of Local Birth RESULTS  RESULTS Importance of Local Birth • Comfort of Local Birth • Positive Community Experience Women’s Experience of Maternity Care “The hospital sent me a card and thanked me, because there had been some major tragedy in this community just before and that was really sad for a passing away and all this crazy stuff, and so it was really a huge thing for the hospital to experience some positive life coming in.” (Town 4 – 010)  Importance of Local Birth • Comfort of Local Birth • Positive Community Experience • Lack of continuity of care • ‘Scared’ by consent form • Influence of care providers • Considerations of risk Women’s Experience of Maternity Care Challenges for Having Local Birth RESULTS  RESULTS Importance of Local Birth • Comfort of Local Birth • Positive Community Experience • Lack of continuity of care • ‘Scared’ by consent form • Influence of care providers • Considerations of risk Women’s Experience of Maternity Care Challenges for Having Local Birth “They don’t have an... ICU… they don’t have any of that type of stuff here in case something is wrong with her; they have to medivac her out and that just takes too long… the baby could be like dead by then.” (Town 2 – 002)  RESULTS Importance of Local Birth Challenges for Having Local Birth • Comfort of Local Birth • Positive Community Experience • Lack of continuity of care • ‘Scared’ by consent form • Influence of care providers • Considerations of risk Women’s Experience of Maternity Care • Family issue • Financial cost • Stress of birth Experience in Referral Hospitals  RESULTS Importance of Local Birth Challenges for Having Local Birth • Comfort of Local Birth • Positive Community Experience • Lack of continuity of care • ‘Scared’ by consent form • Influence of care providers • Considerations of risk Women’s Experience of Maternity Care • Family issue • Financial cost • Stress of birth Experience in Referral Hospitals“I think the biggest one was not having my family. That was really that was one of the sacrifices we made that probably had the biggest impact.” (Town 2 – 016)  RESULTS Importance of Local Birth Challenges for Having Local Birth Experience in Referral Hospitals Expressed Desires • Comfort of Local Birth • Positive Community Experience • Lack of continuity of care ‘Scared’ by consent form • Influence of care providers • Considerations of risk Women’s Experience of Maternity Care • Access to midwifery care • Stress of birth • Family issue • Financial cost  RESULTS • Community ethos • Difficulties in maintaining competence/skills • Safety issues – Emergency transport • Fear or bad outcome – Litigation – Loss of license Care Providers, Local Leaders, and Administrators Experience of Maternity Care • Birth will always happen Challenges for Providing Local Maternity Care Importance of Local Birth Dilemma  RESULTS Importance of Local Birth Challenges for Providing Local Maternity Care • Community ethos • Difficulties in maintaining competence/skills • Safety issues – Emergency transport • Fear or bad outcome – Litigation – Loss of license Care Providers, Local Leaders, and Administrators Experience of Maternity Care Dilemma • Birth will always happen “As long as you have women of child bearing age [here], you are potentially going to be having women having their babies here… I don’t know how many doctors would be willing, to get a court order and force a woman to travel off island if she was refusing to do so.” (Town 2 – 023 : 507--514)  RESULTS Importance of Local Birth Challenges for Providing Local Maternity Care DilemmaEffect in job satisfaction • Community ethos • Difficulties in maintaining competence/skills • Safety issues – Emergency transport • Fear or bad outcome – Litigation – Loss of license Care Providers, Local Leaders, and Administrators Experience of Maternity Care • Maternity care one of “highlights” of practice • Birth will always happen  WHAT CAN BE DONE • Recommendations: – Submitted in report  Rural Women’s & Care Providers Experiences of Maternity Care Fetal Fibronectin Testing at Term Stress and Pregnancy Inter-professional Collaboration Study GP Surgeon Project Referral Hospital Project Rural Birth Index (RBI) Project PROJECTS http://www.ruralmatresearch.net/index.htm  • Has this presentation helped you to… 1. Be informed about rural maternity ‘crisis’ in BC 2. Appreciate the challenges faced by women in rural BC 3. Appreciate the difficulties faced by local leaders and care providers  THANK YOU Question? . http://www.ruralmatresearch.net/index.htm hardy@ruralmatresearch.net

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