Does Midwifery Care Reduce Adverse Infant Birth Outcomes for Women with Low Socioeconomic Position Compared to Care Received from Obstetricians or Family Practitioners?

Project number: 
14-092
Approval date: 
Monday, September 15, 2014
Principal Investigator: 
McRae,Daphne
Institution: 
University of Saskatchewan
Funding Agency: 
not grant funded
Datasets requested: 
Consolidation - demographic (Ministry of Health)
Perinatal Services BC
Consolidation registry (Ministry of Health)
consolidation - census geocodes
Medical Services Plan (BC Ministry of Health)
Research objective: 

1. (a) Is there an association between midwifery care and reduced adverse infant birth outcomes compared to physician or obstetrician-led care for women with low socioeconomic position SEP and low medical and obstetric risk? The underlying hypothesis for this objective is that the depth, quality, and continuity of relationship between a midwife and client exceeds that of other clinician-patient relationships, thereby providing extra psychosocial and educational support that can impact birth outcomes for vulnerable women.

1. (b) If a significant association exists, what is the provincial population attributable risk (PAR) of SGA births and regional PARs for each Health Service Delivery Area in B.C.? Understanding the magnitude of risk-reduction attributable to midwifery care and if and how region of residence impacts risk for this population provides useful information for tailoring practice and policy to identified need.

2. Is there is a statistically significant difference between rates of adverse infant birth outcomes for midwifery clients with low SEP compared to those with high SEP? This comparative analysis will help in interpreting birth outcome equity among midwifery clients and delineate the limitations of perinatal care provision in deconstructing health inequity.

3. Is there a difference in risk of adverse infant outcomes for women in the care of midwives, compared to physicians or obstetricians, who are experiencing occasional versus long-term low SEP? Because income status is dynamic, this analysis will capture a more nuanced understanding of the health impacts of enduring low income and low socioeconomic position compared to less entrenched low SEP.

Publications: 

Journal Publication

  • McRae DN, Janssen PA, Vedam S, Mayhew M, Mpofu D, Teucher U, Muhajarine N. Reduced Prevalence of Small-for-Gestational-Age and Preterm Birth for Women of Low Socioeconomic Position: A Population-Based Cohort Study Comparing Midwifery and Physician-Led Models of Care. British Medical Journal Open. 2018. 8:e022220. doi: 10.1136/bmjopen-2018-022220

Interview (radio/newspaper/television/internet etc.)

Presentation of research material (poster/seminar/lecture etc.)

  • McRae DN, Muhajarine N, Vedam S, Mayhew M, Mpofu D, Teucher U, Janssen PA. Reduced prevalence of small-for-gestational-age birth and other adverse infant birth outcomes for women of low socioeconomic position: a population based cohort study comparing midwifery and physician models of care. Keynote address at: Association of Ontario Midwives Research Symposium; 2018 Nov 19; Toronto, ON.
  • McRae DN, Janssen PA, Mayhew M, Vedam S, Mpofu D, Teucher U, Muhajarine N. Improving Infant Birth Outcomes for Low Socioeconomic Women With or Without Substance Use and Mental Health Conditions. Research summary. Presented to: Midwives Association of BC; 2018 Nov 1; Vancouver, BC.
  • McRae DN, Janssen PA, Mayhew M, Vedam S, Mpofu D, Teucher U, Muhajarine N. Reduced Prevalence of Small-for-Gestational-Age Birth and Preterm Birth for Women of Low Socioeconomic Position: A Cohort Study Comparing Midwifery Versus Physician-Led Care. Oral presentation at: Public Health & Preventive
    Medicine Journal Club; University of Saskatchewan; 2018 Oct 19; Saskatoon, SK.
  • McRae DN, Muhajarine N, Vedam S, Mayhew M, Mpofu D, Teucher U, Janssen PA. Reduced Prevalence of Small-for-Gestational-Age Birth and Other Adverse Birth Outcomes for Women of Low Socioeconomic Position. Oral presentation at: Midwives Association of BC Annual General Meeting; 2018 June 11; Vancouver, BC.
  • McRae DN, Janssen PA, Vedam S, Mayhew M, Mpofu D, Teucher U, Muhajarine N. Antenatal Midwifery Care: Reducing Prevalence of Small-for-Gestational-Age Birth and Preterm Birth Among Women of Low Socioeconomic Position. Poster presentation at: Canadian Institute of Health Research National Poster Competition, Student Research Health Forum; 2017 June 6-9; Winnipeg, MB.

    McRae DN, Muhajarine N, Vedam S, Mayhew M, Mpofu D, Teucher U, Janssen PA. Antenatal Midwifery Care: Reducing Prevalence of Small-for-Gestational-Age Birth and Other Adverse Infant Birth Outcomes Among Vulnerable Women. Poster presentation at: Society for Perinatal Epidemiology Annual Meeting; 2017 June 19-20; Seattle, WA.; Society for Perinatal Epidemiology Annual Meeting; 2017 June 19-20; Seattle, WA.

    McRae DN, Muhajarine N, Vedam S, Mayhew M, Mpofu D, Teucher U, Janssen PA. Antenatal Midwifery Care: Reducing Prevalence of Small-for-Gestational-Age Birth and Other Adverse Infant Birth Outcomes Among Vulnerable Women. Poster presentation at: BC Children’s Hospital Research Institute, Research Trainee Forum; 2017 June 22; Vancouver, BC.

  • McRae DN, Janssen PA, Vedam S, Mayhew M, Mpofu D, Teucher U, Muhajarine N. Antenatal Midwifery Care: Reducing Prevalence of Small-for-Gestational-Age Birth and Other Adverse Infant Birth Outcomes Among Women of Low Socioeconomic Position. Oral presentation at: Academic Perinatology Rounds, BC Women’s Hospital; 2017 May 3; Vancouver, BC.
  • McRae DN, Janssen PA, Mayhew M, Vedam S, Mpofu D, Teucher U, Muhajarine N. Antenatal Midwifery Care: Reducing Prevalence of Small-for-Gestational-Age Birth and Preterm Birth Among Women of Low Socioeconomic Position. Oral presentation at: BC Children’s Hospital Research Seminar Series; 2017 April 28; Vancouver, BC.; Normal Birth Meeting, BC Children’s Hospital Research Institute; 2017 March 6; Vancouver, BC

    McRae DN, Muhajarine N, Vedam S, Mayhew M, Mpofu D, Teucher U, Janssen PA. Antenatal Midwifery Care And Reduced Prevalence of Small-for-Gestational-Age Birth and Preterm Birth Among Women of Low Socioeconomic Position. Oral presentation at: The 12th International Normal Labour and Birth Research Conference; 2017 Oct. 2-4; Grange- Over-Sands, Cumbria, UK.

Conference abstract/presentation

  • McRae D. Antenatal Midwifery Care and Reduced Prevalence of Small-for-Gestational-Age Birth and Other Adverse Infant Birth Outcomes for Women of Low Socioeconomic Position: A Population Based Cohort Study Comparing Midwifery and Physician-Led Models of Care. PhD Thesis Oral Defense at: University of Saskatchewan; 2017 Aug 11; Saskatoon, SK.
  • McRae DN, Muhajarine N, Vedam S, Mayhew M, Mpofu D, Teucher U, Janssen PA. Antenatal Midwifery Care: Reducing Prevalence of Small-for-Gestational-Age Birth and Preterm Birth Among Women of Low Socioeconomic Position . Oral presentation at: Student Resident Research Day 2017, Department of Community Health and Epidemiology; 2017 Feb 10; Saskatoon, SK.

Article for general public release (newspaper/magazine/blog/wiki etc.)


Page last revised: September 2, 2019