Abstract
PROBLEM BEING ADDRESSED: Increasing workload and concerns about physician exhaustion necessitated reorganizing the delivery of obstetric services on Manitoulin Island in Ontario. OBJECTIVE OF PROGRAM: To organize obstetrics in a remote rural community to provide safe, accessible care, improve working conditions for local physicians, and involve the local hospital and health care workers in the solution. MAIN COMPONENTS OF PROGRAM: A prenatal clinic for all obstetric care on the island was established. It was based at the local hospital and organized by a nurse-midwife. Local physicians rotated through the clinic and provided obstetric coverage on their on-call days. CONCLUSIONS: The clinic has helped improve working conditions for local physicians and maintain high-quality obstetric care in this remote area. Local women's initial resistance to the clinic seems to be disappearing with time. Ongoing chart audits reveal intervention rates similar to those found in other Canadian studies of rural obstetric care.
Full text
PDF




Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Allen D. I., Kamradt J. M. Relationship of infant mortality to the availability of obstetrical care in Indiana. J Fam Pract. 1991 Dec;33(6):609–613. [PubMed] [Google Scholar]
- Black D. P., Fyfe I. M. The safety of obstetric services in small communities in northern Ontario. Can Med Assoc J. 1984 Mar 1;130(5):571–576. [PMC free article] [PubMed] [Google Scholar]
- Grzybowski S. C., Cadesky A. S., Hogg W. E. Rural obstetrics: a 5-year prospective study of the outcomes of all pregnancies in a remote northern community. CMAJ. 1991 Apr 15;144(8):987–994. [PMC free article] [PubMed] [Google Scholar]
- Lane C. A., Malm S. M. Innovative low-risk maternity clinic. Family physicians provide care in Calgary. Can Fam Physician. 1997 Jan;43:64–69. [PMC free article] [PubMed] [Google Scholar]
- Nesbitt T. S., Connell F. A., Hart L. G., Rosenblatt R. A. Access to obstetric care in rural areas: effect on birth outcomes. Am J Public Health. 1990 Jul;80(7):814–818. doi: 10.2105/ajph.80.7.814. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rosenblatt R. A., Reinken J., Shoemack P. Is obstetrics safe in small hospitals? Evidence from New Zealand's regionalised perinatal system. Lancet. 1985 Aug 24;2(8452):429–432. doi: 10.1016/s0140-6736(85)92747-3. [DOI] [PubMed] [Google Scholar]
- Rourke J. Small Hospital Medical Services in Ontario: Part 3: Obstetric services. Can Fam Physician. 1991 Aug;37:1729–1734. [PMC free article] [PubMed] [Google Scholar]
- Spooner G. R., Gorman J. A. A review of a rural Saskatchewan obstetric service. Can Fam Physician. 1988 Sep;34:1881–1884. [PMC free article] [PubMed] [Google Scholar]
- Tilyard M. W., Williams S., Seddon R. J., Oakley M. E., Murdoch C. J. Is outcome for general practitioner obstetricians influenced by workload and locality? N Z Med J. 1988 Apr 27;101(844):207–209. [PubMed] [Google Scholar]