Maternity Care Collaboration in Ontario: The Perspectives of Obstetricians and Midwives
Bibliographic record
Abstract
Introduction: Interprofessional collaborative care is the gold standard in maternity care and has been proposed as the best way to manage the impending maternity care crisis in Ontario. This thesis researched the benefits and barriers to interprofessional collaboration from the perspectives of obstetricians and midwives. The goal was to understand how obstetricians and midwives view collaborative practice, how the different professions perceive collaboration, and to explore the attitudes and perceptions regarding collaboration of clinicians practicing in each discipline. Methods: This study adopted a mixed methods design. A province-wide survey was distributed to actively practicing obstetricians and midwives in Ontario. Following completion of the survey, participants were invited to contribute further opinions and perceptions in semi-structured interviews, conducted using a grounded theory approach. Results: Quantitative and qualitative data revealed three key findings. First, when comparing the opinions of obstetricians and midwives, scope of practice was viewed as a contentious issue with fee structures and turf protection being contributory factors. Second, the definition of interprofessional collaboration, and its application to clinical practice, varied by profession, and was viewed as a barrier to effective communication between disciplines. Finally, philosophy of care, particularly surrounding the provision of homebirth and women-centered care, varied starkly across the disciplines. Conclusion: Members of each profession need to develop strategies to ensure mutual respect is given in cases of philosophical and scope differences, an essential component to successful implementation of collaborative initiatives. Governing bodies and professional associations of each discipline need to strive for mutual agreement on appropriate scope of practice to ensure buy-in from members of each profession.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.026 | 0.009 |
| Scholarly communication | 0.006 | 0.002 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".