MIDWIFERY DEFINED BY PHYSICIANS, NURSES AND MIDWIVES - THE BIRTH OF ACONSENSUS

Objective: To describe the form of midwifery practice preferred by phy sicians practising obstetrics, nurses providing maternity care and mid wives. Design: Mail survey conducted in 1991. Setting: Province of Que bec. Participants: A systematic random sample of 844 physicians, 808 n urses and 92 midwives; 597, 723 and 92 respectively completed the ques tionnaire; for an overall response rate of 80%. Main outcome measures: Midwife training options, range of responsibilities, location of midw ifery care, relationship to other maternity care providers and degree of autonomy. Results: Most:of the physicians, nurses and midwives surv eyed agreed that if midwifery was legalized, midwives should have a un iversity degree, provide basic care to women with normal pregnancy and delivery, provide prenatal and postnatal care in hospitals and commun ity health centres, perform delivery in hospitals and work in close co llaboration with the other maternity care professionals. Disagreement existed concerning the level of university training required, the need for training in nursing first, the scope of medical intervention perf ormed by midwives, out-of-hospital delivery, the autonomy of midwives and control over their practice. Conclusion: Some consensus on midwife ry practice exists between physicians, nurses and midwives. In jurisdi ctions where opposition to midwives is strong, such consensus could se rve as the starting point for the introduction of midwifery.