CONTROVERSIES IN MATERNITY CARE - WHERE DO PHYSICIANS, NURSES, AND MIDWIVES STAND

Through a mail survey in 1991, we compared the opinions of 597 physici ans practicing obstetrics, 723 maternity care nurses, and 70 midwives from the province of Quebec, Canada, about selected maternity care iss ues, including the practice of midwifery. Results showed that divergen t points of view existed between and within the three groups on many m aternity care issues. Physicians were more divided over the routine us e of obstetric intervention than the approach to care or their opinion about midwives. Midwives held more client-centered and less intervent ionist attitudes than nurses or physicians. Nurses were much more open to midwives than physicians, but 20 to 30 percent of physicians saw s ome advantages in legalizing the practice of midwifery. Physicians and nurses generally considered midwives as a greater professional threat to the other group than to themselves. The fact that many physicians were critical of current maternity care is difficult to reconcile with their general opposition to midwives. How and to what extent physicia ns will respond to women's desire for more humanized and less interven tionist care remains an open question. Given the problems facing mater nity care in North America, expanding midwifery services is an alterna tive to examine seriously.