Comparing women's assessment of midwifery and medical care in Quebec, Canada

In 1990, the province of Quebec, Canada, adopted a law that authorized the evaluation of the practice of midwifery through pilot projects before its l egalization. A key objective of this evaluation, as defined by the law, was the documentation of women's assessment of maternity care, especially with regard to humanization and continuity of care. Two to 3 months after birth , 933 midwifery clients and 1,000 physicians' clients, matched on several c haracteristics, responded to a mailed questionnaire (response rates were 93 % and 76% respectively). Results showed that women from both groups were ge nerally satisfied with the care they received, although women who received midwifery care were assessed as more positive on every issue surveyed. Obje ctive measures supported impressions that were also confirmed through quali tative data analysis: midwifery clients had a greater number of and longer prenatal visits, their care was perceived to be more personalized. and a gr eater number of midwives' clients breastfed their infants. However, the int erpretation of these results must take into account that the two groups had different personal er;pec:at ions and values with regard to health and hea lth care. These findings are enlightening in evaluating women's needs, expe ctations, and satisfaction with health care services and should be included in future development of maternity care, including midwifery services, in Quebec and other locations. (C) 2001 by the American College of Nurse-Midwi ves.