16 Jul Diabetes, Obesity and Hypertension among Ontario Midwifery Clients
The prevalence of diabetes, obesity and hypertension (DOH) during pregnancy is rising. Although midwives in Ontario primarily provide care to low risk women, when complications such as DOH do arise, it is unknown whether clients still maintain improved perinatal outcomes and fewer interventions compared to those in the non-midwifery population. Furthermore, according to the College of Midwives of Ontario (CMO) practice standards, when certain complications arise, midwives must consult or transfer care of clients to a specialist. However, obesity is not mentioned in these guidelines, and midwives are often obliged instead by varying hospital protocols or obstetrician preferences to consult or transfer care for reasons outside of the CMO guidelines. Transfers of care likely carry large costs for the healthcare system and impacts client care, yet little is known about how frequently this occurs.
This study will have a quantitative and qualitative component. Using the Better Outcomes Registry & Network (BORN) database, we will examine the prevalence of DOH and incidence of related adverse perinatal outcomes and interventions in the midwifery population compared to the non-midwifery population in a retrospective cohort of women. We will also assess the rates and reasons for consultation and transfer of care among midwifery clients with DOH compared with midwifery clients without DOH. For the qualitative component we will conduct interviews with midwives to explore their experiences caring for pregnancies complicated by DOH.
Contact for this study:
Jennifer li (firstname.lastname@example.org)