Outcomes and costs of maternity services in Manitoba

According to Dr. Kellie Thiessen, Assistant Professor and Director of the Midwifery Program in the U of M’s College of Nursing, Manitoba has a dearth of credible evidence-based research to lend support to health care policies surrounding the province’s current midwifery profession.

“Anecdotally, you’ll hear three things about midwifery in Manitoba,” Thiessen says. “First, you’ll hear that Manitoba doesn’t have enough midwives, second, you’ll hear that midwives provide great care and have excellent maternal and neonatal outcomes, and third, you’ll hear that midwifery is a cost-effective model of care. And that may all be very true, but we don’t actually have any evidence to support those beliefs here.”

In response, Thiessen is examining the costs, experiences, and outcomes of midwifery in Manitoba. Built upon the findings of a previous pilot study examining three maternity care providers in Winnipeg, her upcoming cost-analysis research project is titled: Outcomes and costs of Maternity Services in Manitoba.

The study – which received $202,398 in funding through Research Manitoba’s New Investigator Operating Grant – aims to provide data on costs and related outcomes of midwives, family practice physicians, and obstetricians in all regions of the province.

“I’m very interested in health policy and its influence on maternity care outcomes, but I’m also very interested as a researcher on the demographics of women, provider types, place of birth, and availability of services for clients,” Thiessen explains. “The kind of research that is required is long-term work that will involve an interprofessional research team.”

The research team for this project is interdisciplinary and includes professionals from nursing, midwifery, community health sciences, and obstetrics, as well as an expert in health care policy from Health Workforce Canada.

Thiessen says this study is the first time the midwifery professionals in Manitoba will be engaged in high-level academic research and depth of industry-specific inquiry since the work of regulation. “Hopefully this project and subsequent research projects will lead towards making positive and supportive changes to health care policy surrounding maternal care.”

She views this project and its interprofessional research team as integral to continuing on to farther-reaching investigative studies of the midwifery profession in Manitoba. “This is important work that needs to be done for the profession, but it’s also necessary because I feel like we’re behind other provinces,” she says.

The researcher points to problems with adequate numbers of midwives and burnout in the profession in Manitoba as areas she’s really interested in understanding, specifically the health workforce strategies in Manitoba and how they relate to the province’s midwifery profession.

“Once we’ve established a good base of evidence, we can look at the sustainability of the midwifery profession in Manitoba, and we can begin making recommendations to policies and practices that reflect client needs and needs of professional midwives more accurately,” Thiessen explains.

She adds that she would like to see the next steps of this program of research to include a larger, more in-depth cost effectiveness study investigating the efficacy and financial implications of different models of maternity care; and a more comprehensive study looking at various components of the broader health system that impact the maternity and midwifery workforce such as supply and demand, outcomes, and costs per care provider type, and overall models of care and policies that impact those models.

 Hillary Porter