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The North Island Project began with the goal of creating a patient Decision Aid to help women decide where they should give birth (Port McNeill hospital or down island). However, after spending time in the community speaking with women and other community members,
it became clear that the maternity service needs support in order to continue to provide services.
We heard from women about the challenges they face in having to leave the community to give birth. It is often difficult to arrange transportation and it becomes challenging to travel if there are other children in the family. For many families, it is too expensive for partners or other family members to travel down island with them and the whole travel experience can make women feel very anxious.
Leaving the community also means that women and families have to find a place to stay to wait until they go into labour and again for a few days after they have had their baby. This can be difficult as women do not know how long they will need to be out of their community.
We are currently witnessing adverse outcomes due to the ongoing closures or downgrading of rural health services in British Columbia, Canada and Internationally. The loss of local maternity services and subsequent need for women and families to travel for care has resulted in poorer maternal-newborn health outcomes and a number of social challenges associated with leaving the community and dissociation from family ties and larger community social supports. Women often have to leave home several weeks before their babies are due, and are away from home for a substantial period of time while they wait to have their babies.
Aim of Project
A gap currently exists between system imperatives of birth ‘closer to home’ and health service supports that enable such care. We have not systematically looked at how we can support small rural maternity services to provide excellent, high-quality and sustainable maternity care. We will engage in feasibility analysis for each of the Building Blocks for Sustainable Maternity Care (depicted below) in order to further understand how to best support rural maternity care in British Columbia.
Timeline: May 2017 – February 2019
Location: North Vancouver Island
Funding Agency: Joint Standing Committee on Rural Issues in partnership with First Nations Health Authority
Principle Investigator: Jude Kornelsen
UBC Research Coordinator: Kira Barwich
Building Blocks to Sustainable Rural Maternity Care: The North Island Project aims to consider system supports necessary to sustain low volume services in British Columbia. This in-depth, community-driven investigation will use open-ended interviews and focus groups with community members to engage in feasibility analysis of each of the five Building Blocks to Sustainable Maternity Care.
Phase 1 involved engaging with community members to learn about their experiences of birth. Phase 2 involves creating a roadmap of how to support maternity services in Port McNeill. Funding for the project was given by the Joint Standing Committee on Rural Issues and the project is funded for 2 years. The project is being led by Jude Kornelsen in the Department of Family Practice at the University of British Columbia and we are working closely with Hannah Scrivens and the Kwakwaka’wakw Maternal Child and Family Health Project.
We will engage in a feedback loop at every phase in the data gathering with both the local community and the local and referral care provider team to ensure that community values and best clinical practices are appropriately captured and summarized. In addition, we will continue our intensive engagement with communities including indigenous communities, other community key stakeholders, administrators and care providers to reflect community priorities.
Contact us for more information!
Kira Barwich, Research Coordinator