Talking About Risk

CME session on birth with Dr. Kostaka attended by over 30 North Island care providers

Following a year of intensive fieldwork to understand the challenges faced by rural moms, community members and care providers in North Vancouver Island, we are now looking at how to action each of the proposed building blocks for sustainable rural maternity care.

Jude and Kira travelled up to the North Island with Dr. Andrew Kostaka, an Obstetrician from Yellowknife for focused discussions on the “Expanded Inclusion Criteria for Low-risk Deliveries” building block. Dr. Kostaka led a Continuing Medical Education session, asking care providers “what is your greatest fear” and then worked to provide evidence-based strategies for challenging scenarios. This CME session was hosted in Port McNeill and attended by over 30 participants including paramedics, physicians, nursing staff, midwives and students both in-person, and by videoconference across four sites on the North Island.

Building Blocks discussion around appropriate inclusion criteria for low-risk deliveries

The following day, we hosted a discussion in Port Hardy with the North Island physician representative group to look at decision making and risk in low-resource settings. The discussion included Sheila Jager, a midwife from Campbell River and Celina Laursen, a midwife from Haida Gwaii. Dr. Kostaka led a fascinating discussion on respecting patient choice in rural maternity care and engaged with providers in a discussion around autonomy and beneficence. UBCO FLEX student, Krista Loewen, presented her findings from the literature review she conducted on appropriate exclusion criteria for low-risk deliveries in other low-resource communities.


UNBC FLEX student Hanna Chester led two focus group discussions with North Island nurses to hear more from them of what they would need to feel supported and sustainable in providing maternity care. In response to what we are hearing from care providers around a need for more education, our next ‘building block’ will be in April, when we will support a professional development session for North Island nurses on “normal physiological birth”.