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Non-physician providers of obstetric care in Mexico: Perspectives of physicians, obstetric nurses, and professional midwives

By Lisa M DeMaria, Lourdes Campero, Marianne Vidler and Dilys Walker

Human Resources for Health, April 25, 2012

The Mexican Ministry of Health’s 2009 strategy to reduce maternal mortality gives a role to two non-physician models that meet criteria for skilled attendants: obstetric nurses and professional midwives. This study compares and contrasts these two provider types with the medical model, analyzing perspectives on their respective training, scope of practice, and also their perception and/or experiences with integration into the public system as skilled birth attendants. This paper synthesizes qualitative research that was obtained as a component of the quantitative and qualitative study that evaluated three models of obstetric care: professional midwives (PM), obstetric nurses (ON) and general physicians (GP). A total of 27 individual interviews using a semi-structured guide were carried out with PMs, ONs, GPs and specialists. Hospitals in the Mexican public health sector have a heavy obstetric workload; physicians carry the additional burden of non-obstetric cases. The incorporation of a non- physician model at the primary health center level to attend low-risk, normal deliveries would contribute to the reduction of non-necessary referrals. There is also a role for these providers at the hospital level.

DeMaria, Lisa, Lourdes Campero, Marianne Vidler and Dilys Walker. “Non-physician providers of obstetric care in Mexico: Perspectives of physicians, obstetric nurses, and professional midwives.” Human Resources for Health, 10(6), 2012. doi:10.1186/1478-4491-10-6

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