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Table 3 Jurisdictional context related to prenatal smoking/alcohol use, and prenatal health services

From: Decision-making and evidence use during the process of prenatal record review in Canada: a multiphase qualitative study

  Case 1 Case 2 Case 3 Case 4 Case 5
Prevalence of prenatal smoking and alcohol use Rates of maternal smoking/alcohol use are high among the jurisdiction’s aboriginal population Rates of maternal smoking/alcohol use are lower than in other jurisdictions, but PRC feels this may be due to under-reporting Large aboriginal population with high rates of maternal smoking/alcohol use Rates of maternal smoking are high Rates of maternal smoking/alcohol use are high among the jurisdiction’s aboriginal population; increase in aboriginal birth rate has led to increased population rates of FASD
PRC assumes rates of maternal alcohol use are lower than in other jurisdictions
Key public health features related to maternal smoking and alcohol use Jurisdiction has a strong tobacco control lobby Recent local public health awareness campaigns related to maternal smoking, alcohol use and FASD Social drinking in pregnancy is common and culturally accepted among some groups Jurisdiction has a strong tobacco control lobby Active local public health awareness campaigns related to maternal smoking, alcohol use and FASD
Strong cultural values against drinking alcohol during pregnancy
Tobacco use and FASD prevention are priority public health issues
Prenatal health service Prenatal care delivered by GPs and obstetricians, with growing trend towards shared/collaborative maternity care with allied health professionals (midwives, nurses) Prenatal care delivered primarily by obstetricians (midwifery not legislated) Prenatal care delivered primarily by nurses, midwives Prenatal care providers vary in skill levels, particularly in rural areas Prenatal care delivered primarily by physicians, but nurses increasingly becoming the first point of entry of pregnant patients
Jurisdiction is developing electronic prenatal health records Jurisdiction has a perinatal database Large turn-over of health care provider workforce Midwifery in the process of being legislated Midwifery in the process of being legislated
Jurisdiction has a perinatal database Prenatal record is integrated into electronic health records Jurisdiction has a perinatal database
Jurisdiction in process of developing a perinatal database
  1. FASD: fetal alcohol spectrum disorder.