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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.