Changing Childbirth in British Columbia

In 2016 the World Health Organization published a framework and description of what good maternity care should look like. A key message is that the experiences of women during pregnancy, birth and the period after birth are as important as physical health outcomes, when assessing quality of care. Experiences of childbearing women are greatly influenced by the healthcare providers they interact with. Women who see midwives, doctors or nurses who provide emotional support, communicate clearly, listen to women and respect women’s right to make decisions about their own care tend to evaluate their experiences as positive, transition into parenthood more easily and are less likely to report depression, anxiety and posttraumatic stress after birth, compared to women who report disrespectful care.


Efforts to evaluate maternity care systems against the standards set out by the WHO are underway in many countries. The focus of the Changing Childbirth in BC study was to understand how women experience maternity care in BC, especially women from disadvantaged communities. More specifically, this study set out to try and understand the experiences of women as they navigate the different options for maternity care in the province, with a special focus on respectful maternity care. Our team collected data in 2013 and 2014 using two different ways: through an online survey and through focus groups with women around the province.


Our team worked with women and community groups representing diverse communities including recent immigrants and refugees, formally incarcerated women, and those experiencing housing instability. These partners helped drive the direction of the research including picking what topics to study and the questions they wanted to ask.


Changing Childbirth in BC was the first study in the province that looked at person centred outcomes for pregnancy and birth. Over 4000 women participated in the study, from all across the province.


In the report we describe results from the online survey and preliminary findings from the focus groups, about preferences for care, experiences and outcomes of care for women in BC. Participants answered questions about their care provider, their access to care and how they were able to participate in their care and decision making.


During the project we were able to create two validated tools that measure respect (MOR Mothers on Respect Index) and autonomy (MADM Mothers’ Autonomy in Decision Making Scale) in maternity care. These tools are now being used in research and to improve care internationally.


If you have any questions about the results, please contact us

Executive Summary

Executive Summary

Download the executive summary here.

Full Report

Full Report

Download the full report here.

Help Amplify Women's Voices

Find social media content and graphics for sharing.

Help share what women want.

Find graphics, a brief video, and social media content to help share what women tell us about how they are experiencing birth in British Columbia.

What Happened to Me: Using Our Stories to Improve Birth in BC

A play inspired by conversations with families during a province wide study on pregnancy and childbirth in British Columbia

The Changing Childbirth in BC Study hosted a performance inspired by the thousands of stories families shared about their experiences of pregnancy and birth. Afterwards, participants joined for a Talk Back session, where they brought their own ideas on how to improve health care for parents and babies in BC.