Preface - Family-Centred Maternity and Newborn Care: National Guidelines

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A Message from Canada’s Chief Public Health Officer

I am pleased to introduce the newly updated Family-Centred Maternity and Newborn Care: National Guidelines.

Updating the guidelines is one of many activities that the Public Health Agency of Canada carries out to promote and improve the health of mothers, babies and families in Canada. These guidelines originated in 1968 as the Recommended Standards for Maternity and Newborn Care, and have evolved over the years as the concept of family-centred care was introduced.

It is my hope that the revised guidelines serve as a valuable resource for health care providers, policy makers, administrators and parents in planning, implementing and evaluating maternal and newborn care. I believe that they can help facilitate the application of family-centred care from preconception to postpartum, and beyond.

I want to personally thank the many experts from across Canada who contributed to this update. Their expertise and dedication to the revision process have greatly enhanced the Family-Centred Maternity and Newborn Care: National Guidelines and will translate into improved care for millions of Canadian families.

Dr. Theresa Tam
Chief Public Health Officer
Public Health Agency of Canada

History of the guidelines

National guidelines for maternal and newborn care in Canada were first published in 1968 and revised in 1975, 1987 and 2000, making this edition the fifth. The first two versions were titled Recommended Standards for Maternity and Newborn Care and were consistent with an accepted approach to perinatal care that had yet to recognize the crucial nature of family-centred care for mothers, babies and families.

By 1987, a broader, more inclusive approach—incorporating all significant members of the familyFootnote + —had become widely recognized and accepted. As a result, both the focus and the title of this document evolved to Family-Centred Maternity and Newborn Care: National Guidelines.

Purpose of the guidelines

The Family-Centred Maternity and Newborn Care: National Guidelines are intended to assist health care organizations, providers, program planners, policy makers, administrators and families to propose, plan, implement and evaluate maternal and newborn health care policies and practices. They are not considered clinical practice guidelines (CPGs), although CPGs originating from such bodies as The Society of Obstetricians and Gynaecologists of Canada (SOGC), and the UK’s National Institute for Health and Care Excellence (NICE), as well as from the provinces (such as British Columbia’s perinatal guidelines), have been extensively consulted to determine the optimal recommended principles and practices.

Many factors were considered in developing these guidelines, including: the strengths and limitations of technological developments in maternal and newborn health care; the richness of the Canadian mosaic with its culturally diverse population; the recognition of Canada’s responsibility to Indigenous Peoples; the multifaceted nature of health care that incorporates psychological, social, cultural and spiritual components, in addition to biological health; the changing nature of families as they face evolving economic and social demands; and our country’s vast geographical and climatic challenges. These considerations have been filtered through the lens of the Canada Health Act and its primary objective which is “to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers”.

The opening chapter introduces the overall philosophy and guiding principles underlying family-centred maternal and newborn care in Canada. Chapters 2 to 5 review maternal and newborn care during the transition to parenthood from the preconception period, through pregnancy, labour and birth, to early postpartum care (including transition to the community). Chapter 6 focuses on breastfeeding and Chapter 7 on perinatal loss and grief. Chapter 8 describes the organization of maternal and newborn care services. Chapter 9, an epilogue, provides insights into future directions for maternal and newborn care in Canada.

Acknowledgements

The Family-Centred Maternity and Newborn Care: National Guidelines have been produced in collaboration with the Oversight Committee who have provided innumerable hours of their time and expertise since the beginning of the update in 2012. We thank them for their incredible contribution, including:

Khalid Aziz, MA, MEd(IT), FRCPC, FRCPCH, FAAP
Professor
Department of Pediatrics
University of Alberta
Edmonton, Alberta

Anne Biringer, MD CCFP FCFP
Associate Professor
Family and Community Medicine
University of Toronto
Ada and Slaight Family Director of Maternity Care
Ray D Wolfe Department of Family Medicine
Sinai Health System
Toronto, Ontario

Beverley Chalmers, DSc(Med), PhD
International Perinatal Health Consultant
Kingston, Ontario

Luisa Ciofani, RN, M.Sc.(A), IBCLC, PNC(C)
Associate Director of Nursing
Women's Health
McGill University Health Centre
Montreal, Quebec

Sherri Di Lallo, RN, BScN, MN
Aboriginal Nursing Project Lead and Faculty Lecturer
Faculty of Nursing
University of Alberta
Edmonton, Alberta

Michelle LeDrew, RN, BN, MN, CHE
Board of Directors member
Breastfeeding Committee for Canada
Director
Women’s and Newborn Health Program
IWK Health Centre
Halifax, Nova Scotia

Adèle Lemay
Program Consultant
Maternal and Child Health
Public Health Agency of Canada
Ottawa, Ontario

Lynn M. Menard, RN, BScN, MA
Team Leader
Maternal and Child Health
Public Health Agency of Canada
Ottawa, Ontario

Katherine J. Miller, MD, CCFP, FCFP, FRRMS
Past Chair
Maternal Newborn Committee
Society of Rural Physicians of Canada
Assistant Clinical Professor
Department of Family Medicine
McMaster University
Guelph, Ontario

Joanna Nemrava, RM
Past President
Canadian Association of Midwives
Chief
Department of Midwifery
Royal Inland Hospital
Kamloops, British Columbia

The revisions to the Family-Centred Maternity and Newborn Care: National Guidelines could not have been completed without the tremendous effort and cooperation of many individuals and organizations who participated in the update. We thank each of the authors who are listed at the front of each chapter.

The Public Health Agency of Canada would also like to thank the members of the Interdepartmental Working Group for their collaboration and expert review of content.

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