Midwifery and the family physician.

Midwives have provided care for thousands of women who have given birth in their homes over the past 15 years in Canada. Their request for legalization of midwifery services is receiving serious consideration by the governments of Ontario and Quebec. Fewer family physicians are practicing obstetrics, and those who are express concern for the safety of their patients who choose home birth. Consumers, however, argue that planned, midwife-attended birth at home is a safe option. Perinatal mortality rates are consistently low when the statistics on planned are separated from those on unexpected home births. Midwifery services can complement the role of the family physician in providing continuity of care to the laboring woman. The Dutch domiciliary midwifery service demonstrates the possibility of this service being successful, but Canada must build a service designed for Canadian needs.