Building Blocks to Sustainable Rural Maternity Care: Toward a Systems Approach to Service Planning.

This qualitative study aimed to understand, document and analyze system supports needed to sustain rural maternity care in communities without local access to Caesarean section. In-depth interviews and focus groups with 58 healthcare providers and administrators from rural British Columbia were conducted in 2017/2018. Themes from the data led to the development of five systems interventions necessary to stabilize local maternity care: (1) building nursing confidence; (2) supporting interprofessional teams; (3) efficient transport to referral sites; (4) clear inclusion criteria for local deliveries; and (5) enhanced relationships with referral centres.