Rural Maternity Care Research

We are a team of academic and community-based researchers interested in rural maternity care. The team is comprised of:

We believe our diversity of expertise, backgrounds and interests enhance our ability to comprehensively investigate the complexity of challenges and opportunities for rural maternity care in B.C. Our team is continually growing, so if you are interested in getting involved, please visit the page entitled Opportunities for Involvement

Our core team is based in Vancouver, and works closely together to plan and implement the direction and strategies of the RM-NET. To see a detailed biography, click on the team member’s name

The multidisciplinary nature of our team of co-investigators brings the RM-NET fresh perspectives on ways to look at maternity care in rural BC.

If you are interested in collaborating with our research team, please go to the web page entitled Opportunities for Involvement. We also encourage you to regularly check our web page entitled What’s New to learn more about upcoming events and activities. We look forward to hearing from you!

On March 18, 2005 the RM-NET hosted its first collaborators’ symposium entitled Sustainable Rural Maternity Care: Moving Forward with a Research Agenda. You can find out more about this symposium by following the link: RM-NET Collaborators Symposium 2005.

The RM-NET research agenda is supported and enhanced by affiliation with several organizations:

The RM-NET team also partners with the following agencies to fulfill our research:

Jude Kornelsen , PhD, is a sociologist who has been actively involved in facilitating and advocating for the implementation of midwifery across Canada with a particular interest in exploring differences between home and hospital birthing. For the past four years, Jude's research has focused on advancing the rural maternity care research agenda in order to build a stronger understanding of the needs of parturient rural women and their families, and consequently, how these needs can be met. As the co-principal investigator of the Rural Maternity Care New Emerging Team, Jude is currently working on several projects specifically addressing issues related to rural maternity care such as: women's experiences of rural maternity care, policy implications of health care restructuring on rural maternity care, and women's attitudes towards elective caesarean section. Jude lives on Saltspring Island with her three daughters.

Stefan Grzybowski , MD, CCFP, MClSc, FCFP, is a family physician researcher and Professor at the University of British Columbia’s Department of Family Practice. Prior to moving to UBC, Stefan practiced as a family physician for twelve years on the Queen Charlotte Islands / Haida Gwaii. As the co-principal investigator of the Rural Maternity Care New Emerging Team, Stefan’s current research focuses on the study of rural primary care and rural maternity care in British Columbia . He is committed to building research capacity in family medicine and has a long standing interest into the safety of rural maternity care. Stefan is also a co-Leader for the Michael Smith Foundation's BC Rural and Remote Health Research Network, and has two sons at the University of Victoria.

Shelagh Levangie joined the RMNET team in October of 2005 after completing a Masters of Arts in Anthropology from Concordia University, Montreal. Her Masters thesis examined the process of negotiating the United Nations Drafted Declaration on the Rights of Indigenous peoples and its meaning for Canadian First Nations, specifically the Mohawks of Kahnawake, the Canadian government and Canadian/First Nations relations. As part of her fieldwork Shelagh was a participant at the United Nations Inter-sessional Working Group on the Draft Declaration on the Rights of Indigenous Peoples in Geneva, Switzerland and the United Nations Permanent Forum on Indigenous Issues in New York, USA. Shelagh's previous work experience has been with low-income children and families and seniors from Vancouver's Downtown Eastside. Shelagh is excited about joining the RMNET team and furthering her interest in qualitative research, indigenous issues and policy.

Melanie McDonald joined the RMNET as a research assistant in October 2007. Before working at the NET, she spent 8 months as a CIDA/Help the Aged Intern in Ghana, working with the elderly and baby weigh clinics doing health education. She graduated from Mount Allison University in April 2006 with an undergraduate degree in International Relations and Anthropology. During her time at Mount Allison, she did an 8 month qualititative research field study in Thailand with migrant women working in the sex industry examining their major health concerns. She is currently pursuing her doula training and is extremely interested in the issues surrounding rural maternity care. She is currently on the research team of the RMNET's Interprofessional Collaboration and Fetal Fibronectin Testing at Term projects.

Bryce Westlake came to the RMNET in October of 2007 after completing a Bachelor of Arts degree in both Psychology and Sociology at the University of British Columbia. During this time at UBC, he conducted forensic/personality research in the Psychology department. His previous research on deviant personality and sexuality provides a different perspective to the RMNET that can be utilized on several projects. His interests in rural maternity care centre around the accessibility of care to reduce both infant mortality rates and general birthing complications. Bryce enjoys the daily opportunity to indulge his problem-solving and creative side with the projects at RMNET as well as learn more about the British Columbia health care system.

Sarah Munro joined the RM-NET in June 2007 after completing her MA (English Literature) at UBC. Her ongoing academic research has examined the language of childbirth and the influence of popular culture on women’s choices in pregnancy. During her final graduate semester, she completed a directed reading on the rhetoric of caesarean birth in popular childbirth guides under the supervision of Jude Kornelsen. Outside of the research setting, she continues actively to participate in childbirth and women’s issues as a doula and breastfeeding advocate. Sarah works with the NET as Editorial Manager, bridging her passions for language and childbirth. She is particularly interested in the NET’s focus on the psychosocial factors of rural maternity care and thrives on working collaboratively with the team to translate research into writing for rural communities, academia, and policy makers.

Kathrin Stoll joined the RM-NET as a project manager for our Stress and Pregnancy Survey and the Maternal and Newborn Outcomes project. Kathrin immigrated to Canada in 1993. She completed a BA in Psychology in 1999 and a graduate degree in Family Studies in 2004. Between 2005 and 2008 Kathrin worked on a range of research projects, including a study of the umbilical cord clamping practices and attitudes of Canadian maternity care providers, a secondary analysis of predictors of successful external cephalic version, the psychometric evaluation of a fatigue scale for use with pregnant women and new mothers, predictors of good recruitment in obstetric randomized controlled trials, research on attitudes towards pregnancy and childbirth among postsecondary students, barriers to providing and accessing skilled birth attendants in low resource settings, and most recently a study of barriers towards planned home birth among maternity care providers. Prior to working in maternity care research, Kathrin was hired to conduct the baseline research and evaluation of a Health Canada funded anti-smoking media campaign for immigrant and refugee youth. Between 2002 and 2004 Kathrin conducted a study on the psycho-social adjustment of 185 Sudanese refugee claimants (as part of her graduate studies) and also worked with the Social Planning and Research Council of British Columbia and the Canadian Center for Policy Alternatives on a national investigation of determinants of food insecurity among Canadians. Currently she is pursuing a PhD at the University of British Columbia with a focus on women’s health research.

Weihong Chen immigrated to Canada in 2001. She got her Master’s Degree in Nursing in China, and worked as a nursing teacher in Beijing before she came to Canada. Since 2003, she had been involved in a number of population health research projects, from women’s breast health, immigrants’ primary health perspectives, to adolescent health behaviors. Weihong works with the research team as an administrative research assistant. She really enjoys helping facilitate the team’s research work with her multiple administrative and research skills.

Adam McIntyre-Smith initially joined the team in May 2008 for a two-week contract, but enjoyed the atmosphere so much that he decided to stay for the foreseeable future. Adam is working towards his BSc in Microbiology & Immunology and a minor in Business. He hopes to continue his education by attending medical school in 2009. Working at the Centre for Rural Health Research will provide Adam with the opportunity to learn more about the problems facing the BC medical system and help him decide whether or not to pursue a joint MD/MBA degree. Adam enjoys applying his passion for finances and accounting and is looking forward to cultivating new interests.

Robert Reid , MD, PHD, is a primary care physician and health services researcher in the area of ambulatory case-mix adjustment, measurement of quality of primary care, and primary care organization and design, as well as the translation of preventive care research into day-to-day clinical practice. Robert has extensive experience in using large secondary administrative data sources from BC ' s health care system in observational research on health care utilization and costs. He is an adjunct professor in the UBC Department of Health Care and Epidemiology, and affiliate assistant professor in the Department of Health Services at the University of Washington. Robert is currently based at Group Health Cooperative in Seattle , the second largest non-profit health maintenance organization in the United States , where he is assistant investigator at the Center for Health Studies and medical director for Preventive Care. In addition to medical training, Robert also has an MPH in epidemiology and a PhD in health policy and management. Robert has been a principal investigator or co-investigator on research grants with funds from numerous granting agencies from both the United States and Canada.

Michael Klein , M.D., C.C.F.P., F.C.F.P., F.A.A.P. (Neonatal/Perinatal), F.C.P.S.,is a researcher, educator and physician based at Children’s & Women’s Hospital (Vancouver) who is best known for his work on the efficacy of episiotomy as a strategy to prevent perineal trauma which contributed to a dramatic reduction in episiotomy use. Recent research has measured the impact of physician practice patterns, beliefs and the institutional or organizational environment on obstetrical outcomes. This work will provide the foundation for further studies on attitudes of rural practitioners under the auspice of the RM-NET. Dr. Klein has received numerous awards, including Honorary Rural Physician (though he is an urban practitioner) and most recently, the prestigious Morris Wood Award for Lifetime Contributions to Primary Care Research from the North American Primary Care Research Group.

Nadine Schuurman, PhD is a GIScience researcher focused exclusively on population health and health services. She is the PI for a CIHR project that seeks to develop ontology-based metadata for population health research. Dr. Schuurman has developed a methodology to rationalize service areas around hospitals based on travel time. She is also involved in several projects that seek to improve location allocation decisions for rural health services. In 2006 Dr. Schuurman was awarded a CIHR New Investigators Award that enables her to devote more time to research. The computing for these projects is supported by a CFI New Opportunities grant (2002). The content for this research and Nadine's expertise in GIS mapping and analysis will support the maternity catchment area development work which is foundational to the collection of accurate quantitative data for the RM-NET. Nadine is Associate Professor of Geography at Simon Fraser University in Vancouver..

Anne-Marie Broemeling , PhD, is the Director of Information Support and Research for the Interior Health Authority in British Columbia. Anne-Marie is also a core faculty member at the Centre for Health Services & Policy Research (CHSPR), University of British Columbia specializing in health services research. Her current research focuses on chronic conditions, co-morbidity and the impact of chronic conditions and co-morbidity on utilization of services. Anne-Marie is also actively involved in research on primary health care and utilization of home and community care services by BC residents. She has extensive experience using linked health administrative data from the BC Linked Health database. Anne-Marie holds a BA in economics (with distinction) from the University of Victoria, an MSc from the London School of Economics, a PhD in Health Services Management and Policy Sciences (specializing in health economics) from the University of Texas School of Public Health, and she has completed a post-doctoral fellowship with CHSPR.

Harvey Thommasen , MD, CCFP, MSc,has been in rural practice since 1987. As a writer and researcher, Harvey has been the recipient of numerous awards for his insightful work such as a Medical Research Council Studentship and a British Columbia Lung Association Award. He translated these awards into a Canadian Heart Foundation Medical Scientist Fellowship as he continued his medical training and research skill development under the mentorship of Dr. Jim Hogg at St. Paul ’s Hospital. Harvey has 66 publications in medical journals and has written 4 books combining his love of nature with his medical practice. Harvey received the Order of British Columbia in May 2000, the David Bachop Gold Medal for Distinguished Medical Service in 2001, the Queen’s Golden Jubilee Medal in 2003, and the Order of Canada in 2006. From 2001 to 2003 Harvey served as Professor and Chair, Department of Community Health at the University of Northern British Columbia . He was awarded a community based clinician investigator position in September of 2003. Harvey ’s strong and established relationships with rural communities enable and enhance the goals and objectives of the RM-NET. His presence as a ‘front line” rural care provider will provide insights into the proposed research, generate ongoing hypothesis for future studies and facilitate knowledge transfer to community members.

Andrew Kotaska, MD, FRCSC. After receiving his medical degree from UBC in 1992, Andrew completed a one-year rotating internship in Victoria before venturing into rural family practice. He acquired further training in surgical obstetrical skills under the auspices of the United Church Health Services and practiced obstetrics in the communities of Bella Bella and Smithers for seven years. In 2000, a fledgling interest in research was nurtured as a part-time clinical investigator with UBC's Department of Family Practice. A desire to delve more deeply into research and teaching then prompted a return to a residency position in obstetrics and gynecology at UBC. He received his fellowship with the Royal College in 2006 and now works as a consultant at Stanton Territorial Hospital in Yellowknife, NT. Andrew's research interests include the rural provision of obstetrical services, training of family physicians in advanced obstetrical skills, practical approaches to every day problems in obstetrics and gynecology, and the limitations of evidence-based medicine, particularly as currently applied to complex phenomena.

Carlo Marra, PharmD, PhD, is Head of the Health Economics Programme at Vancouver Coastal Health Research Institute, Director of the Collaboration of Outcomes Research and Evaluation, and an Assistant Professor in the Faculty of Pharmaceutical Sciences. Carlo holds a Tier 2 Canada Research Chair in Pharmaceutical Outcomes and is a Michael Smith Foundation for Health Research Scholar. Carlo has extensive experience in the economic evaluation of health care strategies using modeling techniques (decision analysis, discrete event simulation) and conducting cost-effectiveness studies alongside clinical trials. Carlo is also very interested in the intergration of quality of life measures and patient preferences into this type of research. Finally, as a pharmacist, Carlo is very interested in exploring ways that pharmacists can improve chronic disease management in a cost-effective manner.

Karen MacKinnon is currently an Assistant Professor in the School of Nursing at the University of Victoria. She recently completed Postdoctoral Research Fellowship at the Centre for Rural Health Research in Vancouver and is studying rural nurses' experiences with providing maternity care in a variety of rural practice settings across BC. She received her PhD in Nursing at the University of Calgary in 2005 and her doctoral dissertation examined the social determinants of women's preterm labour experiences. Karen is building a research program that focuses on social justice issues affecting women's childbearing experiences and perinatal nursing practice. She has also been involved in research about women's experiences of the nurse's presence during childbirth; the effects of hydrotherapy (water immersion) on women's discomfort/labour pain; continuity of care; early postpartum discharge and infant crying. Karen is a certified Perinatal Nurse who works as a nurse educator and researcher. In the past she has worked as a Clinical Nurse Specialist; as Program Director for the Family Birth Centre Demonstration Project in Brampton Ontario; and as a Community Health Nurse, Childbirth Educator and Lactation Consultant. Karen has also been inovled with AWHONN Canada (Past Chair), with the Canadian Nurses' Association developing Standards for Perinatal Nursing and the CNA Perinatal certification exam. She has also represented nursing on SOGC Council and has a strong interest in interprofessional education and collaborative practice.

Shiraz Moola, MD, FRCSC is currently a solo Obstetrician/Gynaecologist practicing in Nelson, British Columbia. After completing an undergraduate medical degree at Queens University, he completed a postgraduate residency at the University of Toronto. During that time he had the opportunity to train and perform research in rural Zimbabwe and in South Africa. Following his residency he provided consultant care in the Yukon, Northwest Territories and Nunavut. He then worked as a surgical associate in the division of gynaecology oncology at the University of Western Ontario before returning to the Arctic. Serendipity brought him to the Kootenays to take up his current post. He continues to pursue research as a co-investigator with the Rural Maternity Care New Emerging Team (RM-NET). His other research interests include critical care obstetrics, health outcomes research. His clinical interests include ultrasound, minimally invasive surgery and oncology. He has two children, Rohan and Khalil that remain happily growing concerns.