Overview

I am best known as principal investigator for the only North American randomized controlled trial of episiotomy, which showed that episiotomy caused the very problems it was supposed to prevent.

I have continued to focus on best practices in maternity care to help achieve optimal outcome for mothers and newborns. We continue to study the attitudes and beliefs of all those who care for women in their pregnancies and births – family physicians, obstetricians, midwives, nurses, doulas and trainees in these disciplines – as well as the women themselves. These studies demonstrate that attitudes have direct impact on outcome.

The health of rural communities and the place of maternity care in sustainable communities, as well as related areas of safety of rural maternity care and optimal strategies for safe maternity care in any setting, continue to be the focus of my work.

Publications

How I learned to love midwifery and stop worrying about episiotomy
Canadian Journal of Midwifery Research and Practice
04/2017

Evaluation of a Patient Education Pamphlet for Women Considering Vaginal Birth After Cesarean
The Journal of Perinatal Education
Sarah Munro, Kathryn Dewar, Elizabeth Wilcox, Michael C. Klein, Patricia A. Janssen
DOI: 10.1891/1058-1243.26.1.37
01/2017

The refugee experience of acquiring a family doctor
International Journal of Migration, Health and Social Care
Karen J. Grant, Maureen Mayhew, Lorena Mota, Michael C. Klein, Arminée Kazanjian
DOI: 10.1108/ijmhsc-12-2013-0047
03/2015

Nothing Fails Like Success-The Great Immunization Debate
Birth
Michael C. Klein
DOI: 10.1111/birt.12169
03/2015

The Canadian birth place study: examining maternity care provider attitudes and interprofessional conflict around planned home birth
BMC Pregnancy and Childbirth
Saraswathi Vedam, Kathrin Stoll, Laura Schummers, Nichole Fairbrother, Michael C Klein, Dana Thordarson, Jude Kornelsen, Shafik Dharamsi, Judy Rogers, Robert Liston, Janusz Kaczorowski
DOI: 10.1186/1471-2393-14-353
10/2014

The modified medical office assistant role in rural diabetes care.
Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la medecine rurale : le journal officiel de la Societe de medecine rurale du Canada
PubMed: 24698753
2014

Improved outcomes for elderly patients who received care on a transitional care unit
Canadian Family Physician
Manville, Margaret and Klein, Michael C. and Bainbridge, Lesley
2014

Competency in rural practice.
Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la medecine rurale : le journal officiel de la Societe de medecine rurale du Canada
PubMed: 24698749
2014

How birth doulas help clients adapt to changes in circumstances, clinical care, and client preferences during labor.
The Journal of perinatal education
DOI: 10.1891/1058-1243.23.2.96
PubMed: 24839384
2014

Cesarean Section on Maternal Request: A Societal and Professional Failure and Symptom of a Much Larger Problem
Birth
Michael C. Klein
DOI: 10.1111/birt.12006
11/2012

The Canadian Birth Place Study: Describing maternity practice and providers' exposure to home birth
Midwifery
Saraswathi Vedam, Laura Schummers, Kathrin Stoll, Judy Rogers, Michael C. Klein, Nichole Fairbrother, Shafik Dharamsi, Robert Liston, Gua Khee Chong, Janusz Kaczorowski
DOI: 10.1016/j.midw.2012.06.011
10/2012

Pre-University Students’ Attitudes and Beliefs about Childbirth
Canadian Journal of Midwifery Research and Practice
07/2012

Canadian care providers' and pregnant women's approaches to managing birth: minimizing risk while maximizing integrity.
Qualitative health research
DOI: 10.1177/1049732311424292
PubMed: 21940939
05/2012

The Tyranny of Meta-analysis and the Misuse of Randomized Controlled Trials in Maternity Care
Birth
Michael C. Klein
DOI: 10.1111/j.1523-536x.2011.00522.x
02/2012

Factors associated with differences in Canadian perinatal nurses' attitudes toward birth practices.
Journal of obstetric, gynecologic, and neonatal nursing : JOGNN
DOI: 10.1111/j.1552-6909.2012.01412.x
PubMed: 23030678
2012

Early versus late epidural analgesia and the risk of instrumental delivery in nulliparous women.
BJOG : an international journal of obstetrics and gynaecology
DOI: 10.1111/j.1471-0528.2011.03078.x
PubMed: 21988850
11/2011

Birth technology and maternal roles in birth: knowledge and attitudes of canadian women approaching childbirth for the first time.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
DOI: 10.1016/s1701-2163(16)34908-8
PubMed: 21846449
06/2011

Family physicians who provide intrapartum care and those who do not: very different ways of viewing childbirth.
Canadian family physician Medecin de famille canadien
PubMed: 21490345
04/2011

Attitudes of the New Generation of Canadian Obstetricians: How Do They Differ from Their Predecessors?
Birth
Michael C. Klein, Robert Liston, William D. Fraser, Nazli Baradaran, Stephen J. C. Hearps, Jocelyn Tomkinson, Janusz Kaczorowski, Rollin Brant, The Maternity Care Research Group
DOI: 10.1111/j.1523-536x.2010.00462.x
03/2011

Epidural analgesia for pain management: the positive and the negative
Promoting Normal Birth: Research, Reflections & Guidelines
2011

Many women and providers are unprepared for an evidence-based, educated conversation about birth.
The Journal of perinatal education
DOI: 10.1891/1058-1243.20.4.185
PubMed: 22942620
2011

Midwives' belief in normal birth: The Canadian Survey of maternity care provider's attitudes toward labour and birth
Canadian Journal of Midwifery
2011

Time for improved standards for studies of home birth.
American journal of obstetrics and gynecology
DOI: 10.1016/j.ajog.2010.04.042
PubMed: 20579965
11/2010

The life of a Canadian doula: successes, confusion, and conflict.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
PubMed: 20707952
07/2010

A Mirage of Change: Family-Centered Maternity Care in Practice
Birth
Vania Jimenez, Michael C. Klein, Myriam Hivon, Catherine Mason
DOI: 10.1111/j.1523-536x.2010.00396.x
06/2010

What Do Episiotomy and Cesarean Have to Do with Copernicus, Galileo, and Newton?
Birth
Michael C. Klein
DOI: 10.1111/j.1523-536x.2009.00371.x
03/2010

Development of a Support Tool for Complex Decision-Making in the Provision of Rural Maternity Care
Healthcare Policy | Politiques de Santé
Glen Hearns, Michael Klein, William Trousdale, Catherine Ulrich, David Butcher, Christiana Miewald, Ronald Lindstrom, Sahba Eftekhary, Jessica Rosinski, Oralia Gómez-Ramírez, Andrea Procyk
DOI: 10.12927/hcpol.2013.21641
02/2010

Evidence-based Practice in Maternity Care: Examining the Evidence
Woman-Centered Care in Pregnancy and Childbirth
2010

Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician.
CMAJ : Canadian Medical Association Journal
DOI: 10.1503/cmaj.081869
PubMed: 19720688
09/2009

The attitudes of Canadian maternity care practitioners towards labour and birth: many differences but important similarities.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
DOI: 10.1016/s1701-2163(16)34301-8
PubMed: 19941707
09/2009

"Preventive induction" fails to demonstrate benefits for mothers or newborn infants.
American journal of obstetrics and gynecology
DOI: 10.1016/j.ajog.2008.08.025
PubMed: 18823874
04/2009

A Tribute to Phil Hall
Birth
DOI: 10.1111/j.1523-536x.2008.00298.x
03/2009

Preventive Labor Induction-AMOR-IPAT: Much Promise, Not Yet Realized
Birth
Michael C. Klein
DOI: 10.1111/j.1523-536x.2008.00301.x
03/2009

Development and evaluation of a Chinese-language newborn feeding hotline: a prospective cohort study.
BMC pregnancy and childbirth
DOI: 10.1186/1471-2393-9-3
PubMed: 19178746
2009

Birth Models That Work - Edited Robbie E. Davis-Floyd, Lesley Barclay, Betty-Anne Daviss, and Jan Tritten
Birth
Brenda Kent, Michael C. Klein
DOI: 10.1111/j.1523-536x.2009.00368_2.x
2009

How do physicians and midwives manage the third stage of labor?
Birth (Berkeley, Calif.)
DOI: 10.1111/j.1523-536x.2008.00243.x
PubMed: 18844648
09/2008

HYPONATREMIA FOLLOWING ASPHYXIA NEONATORUM
Acta Paediatrica
WILLIAM FELDMAN, KEITH N. DRUMMOND, MICHAEL KLEIN
DOI: 10.1111/j.1651-2227.1970.tb15514.x
01/2008

Informed decision-making: the interaction between sustainable maternity care services and community sustainability—a decision support manual
The Maternity Care Research Group
2008

The Patient-Centered (R)Evolution
Birth
Michael C. Klein, Murray W. Enkin, Andrew Kotaska, Sara G. Shields
DOI: 10.1111/j.1523-536x.2007.00180.x
09/2007

Does Cesarean Section Reduce Postpartum Urinary Incontinence? A Systematic Review
Birth
Joshua Z Press, Michael C Klein, Janusz Kaczorowski, Robert M. Liston, Peter von Dadelszen
DOI: 10.1111/j.1523-536x.2007.00175.x
09/2007

Association Not Causation: What Is the Intervention?
The Annals of Family Medicine
M. C. Klein
DOI: 10.1370/afm.729
07/2007

Outcomes of Planned Hospital Birth Attended by Midwives Compared with Physicians in British Columbia
Birth
Patricia A. Janssen, Elizabeth M. Ryan, Duncan J. Etches, Michael C. Klein, Birgit Reime
DOI: 10.1111/j.1523-536x.2007.00160.x
06/2007

Postpartum maternal and newborn discharge.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
DOI: 10.1016/s1701-2163(16)32444-6
PubMed: 17475130
04/2007

The Shaman: the medicine man has not died
JP Sturmberg, ed. The Foundations of Primary Care: daring to be different
2007

Standards for the measurement of birth weight, length and head circumference at term in neonates of European, Chinese and South Asian ancestry.
Open medicine : a peer-reviewed, independent, open-access journal
PubMed: 20101298
2007

Early labor assessment and support at home versus telephone triage: a randomized controlled trial.
Obstetrics and gynecology
DOI: 10.1097/01.aog.0000247644.64154.bb
PubMed: 17138781
12/2006

Not safer and not cheaper?
Canadian Medical Association Journal
M. Klein
DOI: 10.1503/cmaj.1060106
11/2006

Why Do Women Go Along with This Stuff?
Birth
Michael C. Klein, Carol Sakala, Penny Simkin, Robbie Davis-Floyd, Judith P. Rooks, Jane Pincus
DOI: 10.1111/j.1523-536x.2006.00110.x
09/2006

IN THE LITERATURE: Pushing in the Wrong Direction
Birth
Michael C. Klein
DOI: 10.1111/j.1523-536x.2006.00111.x
09/2006

Epidural Analgesia: Is It Increasing C-Section Rates
Canadian Journal of Diagnosis
08/2006

Does epidural analgesia increase rate of cesarean section?
Canadian family physician Medecin de famille canadien
PubMed: 16639961
04/2006

Epidural analgesia associated with low-dose oxytocin augmentation increases cesarean births: a critical look at the external validity of randomized trials.
American journal of obstetrics and gynecology
DOI: 10.1016/j.ajog.2005.09.014
PubMed: 16522417
03/2006

Epidural Analgesia: Does It or Doesn’t It?
Birth
Michael C. Klein
DOI: 10.1111/j.0730-7659.2006.00076.x
02/2006

Maternal transport policy.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
PubMed: 16411011
10/2005

Obstetrician's Fear of Childbirth: How Did It Happen?
Birth
Michael C. Klein
DOI: 10.1111/j.0730-7659.2005.00371.x
09/2005

Intrathecal analgesia and the cesarean rate.
The Journal of family practice
PubMed: 16061056
08/2005

Maternity Care by Family Physicians: Characteristics of Successful and Sustainable Models
Journal of Obstetrics and Gynaecology Canada
David J. Price, Carolyn Lane, Michael C. Klein
DOI: 10.1016/s1701-2163(16)30528-x
05/2005

A comparison of urinary and sexual outcomes in women experiencing vaginal and Caesarean births.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
DOI: 10.1016/s1701-2163(16)30459-5
PubMed: 15937606
04/2005

Early epidurals increase caesarean rate, meta-analysis shows.
BMJ : British Medical Journal
DOI: 10.1136/bmj.330.7494.790-b
04/2005

Perinatal nursing education for single-room maternity care: an evaluation of a competency-based model
Journal of Clinical Nursing
Patricia A Janssen, Lois Keen, Jetty Soolsma, Laurie C Seymour, Susan J Harris, Michael C Klein, Birgit Reime
DOI: 10.1111/j.1365-2702.2004.01014.x
01/2005

Perinatal outcomes at Bella Coola General Hospital: 1940 to 2001.
Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la medecine rurale : le journal officiel de la Societe de medecine rurale du Canada
PubMed: 15656920
2005

Obstetric maternal outcomes at Bella Coola General Hospital: 1940 to 2001.
Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la medecine rurale : le journal officiel de la Societe de medecine rurale du Canada
PubMed: 15656919
2005

Cesarean section on Demand: Is it ethical?
Canadian Journal of Diagnosis
2005

Quick Fix Culture: The Cesarean-Section-on-Demand Debate
Birth
Michael C. Klein
DOI: 10.1111/j.0730-7659.2004.00300.x
09/2004

Outcomes after vacuum-assisted deliveries. Births attended by community family practitioners.
Canadian family physician Medecin de famille canadien
PubMed: 15455810
08/2004

Guidelines for operative vaginal birth.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
PubMed: 15307980
08/2004

Single Room Maternity Care: Perinatal Outcomes, Economic Costs, and Physician Preferences
Journal of Obstetrics and Gynaecology Canada
Susan J. Harris, Malcolm D. Farren, Patricia A. Janssen, Michael C. Klein, Shoo K. Lee
DOI: 10.1016/s1701-2163(16)30610-7
07/2004

Guidelines for Vaginal Birth after Previous Caesarean Birth
Journal of Obstetrics and Gynaecology Canada
DOI: 10.1016/s1701-2163(16)30614-4
07/2004

The effect of family physician timing of maternal admission on procedures in labour and maternal and infant morbidity.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
DOI: 10.1016/s1701-2163(16)30611-9
PubMed: 15248933
07/2004

Elective cesarean section.
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
DOI: 10.1503/cmaj.1040516
PubMed: 15238478
07/2004

Does experience or delivery volume of family physicians predict maternal and newborn outcomes?
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
PubMed: 14970076
02/2004

Conception, Pregnancy and Childbirth
Oxford Textbook of Primary Medical Care
2004

Do maternity care provider groups have different attitudes towards birth?
BJOG: An International Journal of Obstetrics and Gynaecology
Birgit Reime, Michael C. Klein, Ann Kelly, Nancy Duxbury, Lee Saxell, Robert Liston, Frederique Josephine Petra Maria Prompers, Robert Stefan Willem Entjes, Victor Wong
DOI: 10.1111/j.1471-0528.2004.00338.x
2004

Management of labor pain: promoting patient choice.
American family physician
PubMed: 14524393
09/2003

Improving competence in maternity care. Women's Advanced Maternity Fellowship for Rural Practitioners.
Canadian family physician Medecin de famille canadien
PubMed: 14526868
09/2003

The nature and management of labor pain: part II. Pharmacologic pain relief.
American family physician
PubMed: 14524398
09/2003

The nature and management of labor pain: part I. Nonpharmacologic pain relief.
American family physician
PubMed: 14524397
09/2003

Delivery volume debated.
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
10/2002

The management of nausea and vomiting of pregnancy.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
PubMed: 12405123
10/2002

In for the long haul. Which family physicians plan to continue delivering babies?
Canadian family physician Medecin de famille canadien
PubMed: 12166012
07/2002

Mothers, babies and communities. Centralizing maternity care exposes mothers and babies to complications and endangers community sustainability.
Canadian Family Physician
07/2002

Hemorrhagic shock.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
PubMed: 12196857
06/2002

Does delivery volume of family physicians predict maternal and newborn outcome?
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
PubMed: 12041842
05/2002

Risk Factors for Difficult Delivery in Nulliparas With Epidural Analgesia in Second Stage of Labor
Obstetrics & Gynecology
William D. Fraser, Mireille Cayer, Bettina M. Soeder, Lucile Turcot, Sylvie Marcoux
DOI: 10.1097/00006250-200203000-00008
03/2002

Use of Episiotomy in the United States
Birth
Michael C. Klein
DOI: 10.1046/j.1523-536x.2002.0163a.x
03/2002

Outcomes of planned home births versus planned hospital births after regulation of midwifery in British Columbia.
CMAJ : Canadian Medical Association Journal
PubMed: 11868639
02/2002

Striae gravidarum as a predictor of vaginal lacerations at delivery.
Southern medical journal
PubMed: 11592761
09/2001

Single Room Maternity Care: The Nursing Response
Birth
Patricia A. Janssen, Susan J. Harris, Jetty Soolsma, Michael C. Klein, Laurie C. Seymour
DOI: 10.1046/j.1523-536x.2001.00173.x
09/2001

Differences in institutional cesarean delivery rates-the role of pain management.
The Journal of family practice
PubMed: 11252209
03/2001

Epidural Analgesia Use as a Marker for Physician Approach to Birth: Implications for Maternal and Newborn Outcomes
Birth
Michael C. Klein, Stefan Grzybowski, Sue Harris, Robert Liston, Andrea Spence, Grace Le, Dorothea Brummendorf, Sharon Kim, Janusz Kaczorowski
DOI: 10.1046/j.1523-536x.2001.00243.x
2001

Privileging and consultation in maternity and newborn care
Canadian Family Physician
09/2000

The Quebec midwifery experiment: lessons for Canada.
Canadian journal of public health = Revue canadienne de sante publique
PubMed: 10765572
2000

Single Room Maternity Care and Client Satisfaction
Birth
Patricia A Janssen, Michael C Klein, Susan J Harris, Jetty Soolsma, Laurie C Seymour
DOI: 10.1046/j.1523-536x.2000.00235.x
2000

Managing hyperbilirubinemia in term newborn infants.
Canadian family physician Medecin de famille canadien
PubMed: 10587756
11/1999

Launch of a rural advanced maternity care curriculum.
Canadian family physician Medecin de famille canadien
PubMed: 10540681
10/1999

Practice tips. A method for presenting maternal serum screening. Promoting choice and saving time.
Canadian family physician Medecin de famille canadien
PubMed: 10463088
08/1999

Maternal serum screening.
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
PubMed: 10234333
04/1999

Walking in labor.
The Journal of family practice
PubMed: 10086770
03/1999

You Be the Husband and Let Me Be the Doctor
Patients and Doctors: Life changing stories from primary care
1999

Advanced Life Support in Obstetrics: Practical approaches to obstetric emergencies
Canadian Family Physician
11/1998

Joint Position Paper on Rural Maternity Care
Journal SOGC
DOI: 10.1016/s0849-5831(98)80041-4
04/1998

Rural obstetrics. Joint position paper on rural maternity care. Joint Working Group of the Society of Rural Physicians of Canada (SRPC), The Maternity Care Committee of the College of Family Physicians of Canada (CFPC), and the Society of Obstetricians and Gynaecologists of Canada (SOGC).
Canadian family physician Medecin de famille canadien
PubMed: 9585856
04/1998

Factors Influencing Perineal Trauma during Delivery
Journal SOGC
Michael C. Klein, Patricia A. Janssen
DOI: 10.1016/s0849-5831(98)80006-2
02/1998

Teenage Pregnancy and Adolescent Sexuality: Present Status, Practice Issues, Effective Strategies
BC Medical Journal
02/1998

Providing high-quality maternity care.
Canadian family physician Medecin de famille canadien
06/1997

Determinants of vaginal-perineal integrity and pelvic floor functioning in childbirth.
American journal of obstetrics and gynecology
DOI: 10.1016/s0002-9378(97)70506-4
PubMed: 9065189
02/1997

Attitudes toward obstetrics training. Residents surveyed at McGill University and University of Montreal.
Canadian family physician Medecin de famille canadien
PubMed: 9040911
02/1997

A randomized trial of a program of early postpartum discharge with nurse visitation.
American journal of obstetrics and gynecology
DOI: 10.1016/s0002-9378(97)80037-3
PubMed: 9024115
01/1997

How can second-stage management prevent perineal trauma? Critical review.
Canadian family physician Medecin de famille canadien
PubMed: 9626426
01/1997

Too close for comfort? A family physician questions whether medical professionals should be excluded from their loved ones' care.
CMAJ : Canadian Medical Association Journal
PubMed: 9006566
01/1997

A new role model for maternity care.
Canadian family physician Medecin de famille canadien
PubMed: 9626413
01/1997

One-to-one Nurse Support in Labor
Birth
Michael C. Klein, Mayri Sagady
DOI: 10.1111/j.1523-536x.1997.tb00606.x
1997

CFPC-SRPC: hot-wired at lastLetter
Canadian Journal of Rural Medicine
1997

Controversies surrounding the administration of vitamin K to newborns: a review.
CMAJ : Canadian Medical Association Journal
PubMed: 8564900
02/1996

Episiotomy results stand despite lack of compliance.
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
PubMed: 8529183
12/1995

Studying episiotomy: when beliefs conflict with science.
The Journal of family practice
PubMed: 7595267
11/1995

Physicians' beliefs and behaviour during a randomized controlled trial of episiotomy: consequences for women in their care.
CMAJ : Canadian Medical Association Journal
PubMed: 7664230
09/1995

Family Physician Maternity Care: outcomes when family physicians provide most community-based care (an editorial)
Canadian Family Physician
04/1995

Relationship of episiotomy to perineal trauma and morbidity, sexual dysfunction, and pelvic floor relaxation.
American journal of obstetrics and gynecology
DOI: 10.1016/0002-9378(94)90070-1
PubMed: 8092203
09/1994

The midwife dossier: cooperation or competition?
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
PubMed: 8313284
03/1994

Primary Care: The Effectiveness of Family Practice Maternity Care: a cross cultural and environmental view
Primary care obstetrics
09/1993

The Active Management of labor: Whose Agenda?
Birth
Michael Klein
DOI: 10.1111/j.1523-536x.1993.tb00425.x
06/1993

Episiotomy as a Preventive Strategy: Does it work?
Journal of the Society of Obstetricians and Gynaecologists of Canada
06/1993

The Impact of the Rochester Neighbourhood Health Center on the Hospitalization of Children
Haggerty, R.J. et al. Ed. Child Health and the Community, John Wiley & Son (2nd edition)
1993

Does episiotomy prevent perineal trauma and pelvic floor relaxation?
The Online journal of current clinical trials
PubMed: 1343606
07/1992

Vitamin D Deficiency Rickets is still with us: a case report
Canadian Family Physician
1992

Do Women Under the Care of Family Physicians Have Fewer Cesarean Sections?
Family Practice Research
1992

Midwifery - A Family Doctor's View from Quebec
Birth
Michael Klein
DOI: 10.1111/j.1523-536x.1991.tb00069.x
06/1991

The Demise of the Rotating Internship and Family Practice Program Expansion: View from the trenches.
Canadian family physician Medecin de famille canadien
PubMed: 21229001
03/1991

Structure of Practice and Obstetrical Research
Family Medicine Research Update
1991

The Influence of Birth Setting on the Father's Behavior Toward His Partner and Infant
Birth
Ruta Westreich, Liliane Spector-Dunsky, Michael Klein, Apostolos Papageorgiou, Michael Kramer, Morrie Gelfand
DOI: 10.1111/j.1523-536x.1991.tb00102.x
1991

Influence of Perinatal Asphyxia on Neurologic Outcome: consequences for family practice accoucheurs
Canadian Family Physician
PubMed: 21233995
10/1990

Miscarriage: Etiology, Treatment and Practical Considerations
Canadian Family Physician
1988

Maternal and Neonatal Outcome in Pregnancies with No Risk FactorsLetter
Canadian Medical Association Journal
1988

Is maternity care different in family practice? A pilot matched pair study
The Journal of family practice
1987

Perinatal Care in Europe: Lessons to be learned
Canadian Family Physician
1987

The Canadian Family Practice Accoucheur
Canadian Family Physician
PubMed: PMC2327651
03/1986

Emergency Gyn/OB: Title's A Misnomer.
Canadian family physician Medecin de famille canadien
05/1984

Outcomes of Birthing Rooms
Journal of Family Practice
03/1984

Birth Rooms - are they an answer to consumer dissatisfaction with maternity care
Maternal and Child Health
03/1984

Who Should Provide Primary Health Care to Children: Pediatricians or Family Medicine Physicians?
Pediatrics
Hoekelman, Robert A. and Klein, Michael and Strain, James E.
1984

Birth Room Transfer and Procedure Rates ? What Do They Tell About the Setting?
Birth
Michael Klein, Ruta Westreich
DOI: 10.1111/j.1523-536x.1983.tb01407.x
06/1983

A comparison of low-risk pregnant women booked for delivery in two systems of care: shared-care (consultant) and integrated general practice unit. II. Labour and delivery management and neonatal outcome
BJOG: An International Journal of Obstetrics and Gynaecology
MICHAEL KLEIN, IVOR LLOYD, CHRISTOPHER REDMAN, MICHAEL BULL, A. C. TURNBULL
DOI: 10.1111/j.1471-0528.1983.tb08895.x
02/1983

A comparison of low-risk pregnant women booked for delivery in two systems of care: shared-care (consultant) and integrated general practice unit. I. Obstetrical procedures and neonatal outcome
BJOG: An International Journal of Obstetrics and Gynaecology
MICHAEL KLEIN, IVOR LLOYD, CHRISTOPHER REDMAN, MICHAEL BULL, A. C. TURNBULL
DOI: 10.1111/j.1471-0528.1983.tb08894.x
02/1983

[Satisfaction of couples towards birth when using a birthing room or the traditional delivery room.].
Sante mentale au Quebec
PubMed: 17093783
1983

Contracting for Trust in Family Practice Obstetrics
Canadian Family Physician
PubMed: PMC2154275
1983

Teaching the Behavioral Sciences in Family Medicine
Canadian Family Physician
PubMed: PMC2305985
05/1981

What Do Family Practice Residents Do in Prevention and Counselling?
Canadian Family Physician
04/1981

Low Birth Weight and the Battered Child Syndrome
Traumatic Abuse and Neglect of Children at Home
1980

Teaching Through One Way Glass
Canadian Family Physician
1978

Can perinatal regionalization be reconciled with family-centered maternal care?
The Journal of family practice
PubMed: 591888
12/1977

Infant Health Screening by Family Physicians and Pediatricians
Canadian Family Physician
12/1977

Non-treatment of screened children with intermediate blood lead levels.
Pediatrics
PubMed: 1161378
08/1975

The Impact of the Rochester Neighbourhood Health Center on the Hospitalization of Children
Haggerty, R.J. et al. Ed. Child Health and the Community
1975

Hyperglycemia and Sickness
Paediatrics
10/1974

Lead poisoning. Current status of the problem facing pediatricians.
American journal of diseases of children (1960)
DOI: 10.1001/archpedi.1974.02110250031004
PubMed: 4209739
06/1974

Impact of the Rochester Neighbourhood Health Center on Hospitalization of Children in Rochester, New York 1968 1970
Paediatrics
1973

Low Birth Weight and the Battered Child Syndrome
Archives of Pediatrics & Adolescent Medicine
Michael Klein
DOI: 10.1001/archpedi.1971.02110010051005
07/1971

Earthenware Containers as a Source of Fatal Lead PoisoningCase Study and Public-Health Considerations
New England Journal of Medicine
Michael Klein, Rosalie Namer, Eleanor Harpur, Richard Corbin
DOI: 10.1056/nejm197009242831302
09/1970

Lead Release from Earthenware
New England Journal of Medicine
DOI: 10.1056/nejm197012032832322
1970

Urine Screening for Disorders of Mucopolysaccharide Metabolism
Paediatrics
1969

Aminoaciduria of Vitamin D Deficiency Rickets in Ethiopian Infants
The Ethiopian Medical Journal
1967

Vitamin D, Resistant Rickets with Aminoaciduria A study of an Ethiopian family
The Ethiopian Medical Journal
1965

Research

Current Projects
Our study, "Does delivery volume of family physicians predict maternal and newborn outcome?" (CMAJ, April 2002) on the lack of association between low volume maternity practice and adverse outcome has already led to a rescinding of the Society of Obstetricians and Gynaecologists of Canada (SOGC) Policy on Low Volume Obstetrics and the creation of a new one based on a collaboration between the SOGC, College of Family Physicians of Canada (CFPC) and Society of Rural Physicians of Canada (SRPC) indicating that low volume is not a problem. With colleagues across BC and Canada we research approaches in low volume (usually rural) settings. For example, with Dr. Colin Yarow in Kelowna we have shown that vacuum extraction by family physicians is safe. This is the first study by family physicians on this technology.

Our study "In for the Long Haul--determinants of sustainable practice" (Can Fam Physician, June 2002) tests and evaluates both curricular and practice based interventions in the promotion of safe sustainable practice. We have begun a similar project with Halifax colleagues to determine if the sustainability issues found in BC are similar in Nova Scotia. Similar projects are underway with collaborators in Montreal, Toronto, Ottawa and several rural settings for this and the volume studies. We have published papers on the difficulties of centralization. These studies have led on to our current series of studies on the attitudes of all providers of maternity care and the women themselves.

We are heavily involved in the caesarean section on demand debate and

have published original research on pelvic floor functioning in relation to vaginal vs. caesarean birth and are working on a critical review of pelvic floor functioning by mode of birth. We are now looking at the attitudes of ethnic communities toward caesarean by choice. A linked study of the impact of epidural analgesia on caesarean section rates is in progress as well as a new study (with Andrew Kotaska PI) on high vs. low dose oxytocin augmentation in the presence of epidural analgesia.

Working with Patti Janssen, we have completed a series of five studies on single room maternity care and are engaged in the long term study of home birth in BC.

We are beginning a study on the place of maternity care in rural community sustainability – this in collaboration with the SFU Centre for Sustainable Community Development.

Honours & Awards

Award of Excellence: Family Physician Researcher of the Year, College of Family Physicians of Canada - November 2013

Maurice Wood Award for Lifetime Contributions to Primary Care Research, NAPCRG (The North American Primary Care Research Group) – October 2003

Family Physician Researcher of the Year Award 2004, College of Family Physicians of Canada . “The award recognizes a family medicine researcher who has made original contributions to research and has been a pivotal force in the definition, development and dissemination of concepts central to the discipline of Family Medicine in Canada ."