Selected Peer Reviewed Articles and Book Chapters (from more than 175)

  1. Michael C. Klein, Adetunji Oremakinde and Daniel R. Wong. Aortic dissection: A story of rural assessment, evacuation, and survival. Canadian Family Physician January 2024, 70 (1) 25-29; DOI:
  2. Klein MC. Homage to Murray Enkin and the complexity of evidence-based medicine. In Canadian Birth Stories. eds Laura Pascoe and Josee Leduc. Doula Support Foundation. September. 2023
  3. Klein MC. Homage to Dr. Murray Enkin and the complexity of evidence-based medicine. Birth.2023;50(2):255-257.
  4. Klein MC. My Last Birth. in A collection of family practice birth stories. College of Family Physicians of Canada. editor. Milena Forte. May 2023
  5. Farrales LL, Cacciatore J, Jonas-Simpson C, Dharamsi S, Ascher J, Klein MC. What do bereaved parents want health care providers to know when their babies are stillborn: a community-based participatory study. BMC Psychology. 2020 8:18.
  6. Klein MC. My last Montreal Birth. Can J Midwifery research and Practice. 2019. 17 (2). 42-43
  7. Michael C. Klein. Dissident Doctor–catching babies and challenging the medical status quo. 2018. Douglas and McIntyre. ISBN 978-1-77162-192-2
  8. Klein MC, Ehman W. An embarrassment of maternity riches. Canadian Family Physician. November 13, 2018. Invited Blog Post.
  9. Klein MC. Being Optimistic—the benefits of avoiding negative prognostication for both adults and neonates. Canadian Family Physician. June 25, 2018. Blog Post.
  10. Klein MC. Home Birth: how can it be safe? International Doula. 2018. vol 24 issue 4. 9-13.
  11. Klein MC, Simkin P, Young. D. “ Be kind to the mother” : A celebration of the life of Marshall Klaus, 1927-2017. Birth . 2017;00:1‐4.
  12. Munro S, Dewar K, Wilcox E, Klein MC, Janssen PA. Evaluation of a Patient Education Pamphlet for Women Considering Vaginal Birth After Cesarean. 2017. The Journal of Perinatal Education, 26(1), 37–48,
  13. Klein MC. How I learned to love midwifery and stop worrying about episiotomy. Can J. Midwifery Research and Practice. 116 (1) Spring 2017. 39-45.
  14. Klein MC. Many Women and Providers Are Unprepared for an Evidence-Based, Educated Conversation About Birth. J. Perinatal Education. 2011;20 (4): 184-1874.
  15. McNiven P, Klein MC, Baradaran N, Tomkinson J, Hearps SJC, Saxell L. (2011) Midwives’ belief in normal birth: The Canadian Survey of maternity care provider’s attitudes toward labour and birth. The Canadian Journal of Midwifery Research and Practice. 2011.10; (2) Summer: 11-21.
  16. Klein MC, Kaczorowski J, Hearps SJ et al Birth Technology and Maternal Roles in Birth: Knowledge and Attitudes of Canadian Women Approaching Childbirth for the First Time. Journal of Obstetrics and Gynecolgy Canada. June 2011: 598-608
  17. Klein MC, Baradaran N, Kaczorowski J, Hearps S, Tomkinson J, Brandt R. Family physicians who provide intrapartum care and those who do not: very different ways of viewing childbirth. Canadian Family Physician. 2011; 57 April: e139-e147
  18. Klein MC, Liston R, Fraser WD, Baradaran N, Hearps S, Tomkinson J, Kazorowski J, Brant R. The attitudes of the new generation of Canadian obstetricians: how do they differ from the predecessors. Birth. 2011; 38: 129-139
  19. Michael C. Klein Promoting Normal Birth: Research, Reflections & Guidelines. Sylvie Donna editor. Chapter 2 pages 20-30. Epidural analgesia for pain management: the positive and the negative. May 10th 2011. Fresh Heart Publishing. London UK. 358 pages.
  20. Miewald C, Klein MC, Ulrich C, Butcher D, Eftekhary S, Rosinski J, Procyk A. “You Don’t Know What You’ve Got Till Its Gone” : The Role of Maternity Care in Community Sustainability. Can J Rural Medicine. 2011;16(1): 7-12
  21. Jimenez V, Klein MC, M, Mason C. A Mirage of Change: Family-Centered Maternity Care in Practice. Birth. 2010:37 (2):160-167
  22. Eftekhary S, Klein MC, Xu S. The Life of a Canadian Doula: Successes, Confusion, and Conflict. J Obstet Gynaecol Canada.2010;32(7):642–649
  23. Klein MC. From routine episiotomy to routine Cesarean section: how society came from rejecting one to embracing another. Bear Bones Publication of the Department of Family Practice University of British Columbia. 2010. Spring 10 (1): 12-17.
  24. Klein MC.What do episiotomy and cesarean have to do with Copernicus, Galileo and Newton? Birth. March 2010; 37(1): 1-2.
  25. Hearns G, Klein MC, Trousdale W, Ulrich C, Butcher D, Miewald C, Lindstrom R, Eftekhary S, Rosinski J, Gomez-Ramirez O, Procyk A. Development of a support tool for complex decision-making in the provision of rural maternity care. Health Care Policy. 2010;5 (3): 83-95.
  26. Klein MC. Chapter 10. Evidence-based Practice in Maternity Care: Examining the Evidence. Pages 45-51. in Woman-Centered Care in Pregnancy and Childbirth. Edited by Sara Shields and Lucy Candib. Radcliff Publishing Oxford and New York. 575 pages.
  27. Klein MC, Kaczorowski J, Hall W, et al. The Attitudes of Canadian Maternity Care Practitioners Towards Labour and Birth: Many Differences But Important Similarities. . Journal of Obstetrics & Gynaecology Canada: 2009;31:827-840.
  28. Janssen P, Saxell L, Page L, Klein MC, Liston R, Lee SK. Outcomes of planned home birth with registered midwives versus planned hospital birth with a midwife or a physician. Can Med Assoc J. 081869 August 31, 2009.
  29. Hearns G, Trousdale W, Klein MC, Butcher D, Ulrich C, Miewald C, Eftekhary S. Informed decision-making: the interaction between sustainable maternity care services and community sustainability—a decision support manual. December 2008. The Maternity Care Research Group, The University of British Columbia and the Child and Family Research Institute and Northern Health. Vancouver British Columbia.
  30. Klein MC. A Tribute to Phil Hall. Birth. 36 (1) March 2009:4
  31. Klein MC. Invited editorial. In the Literature: Preventive induction—AMOR- IPAT—much promise, not yet realized. Birth. 36 (1) March 2009: 83-85
  32. Tan, MW, Klein MC, Saxell L, Shirkoohy SE, Asrat G. How do physicians and midwives mange the third stage of labor? BIRTH. 35:3 September 2008: 220-229
  33. Simkin, P, Klein, MC. Nonpharmacological approaches to management of labor pain. In: UpToDate, Rose, BD (Ed), UpToDate, Waltham, MA, 2007
  34. Klein MC, Enkin MW, Kotaska A, Shields SG, The Patient-Centered (R) Evolution, Birth, 34(3): 264 -266, September 2007.
  35. Press JZ, Klein MC, Kaczorowski J, Liston RM, von Dadelszen P, Does Cesarean Section Reduce Postpartum Urinary Incontinence? A Systematic Review, Birth, 34(3): 228 -237, September 2007.
  36. Klein MC. Editorial: Association Not Causation: What Is the Intervention? Annals of Family Medicine, 5:294-297, 2007.
  37. Janssen PA, Thiessen P, Klein MC, Whitfield MF, MacNab YC, Cullis-Kuhn SC, Standards for the measurement of birth weight, length and head circumference at term in neonates of European, Chinese and South Asian ancestry, Open Medicine, 1(2): 74-88, July 2007.
  38. Janssen P A, Ryan E M, Etches D J, Klein MC, Reime B, Planned Hospital Birth Attended by Midwives Compared with Physicians in British Columbia, Birth, 34(2): 140-147, June 2007.
  39. Klein MC. The Shaman: the medicine man has not died. In: JP Sturmberg, ed. The Foundations of Primary Care: daring to be different. Oxford and Seattle: Radcliffe Publishing: pages 4-6, 2007.
  40. Klein MC, Childbirth and the Pelvic Floor: Will a planned c-section prevent problems? Family Health, 23(1):28-33, Spring 2007.
  41. Klein MC, Sakala C, Simkin P, Davis-Floyd R, Rooks JP, Pincus J. Why Do Women Go Along with This Stuff? Birth, 33: 245-250, 2006.
  42. Janssen PA, Still DK, Klein MC, Singer J, Carty, EA, Liston RM, Zupancic JA, Labor Assessment and Support at Home versus Telephone Triage: A Randomized Controlled Trial, American College of Obstetrician and Gynecology, 108(6): 1463-69, December 2006.
  43. Klein MC. Pushing in the wrong direction. (Commentary), Birth, 33(3): 251-253, September 2006.
  44. Klein MC. Epidural Analgesia: Is It Increasing C-Section Rates?, The Canadian Journal of Diagnosis, 3(8):73-75, August 2006.
  45. Janssen PA, Ryan EM, Etches DJ, Klein MC, Reime B. Outcomes of Planned Hospital Birth Attended by Midwives Compared with Physicians in British Columbia Birth. 2007 (2). 140–147.
  46. Klein MC, Sakala C, Simkin P, Davis-Floyd R, Rooks JP, Pincus J. Why Do Women Go Along with This Stuff? Birth 2006;33:245-250.
  47. Klein MC. Invited Commentary. What a difference a day makes in “cesarean section on maternal request.”, 4 June 2006.
  48. Klein MC. Invited Commentary. Vaginal Childbirth–an extreme sport., 4 June 2006.
  49. Klein MC. Epidural analgesia: does it or doesn’t it? Invited Commentary on Wong et al. NEJM 2005;352 (7): 718-720. Birth 2006; 33 (1): 74-76.Klein MC. Invited editorial. Does epidural analgesia increase the cesarean section rate? Can Fam Phys 2006; 52 (April): 419-21
  50. Kotaska AJ. Klein MC. Liston RM. Epidural analgesia associated with low-dose oxytocin augmentation increases cesarean births: a critical look at the external validity of randomized trials. [Review] [25 refs] [Journal Article. Review] American Journal of Obstetrics & Gynecology. 194(3):809-14, 2006 Mar.
  51. Press J, Klein MC, von Dadelszen P. Mode of delivery and pelvic floor dysfunction: a systematic review of the literature on urinary and fecal incontinence and sexual dysfunction by mode of delivery. Medscape Clinical Update from WEBMD Ob/GYN and Women’s Health. 2006
  52. Klein MC. Obstetrician’s fear of birth: how did it happen? Birth 2005; 32 (3): 207-8
  53. Klein MC. The Power of Birth. Invited commentary on Shields SG. On this day of mothers and sons. Annals of Family Medicine 2005; 3 (4) 263-268
  54. Price D, Lane CA, Klein MC. Maternity care by family physicians: characteristics of successful and sustainable models. JOGC 2005;27:460-466.
  55. Klein MC, Kaczorowski J, Firoz T, Hubinette M, Jorgensen S, Gauthier R. Urinary and sexual outcomes in women experiencing vaginal compared with cesarean births. JOGC 2005; 27 (4): 313-320.
  56. Klein MC. Cesarean section on Demand: Is it ethical? Can J Diagnosis. 2005; 22 (5): 67-8
  57. Klein M, Early epidurals increase caesarean rate: meta-analysis shows. BMJ.2005; 330: 790.
  58. Thommasen HV, Klein MC, Mackenzie T, Grzybowski S. Perinatal outcomes at Bella Coola General Hospital: 1940 to 2001. 2005: Can J Rural Med. 10 (1) 22-8.
  59. Thommasen HV, Klein MC, Mackenzie T, Lynch N, Reyes R, Grzybowski S. Obstetric maternal Outcomes at Bella Coola General Hospital: 1940 to 2001. 2005: Can J Rural Med.10(1):13-21
  60. Janssen PA, Keen L, Soolsma J, Harris SJ, Klein MC, Reime B. Perinatal nursing education for single-room maternity care: evaluation of a competency-based model. J Clin Nursing 2005: 14: 95-101.
  61. Klein MC. Elective cesarean section. [comment]. CMAJ Canadian Medical Association Journal. 171(1):14-5; author reply 15-6, 2004 Jul 6.
  62. Klein, MC. External validity and internal trial conditions. BMJ 24 November 2004 response to Kotaska, A. Inappropriate use of randomized controlled trials to evaluate complex phenomena: case study of vaginal breech delivery. BMJ 2004: 329: 1039-1042
  63. Reime B, Klein MC, Kelly A, Duxbury N, Saxell L, Liston R, Prompers FJPM, Entjies RSW, Wong V. Do maternity care provider groups have different attitudes toward birth? BJOC—An International Journal of Obstetrics and Gynecology.2004;111:1388-93
  64. Klein MC. Quick Fix Culture: The cesarean-section-on-demand debate. Guest editorial. Birth 2004;32(3): 161-4.
  65. Yarrow C, Benoit GA, Klein MC. Outcomes after vacuum-assisted deliveries: births attended by community family practitioners. Can Fam Physician 2004;50: 1009-14.
  66. Martel MJ, MacKinnon, Arsenault MY, Bartellas, E, Cargill YM, Daniels RN, Gleason T, Iglesias S, Klein MC, Roggensack A, Wilson AK. Guidelines for vaginal birth after previous caesarean birth. JOGC. 2004: 26 (4): 660-70.
  67. Klein MC, Kelly A, Kaczorowski J, Grzybowski S. The effect of family physician timing of maternal admission on procedures in labour and maternal and infant morbidity. JOGC. 2004: 26 (4): 641-5.
  68. Harris SJ, Farren MD, Janssen PA, Klein MC, Lee SK. Single room maternity care: Perinatal outcomes, economic costs, and physician preferences. JOGC. 2004; 26 (4): 633-40.
  69. Kelly A, Klein MC, Kaczorowski J, Grzybowski. Does experience or delivery volume of family physicians predict maternal and newborn outcomes? CMAJ. 2004; 170 (4): 446-7.
  70. Klein, MC. Coeditor: Section on Conception, Pregnancy and Childbirth. Oxford Textbook of Primary Medical Care. Vol. 2, Section 8 2004.
  71. Leeman L, Fontaine P, King V, Klein MC, Ratcliffe S. Management of labor pain: Promoting patient choice, Editorial. American Family Physician 2003;68:1023-6
  72. Leeman L, Fontaine P, King V, Klein MC, Ratcliffe S. The nature and management of labor pain: Part II. Pharmacologic pain relief. American Family Physician 2003;68:1115-20.
  73. Leeman L, Fontaine P, King V, Klein MC, Ratcliffe S. The nature and management of labor pain: Part I. Nonpharmacologic pain relief. American Family Physician 2003;68:1109-12.
  74. Klein M, Johnston S, Christilaw J, Carty E Mothers, babies and communities. Centralizing maternity care exposes mothers and babies to complications and endangers community sustainability. Can Fam Physician 2002;48:1177-79.
  75. Klein MC, Spence A, Kelly A, Kaczorowski J. Does delivery volume of family physicians predict maternal and newborn outcome? CMAJ 2002;166(10):1257-1264.
  76. Klein MC, Kelly A, Spence A, Kaczorowski J, Grzybowski S. In for the Long Haul: why do family physicians plan to continue or discontinue intrapartum maternity care. Can Fam Physician 2002;48:1216-22.
  77. Janssen P, Lee S, Ryan E, Etches D, Farquharson D, Peacock D, Klein M Outcomes of Home vs Hospital-Intended Birth after Regulation of Midwifery in British Columbia.. CMAJ, 166(3):315-23, Feb 2002.
  78. Klein MC, Grzybowski S, Harris S, Liston R, Spence A, Le G, Brummendorf D, Kim S, Kaczorowski J. Epidural analgesia use as a marker for physician approach to birth: implications for maternal and newborn outcomes. Birth 28(4): 243-8; December 2001
  79. Janssen P, Harris S, Soolsma J, Klein MC, Seymour L. Single Room Maternity Care: The Nursing Response. Birth 28:3 September 2001
  80. Klein, MC. Reducing Perineal Trauma and Pelvic Floor Relaxation: An evidence-based approach. (Book Chapter). Clinics in Family Practice, Saunders. Vol.3, No.2 June 2001
  81. Janssen P. Klein MC, Soolsma J. Differences in Institutional Cesarean Delivery Rates: The role of pain management. J Fam Pract Vol.50(3):217-223, March 2001
  82. Goluboff S, Reynolds L, Klein M, Handfield-Jones R. Privileging and consultation in maternity and newborn care. Canadian Family Physician, Vol.46: September 2000
  83. Janssen P, Klein M, Harris S, Soolsma J, Seymour L. Single Room Maternity Care and Client Satisfaction. Birth, 27(4):235-243: December 2000.
  84. Klein M. Editorial: The Quebec Midwifery Experiment: Lessons for Canada. Canadian Journal of Public Health, January-February 2000.
  85. Klein M. Managing Hyperbilirubinemia in term newborn infants (Editorial) Canadian Family Physician, Vol 45: November 1999
  86. Klein M. Practice Tips: A method for presenting maternal serum screening. Canadian Family Physician, Vol.45:August 1999, 1875-6
  87. Iglesias S, Grzybowski S, Klein M, Gagne GP, Lalonde A. Rural Obstetrics. Joint Position Paper on Rural Maternity Care. Canadian Family Physician, Vol 44: April 1998
  88. Klein MC, Janssen PA, MacWilliams L, Kaczorowski J, Johnson B: Determinants of Vaginal/Perineal Integrity and Pelvic Floor Functioning in Childbirth. Am J Obs & Gyn February 1997 .
  89. Klein M: Studying Episiotomy: When Beliefs Conflict with Science. J Fam Practice 1995; 41(5):483-488.
  90. Klein MC, Kaczorowski J, Robbins JM, Gauthier RJ, Jorgensen SH, Joshi AK: Physician Beliefs and Behaviour within a Randomized Controlled Trial of Episiotomy: Consequences for Women under their Care. Can Med Assoc J, 1995; 153(6):769-779.
  91. Klein M, Gauthier R, Robbins J, Kaczorowski J, Jorgensen S, Franco E, Johnson B, Waghorn K, Gelfand M, Guralnick M, Luskey G, Joshi J: Relation of Episiotomy to Perineal Trauma and Morbidity, Sexual Dysfunction and Pelvic Floor Relaxation. Amer J Obstet Gynecol, 1994; 171(3):591-8.
  92. Klein MC et al. Does Episiotomy Prevent Perineal Trauma and Pelvic Floor Relaxation? First North American Trial of Episiotomy.Inaugural issue: On-Line Journal of Current Clinical Trials. American Association Advancement Science. 1992;1:July 1 (Doc 10).
  93. Klein, M. and Reynolds, JL., Influence of Perinatal Asphyxia on Neurologic Outcome: Consequences for Family Practice Accoucheurs. Can. Fam. Phys. 1990;36:1735 39.
  94. Klein, M and Zander, L.: Role of the Family Practitioner in Maternity Care.In: Chalmers I, Enkin M, Keirse MJNC (eds) Effective Care in Pregnancy and Childbirth. Oxford University Press, Oxford, 1989.
  95. Klein, M.: The Canadian Family Practice Accoucheur.Can.Fam.Phys. 1986;32:533 540.
  96. Klein, M. et al. Booking for Maternity Care: A Comparison of Two Systems. Occasional Paper # 31. The Royal College of General Practitioners. 1985.
  97. Klein, M et al: Care In A Birth Room vs Conventional Setting: a controlled trial. CMAJ 131:1461-6, 1984.
  98. Klein, M.: Contracting for Trust in Family Practice Obstetrics. Can. Fam. Phys.1983; 29: 2225 7.
  99. Klein, M. et al. Comparison of Low Risk Women Booked for Delivery in Two Different Systems of Care, Part II. Management of Labour, Treatment of Labour Pain and Associated Infant Outcomes. Brit. J. Obst. Gynec., 1983, 90: 123 128.
  100. Klein, M. et al. Comparison of Low Risk Women Booked for Delivery in Two Different Systems of Care, Part I: Obstetrical Procedures and Newborn Outcomes. Brit. J. Obst. Gynec. 1983. 90: 118 122.
  101. Klein M, Stern L: Low birth weight and the battered child syndrome. Am J Dis Child. 1971; 122:15-18.