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Sunday 23rd October 2016

Birthing reforms call

11th October 2006

05042006_baby_ward.jpgCanada is facing a crisis in obstetric care because more women--particularly those from remote and often aboriginal communities--are dying in childbirth and the country’s position relative to other countries for infant and perinatal mortality has fallen, the Society of Obstetricians and Gynaecologists of Canada says.

The country must address shortages in maternity care staff and investigate ways to provide optimal care of mothers and newborns to achieve better outcomes, the society says.

Data from the Organisation for Economic Cooperation and Development (OECD) show that in 1990 Canada was one of the world’s safest places to give birth, ranking sixth on infant mortality, 12th on perinatal mortality, and second on maternal mortality.

This year Canada has slid to 21st place for infant mortality, 14th for perinatal mortality, and 11th for maternal mortality.

Moreover, Canada’s average maternal mortality masks big regional variations. The reality for Canada’s rural and remote communities, particularly aboriginal communities, is particularly disturbing, the society says. Some women in Canada’s rural and remote communities do not have local access to facilities for safe birth. Women are being routinely evacuated from their communities so that they can be assured appropriate care in urban centres.

The society is therefore recommending that the country’s government invest C$5 million (£2.4 million) to C$7 million a year over 10 years in a new birthing strategy. The strategy, developed with the support of Canada’s provincial governments and territories, would establish a blueprint for the provision of optimal maternal and newborn care services in urban, remote, rural, and aboriginal communities.

In Canada family doctors and obstetricians perform about 98% of deliveries and midwives perform maybe 2-3%. The society wants to see more health professionals providing maternity care as well as increased collaboration among professionals involved in providing obstetric care—midwives,community health nurses, family doctors, and specialists.

Over the past decade the society has raised concerns that fewer and fewer Canadian family doctors are providing obstetric care. Several reasons are given for this decline, including lifestyle and pay issues.

In the next five years it is expected that 30% of Canada’s obstetricians will retire from full time practice and that others will streamline their practice to include only gynaecology. There has been a “virtual halt? in the number of obstetricians in Canada doing obstetrics.

The society has also strongly urged the Canadian government to invest—through its official development assistance—in health strategy to help reduce maternal mortality and morbidity worldwide.

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