It is time for a national birthing strategy

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Canada’s obstetrics and gynecology society is proposing a national birthing strategy to help address a shortage of maternity healthcare professionals – and a looming maternity care crisis. The current shortage is the combined result of a number of factors including a reduction in the number of physicians who perform deliveries, the large cohort of Canadian obstetricians who will be retiring or reducing the scope of their practice in coming years, as well as a national shortage of midwives. Compounding the problem for the future is an inadequate number of medical students choosing to specialize in obstetrics, and only partial government support, education and licensing opportunities for midwifery care in some provinces and territories.

“Delivering babies requires that skilled professionals be available on short notice, 24 hours a day, 365 days a year. Looking at these trends, it’s not difficult to see that we have a serious problem on the way,” says André Lalonde, Executive Vice-President of the Society of Obstetricians and Gynaecologists of Canada. “We need to take action now to prepare for this, to make sure that Canadians have access to the safest possible pregnancy and childbirth.”

Statistics from the Organisation for Economic Co-operation and Development (OECD) are already showing a decline in Canada’s international ranking with regard to maternal and newborn health. In 1990, Canada was one of the world’s safest places to give birth, ranking 6th for infant mortality and 2nd for maternal mortality. Today, Canada has fallen to 21st for infant mortality and 11th for maternal mortality. And, while the effects of the shortages can be seen across the country, particularly affected are women living in rural and northern communities.

“We know that we are not meeting the needs of mothers and babies in rural and remote communities. Women in Canada’s remote and rural communities are routinely evacuated from their homes, their families, their communities, often their culture and support systems, so that they can be assured appropriate care during childbirth,” says Don Davis, President of the Society of Obstetricians and Gynaecologists of Canada. “Imagine, being 35 or 36 weeks pregnant and having to leave all you know and love behind and go somewhere else for what is arguably the most important time in your life.”

To help address this shortage, the Society of Obstetricians and Gynaecologists of Canada (SOGC) has proposed a new National Birthing Strategy to ensure that all women across Canada are offered the safest pregnancy and childbirth possible. Currently, maternity care varies across provinces and territories. There is no consistent system-wide approach to address the human resources shortages, and some provinces and territories are ill prepared to manage the current situation and future challenges.

The SOGC’s proposed National Birthing Strategy would provide a guiding framework for provincial and territorial health authorities to redefine the way they offer maternity care. By developing a more efficient way to manage pregnancy and birth, the strategy aims to stretch resources further and help offset the effects of the shortage. The strategy will also focus on finding solutions to the unique challenges facing women in rural and remote areas.

The SOGC has also called upon a long list of partners to contribute to the development of the new birthing strategy, including groups representing midwives, nurses, family practitioners, rural physicians and other specialists involved in maternity care. To ensure that the strategy is developed to meet the needs of all Canadians, cultural groups such as those representing First Nations and Aboriginal peoples have been invited to participate in the project.  

To accomplish this strategy, the SOGC is calling on the Government of Canada to invest five to seven million dollars annually for the next 10 years. The SOGC is also calling upon the support of provincial and territorial governments in developing and implementing the new strategy. Last fall, Davis and Lalonde appeared before the House of Commons Standing Committee on Finance to present the National Birthing Strategy as part of the federal government’s pre-budget consultations. The SOGC remains in consultation with the federal government and its partners to arrange funding for this project.

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