Giving birth in rural Canada: different experiences, similar outcomes

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Hospital Births in Canada: A Focus on Women Living in Rural and Remote Areas

Highlights of 2011–2012 Selected Indicators Describing the Birthing Process in Canada

July 4, 2013—More than 17% of women from rural areas travelled longer than two hours to reach the hospital where they delivered their babies, compared with less than 1% of urban women. A new report released today by the Canadian Institute for Health Information (CIHI) found this and other differences—in areas such as baby size and rates of preterm birth—when comparing birthing experiences and outcomes of rural and urban women who delivered in hospitals.

Hospital Births in Canada: A Focus on Women Living in Rural and Remote Areas found that the distance travelled to hospital for rural women depended on where they lived. For example, more than 80% of women from the following rural areas travelled two hours or longer to reach a hospital to give birth: Yukon; Athabasca, Saskatchewan; Burntwood, Manitoba; Keewatin Yatthé, Saskatchewan; and Nunavut.

“There are unique differences in urban and rural birthing experiences,” says Anne McFarlane, CIHI’s Vice President, Western Office and Developmental Initiatives. “By understanding them, health planners can review their systems of care to make sure all mothers and babies across Canada have the best possible outcomes.”

Type of health care providers attending births varies

CIHI’s report also found that women from rural areas were more likely than urban women to have their babies delivered by a family physician and less likely to have the birth attended by an obstetrician/gynecologist (OB/GYN) or midwife.

Differences in Caesarean section providers for rural women were also seen. Rural women were 13 times more likely to have their C-section performed by a family physician or general surgeon. Conversely, almost all C-sections for urban women were attended by an OB/GYN, compared with about 75% of C-sections for rural women.

Babies born to rural and urban mothers tend to have comparable outcomes

CIHI’s report also examined outcomes and found that babies born to rural women were more likely to be large for gestational age, which can lead to longer labour times and increased chances of needing a C-section. Babies with rural mothers were also less likely to be small for gestational age, which can sometimes lead to health complications for the baby.

Rural and urban women had similar rates of preterm birth (before 37 weeks of gestation); however, rural women who delivered in an urban hospital were three times more likely to have preterm babies than rural women who delivered in a rural hospital.

“The higher number of preterm births for mothers from rural and remote areas in urban hospitals could be due to effective triaging of high-risk women from those areas to specialized hospitals in urban centres,” explains Cecile Hunt, CEO of Prince Albert Parkland Health Region. “It is encouraging to see the system is working well and babies have comparable outcomes, regardless of where they are delivered. The differences highlighted in the report will further allow planners to ensure the needs of women from rural and remote areas are being met.”

CIHI also released other new data today on pregnancy, childbirth and newborns

  • The number of babies born in Canadian hospitals has been relatively stable for the past five years. There were almost 373,000 babies born in hospital in 2011–2012, representing a slight increase since 2010–2011.
  • In 2011–2012, the Canadian primary C-section rate remained relatively stable at 18%, but variations still existed among provinces. British Columbia (22%) and Newfoundland and Labrador (21%) continued to have the highest primary C-section rates, while Manitoba (14%) and Quebec (15%) had the lowest rates.
  • The primary C-section rate was higher among women age 35 and older (22%) than among women younger than 35 (17%).
  • In 2011–2012, the rate of babies born preterm was 8%. This rate has remained relatively stable for the past six years.

This information and more can be found in the Quick Stats section of CIHI’s website.

Media contacts: media@cihi.ca

Angela Baker
416-549-5402
Cell: 416-451-5083

Sandra Koppert
613-694-6280
Cell: 613-297-7792