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Canada's low maternal death rates is too low, professor argues.

Toronto -- Is Canada's maternal death rate too low? University of Toronto Professor Donna E. Stewart, Canada's maternal death rate may be undercounted because the statistical criteria are narrow.

In the Canadian Medical Association Journal, (Jan. 31, '06), she proposes that broader guidelines, such as those used in the United Kingdom would give higher numbers and would help create better programs for prevention and treatment.

"In Canada, maternal death rates are based on causes of death directly attributable to classic obstetric indicators and within 42 days of the birth event" Professor Stewart does not believe this is good enough." If we want to lower rates in this country, the first step would be to take a broader conceptualization of maternal morbidity and mortality and include deaths attributable to mental health conditions and violence.

In the U.K., statistics cover a 12 month period of monitoring and takes non-obstetric factors into account, which include the impact of depression, suicide and socio economic factors. More recently, they have added pre-exiting conditions which were exacerbated by pregnancy and child birth. Because of this type of monitoring, U.K. health services provide services that have helped bring the maternal rate down below Canada's.

Among the causes of maternal death identified in the U.K. were suicide and drug overdoses, suicide or other violent causes and accidental drug overdoses.

"At the practice level," Professor Stewart believes, "we need to ask about and intervene in maternal depression, substance abuse and violence in the home and to consider the special needs of women with low income, poor social support, communication problems and irregular attendance at prenatal care classes."

Canada reports a maternal death rate of six deaths per 100,000 live births, which Stewart conders too many. She argues that "a broader conceptualization of health in future Canadian maternal and child health reports will enable us to further reduce our maternal death rate."
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Title Annotation:HEALTH
Publication:Community Action
Date:Feb 20, 2006
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