Canada is experiencing a worrying increase in maternal mortality. This is what emerges from the latest large global study published in March in the medical journal The Lancet. Between 2015 and 2023, the number of deaths occurring during pregnancy or up to one year after childbirth increased by 18%. A trajectory all the more striking as it contrasts with that observed in most comparable countries. In Europe, Australia and several Asia-Pacific countries, maternal mortality has on the contrary decreased over the same period. To explain it, researchers looked at several hypotheses.
For Lynn Murphy-Kaulbeck, specialist in maternal-fetal medicine and associate professor at Dalhousie University in Canada, this increase could firstly reflect a better ability to identify and count maternal deaths. “Are the numbers increasing? Are they decreasing? It’s hard to sayshe emphasizes. What worries me most is the impression that not all maternal deaths have yet been recorded. But it is also possible that we will identify more than before.”
Some Canadian provinces have actually strengthened their registration systems, confirms Isabelle Malhamé, researcher in cardiovascular health at the Sainte-Justine Hospital Center and the McGill University Health Center, in Montreal. The authors of the study believe, however, that this statistical improvement does not explain everything. They also point to the postponement of pregnancies to a later age. Across the Atlantic, the increase in the age of motherhood is explained in particular by the lengthening of higher education and the priority given to a professional career.
“When people delay pregnancy from their 20s to 30s, the impact remains relatively limitedspecifies Maegan Ashworth Dirac, professor of family medicine at the University of Washington, in an article in the media specializing in health Think Global Health. On the other hand, from the forties or fifties, the effects begin to become visible.
According to the Institute for Health Metrics and Evaluation (IHME) Global Burden of Disease study, pregnant women in their early 40s have a three times higher risk of death than those who give birth in their early 30s. However, this finding is limited to high-income countries.
Young mothers more affected
The Canadian data also reveals a more unexpected phenomenon: the risk of maternal mortality decreases among older women, but increases among younger ones. Among pregnant people in their early twenties, the number of deaths even jumped by 300% between 1990 and 2023. Several reasons are mentioned pell-mell: a lack of access to contraception and family planning services, a deterioration in the mental health of younger generations, aggravated by the Covid-19 pandemic and the intensive use of social networks.
The distrust of certain populations towards health institutions also plays a role. In Canada, indigenous peoples still bear the scars of residential schools, a system imposed for nearly 150 years. Thousands of children are said to have lost their lives there, while physical and sexual violence was widespread.
Even today, these communities face persistent obstacles such as language barriers, geographic distance from healthcare facilities or experiences of discrimination in the medical system. These factors accentuate their distrust of health structures.
In the opinion of researchers, Canada must now have a national maternal health program capable of improving access to care – particularly in rural and isolated regions – and better supporting the most vulnerable populations.
