Substantial differences in obstetric care for First Nations women in Canada: BC study

November 02, 2015

There are substantial differences in obstetric care provided to First Nations women compared with women in the general population, and these differences may contribute to higher infant mortality in First Nations populations, according to research published in CMAJ (Canadian Medical Association Journal).

"Although signs suggest that obstetric interventions are being used too readily in developed countries, the lower rates we saw among First Nations mothers are of concern when coupled with the known increased risk of adverse perinatal and infant outcomes," writes Corinne Riddell, PhD candidate, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, with coauthors.

The study compared the quality and type of obstetric care provided for first-time single births among First Nations and non-First Nations mothers in British Columbia, Canada. It included 215 993 single births over 12 years, of which 9152 were to members of First Nations. First Nations mothers were more likely to live in rural areas and live farther from a hospital than non-First Nations mothers. They were also 7 times more likely to have a baby during their teens, had a higher likelihood of preterm birth and were less likely to give birth after 41 weeks.

Obstetric care varied as well. First Nations mothers were less likely to undergo labour induction or to receive an epidural. They were also somewhat less likely to have an instrumental delivery or cesarean delivery.

"First Nations mothers were less likely to have early ultrasonography, less likely to have at least 4 antenatal visits and less likely to undergo induction for indications of post-dates gestation and prelabour rupture of membranes. Because these indicators reflect current standards of care, estimated differences are not at risk for confounding by maternal risk factors, rurality or level of service at the local hospital," write the authors.

The researchers noted their inability to determine whether these differences in care were linked to the type of health care provider or to the location of delivery (home or hospital). Only the person who delivers the baby is noted on the delivery record, and this person may not be the one who cared for the woman during pregnancy. Also, the authors were unable to incorporate women's preferences for their birth. For example, many women successfully use nonpharmacologic methods to cope during labour so a lower epidural rate could reflect a woman's choice to not have one.

"Such differences warrant further investigation, given consistently found increases in perinatal mortality that may be a downstream consequence of differences in care," the authors conclude.

Canadian Medical Association Journal

Related Birth Articles from Brightsurf:

The birth of a bacterial tRNA gene
The Microbial Evolutionary Dynamics Group at the Max Planck Institute for Evolutionary Biology in Plön has directly observed the birth of a tRNA gene, using experimental evolution of bacterial populations in the laboratory.

Your brain on birth control
Millions of women have been taking oral contraceptives, but little is known about whether the synthetic hormones found in the oral contraceptives have behavioural and neurophysiological effects, especially during puberty and early adolescence, which are critical periods of brain development.

Virgin birth has scientists buzzing
In a study published today in Current Biology, researchers from University of Sydney have identified the single gene that determines how Cape honey bees reproduce without ever having sex.

Birth timing may affect brain development
Moving birth a day early triggers an early start to widespread neuron death, according to new research in mice published in eNeuro.

The birth of vision, from the retina to the brain
How do neurons differentiate to become individual components of the visual system?

Baby pterodactyls could fly from birth
A breakthrough discovery has found that pterodactyls, extinct flying reptiles also known as pterosaurs, had a remarkable ability -- they could fly from birth.

Study identifies possible causes of and protectors against premature birth
Seven types of bacteria and certain immune factors in a woman's vagina and cervix may be responsible for increasing the risk of spontaneous preterm birth (sPTB) or protect against it, according to a new study from the Perelman School of Medicine at the University of Pennsylvania and the University of Maryland School of Medicine.

Certain characteristics linked with depression before and after giving birth
Depression during pregnancy and following childbirth (perinatal depression) is a common and potentially severe condition.

Medically assisted reproduction does not raise risk of preterm birth and low birth weight
Study shows that couples can decide about using medically assisted reproduction free from concerns about increasing the health risks to their baby.

How to 'jumpstart' rhythmic breathing at birth
Researchers reveal neuronal pathways that 'jumpstart' breathing at birth and may explain breathing abnormalities seen in premature babies.

Read More: Birth News and Birth Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to