Kitty Carr, pictured with her husband Paul Carr, suffered a massive heart attack after giving birth and died at the Maple Ridge Regional Hospital in B.C. on Dec. 31, 1994.Supplied
It was only four hours after giving birth to a baby girl that Kitty Carr suffered a massive heart attack and died at the Maple Ridge Regional Hospital in B.C. on Dec. 31, 1994.
Nearly 30 years later, her husband, Paul, carries what transpired on that tragic day and Kitty’s memory with him as motivation to shine a light on maternal deaths.
Mr. Carr is among a growing chorus that believes Canada is falling short in how it collects data about this issue. “I have a responsibility to my wife to do something about this,” he said. “I have a responsibility to my daughter.”
Recently, the Society of Obstetricians and Gynaecologists of Canada (SOGC) called for Ottawa to establish a national framework for standardized collection and surveillance of maternal mortality and morbidity data – something federal Health Minister Mark Holland said this week he would consider.
The SOGC defines maternal mortality as any death related to or aggravated by pregnancy, its management or child birth, or within 42 days of the termination of a pregnancy.
It considers maternal morbidity, on the other hand, as any health condition attributed to and/or aggravated by pregnancy and childbirth that has a negative impact on well-being. This includes short- or long-term health issues.
The national organization comprises obstetricians, gynecologists, family physicians, nurses, midwives and other health professionals who work in women’s sexual and reproductive health. It believes Ottawa should take a leadership role to encourage and assist provinces and territories to collect, standardize and share data.
SOGC president Lynn Murphy-Kaulbeck said standardized collection of information would amount to an essential step to improve maternal-health outcomes. She also noted disparities, particularly for Black and Indigenous patients, who have higher rates of maternal mortality, as well as the impact of mental health on patients.
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“Every death is important and whether it’s direct or indirect, it’s a maternal death, and we need to prevent it,” Dr. Murphy-Kaulbeck said.
When asked by The Globe and Mail about the call from the SOGC to develop a national surveillance system, Mr. Holland said this week on Parliament Hill that it is “something that we’re looking at.”
The federal government must do everything it can to protect Canadians’ health and this is “certainly true for new mothers,” he said. The minister said he did not want to specify a direction the government will be taking on this but “it’s fair to say I’m very seized by what they put forward.”
National surveillance systems exist in Britain and in the U.S. and “we do not have that in Canada,” Dr. Murphy-Kaulbeck said.
The core of the problem relates to the fact that provinces and territories approach information collection differently – something Dr. Murphy-Kaulbeck said needs to change so that the same type of data can be collected and stored.
In a past Statistics Canada report on health outcomes, the agency reported that maternal mortality, which it defines as the total number of obstetric causes that occurred within one year of delivery or the end of a pregnancy, had increased but was “relatively low compared with other causes of death.”
It said maternal mortality during pregnancy, within 42 days of delivery, or the end of the pregnancy has increased over time: it more than doubled from 0.6 per 100,000 live births in 2000 to 1.4 per 100,000 in 2020.
Additionally, the agency reported that the maternal mortality rate within one year of delivery, or the end of a pregnancy, increased from 3.1 per 100,000 live births in 2000 to 8.1 per 100,000 in 2020.
Mr. Carr said the picture painted by Statistics Canada, that indicates maternal deaths are rare, makes it seem that the country does not have a problem. But he said: “I’m sorry, we do.”
The SOGC says current data collection practices do not sufficiently capture the prevalence of deaths because data sources are traditionally based on death registrations and hospital information. It says these sources fail to provide context needed to identify prevention methods. As well, it says the sources misclassify maternal deaths, leading to underrepresentation.
A report on trends in maternal mortality published by the World Health Organization, UNICEF and other organizations in 2019 estimated that the real number could be 60 per cent higher than Canadian figures.
Mr. Carr, who established the Kitty Carr Fund to support research and work aimed at understanding and preventing maternal morbidity and mortality, said it is unacceptable for a wealthy country to not have a reliable method to define and measure deaths.
This must change, he said, because he does not want other mothers or families in Canada to suffer a similar fate.
“We need accurate data to solve this problem.”