Canada has the lowest number of maternity care professionals among 11 comparable wealthy countries, while maternal deaths, infant mortality and wait times for gynaecological treatment are raising concerns about the state of the country's health care system.A new report from Calgary-based SecondStreet.org found Canada has just 0.13 obstetrician-gynaecologists (OB-GYNs) and midwives per 1,000 residents, more than 11 times fewer than Sweden.The report, titled Women and Children Last: An Examination of Canada’s Maternal Care Crisis, also found maternal deaths increased 18% between 2015 and 2023.Report author Bacchus Barua said the findings point to serious weaknesses in how Canada delivers maternity care.“Stories of closed maternity units and diverted patients aren’t isolated incidents,” said Barua.“The data show a system short of the very professionals that mothers and newborns rely on.”According to the report, Canada had just 0.08 OB-GYNs and 0.05 midwives per 1,000 residents in 2024.That placed Canada last among 11 comparable high-income countries, where the combined average was 0.70 maternity care professionals per 1,000 people.Sweden topped the comparison with 1.5 OB-GYNs and midwives per 1,000 residents.Among Organisation for Economic Co-operation and Development (OECD) countries, Canada ranked 34th out of 36 for OB-GYNs and tied for last among 24 countries reporting data on licensed midwives.The report also found Canada relies more heavily on specialist physicians to deliver maternity care than most comparable countries.“Canada and the United States are also the only two countries in this group that rely primarily on an OB-GYN-led model of care,” Barua said.“Every other country uses significantly more midwives.”The shortage of maternity care professionals comes as Canadian women face increasingly long waits for gynaecological treatment.According to Fraser Institute data cited in the report, the median wait between a family doctor's referral and treatment reached 40.6 weeks in 2025.That represents a 174% increase from 14.8 weeks in 2005..Maternal mortality figures also show Canada moving in the opposite direction from the average among OECD countries.Canada's maternal mortality rate increased from 8.8 deaths per 100,000 live births in 2005 to 12.6 in 2024.Over the same period, the OECD average declined from 11.5 to 8.7 deaths per 100,000 live births.Canada's 2024 maternal mortality rate was approximately seven times Norway's rate of 1.8 deaths per 100,000 live births.The report also identified concerns about injuries associated with childbirth.Canada recorded 16.1 cases of obstetric trauma for every 100 instrument-assisted vaginal deliveries, more than four times the Netherlands' rate of 3.8.Infant health outcomes were also worse than those reported in several comparable countries.Canada's infant mortality rate stood at 4.5 deaths per 1,000 live births in 2024, compared with 2.0 in Sweden.The report found 7.2% of Canadian babies were born with a low birth weight, compared with 4.1% in Sweden.Low birth weight is associated with increased risks of health complications for newborns.SecondStreet.org argues the findings demonstrate that increasing health care spending alone will not resolve Canada's maternity care challenges.Instead, the organization is calling for policymakers to examine how maternity services are organized, funded and delivered.Barua said Canada's reliance on an OB-GYN-led model deserves particular scrutiny given the greater use of midwives in other developed countries.“Though the factors driving our poor outcomes are undoubtedly complex, spending more money is not the answer,” he said.“Instead, policymakers should look closely at how maternity care is currently organized and funded.”The report's international comparisons highlight differences in staffing levels and health outcomes, although those figures alone do not establish that Canada's maternity care model is responsible for its higher mortality rates.The findings add to concerns about access to health services as Canadian patients face lengthy waits for specialist treatment and some communities struggle to maintain local maternity services.The full report, Women and Children Last: An Examination of Canada’s Maternal Care Crisis, is available through SecondStreet.org.
