Canada is facing a growing maternal care crisis, marked by rising mortality rates among mothers as well as high infant mortality rates compared to other comparable countries, a new study suggests.
The report from SecondStreet.org found that Canada’s maternal mortality rate has risen 43 percent over the past two decades, and infant outcomes lag behind many comparable countries.
The maternal care workforce shortage in Canada is pronounced, the report says, with an estimated 0.13 obstetrician-gynaecologists and midwives per 1,000 people. That is the lowest rate among 11 comparable high-income countries and more than 11 times below Sweden’s rate of 1.5.
This deficit is compounded by long specialist wait times and burned-out health care staff, according to the report, authored by SecondStreet.org research director Bacchus Barua.
“Stories of closed maternity units and diverted patients aren’t isolated incidents,” Barua said. “The data show a system short of the very professionals that mothers and newborns rely on.”
Maternal Outcomes
Maternal mortality serves as an indicator of maternal health outcomes and is defined by the OECD as “the death of a woman during pregnancy or childbirth, or within 42 days of the termination of pregnancy.”
Canada’s maternal mortality rate climbed from 8.8 deaths per 100,000 live births in 2005 to 12.6 in 2024, the report said. Meanwhile, the OECD average declined from 11.5 to 8.7.
Canada’s 2024 rate was approximately seven times Norway’s 1.8 rate, ranking Canada 30th among the 36 OECD countries that reported their statistics.
“Simply put, while the maternal mortality rate declined across the OECD between 2005 and 2024, Canada’s rate moved in the opposite direction, suggesting a deterioration in maternal health outcomes relative to many of its peers,” Barua wrote.
Canada also recorded higher rates of caesarean deliveries and obstetric trauma.
It reported 327.4 inpatient caesarean deliveries for every 1,000 live births in 2023, equivalent to 32.7 percent and exceeding the OECD average of 28.5 percent.
Canada also scored poorly on measures of obstetric trauma, including rates of third- and fourth-degree vaginal tears during childbirth. It recorded the highest rate of obstetric trauma, with or without instrument use, among the 27 countries with available data for 2023.
Infant Outcomes
Canada’s infant mortality rate stood at 4.5 deaths per 1,000 live births in 2024, more than double Sweden’s rate of 2.
The share of babies born with low birth weight—below 5.5 pounds—was also higher in Canada, at 7.2 percent, versus 4.1 percent in Sweden and the OECD average of 6.7 percent, the report found.
“Mortality indicators are even more concerning,” the author said. He pointed to a previous study he co-wrote which found that Canada had significantly higher infant and perinatal mortality in 2021, compared to the average high-income universal health care country.
More recent international data indicate that these challenges remain. Canada ranked 23rd worst among 34 countries for perinatal mortality, the death of a fetus or a newborn infant during the critical period surrounding birth.
Canada ranked 29th worst among 36 countries for both neonatal mortality, the death of a live-born infant during the first 28 days of life, and infant mortality, the death of a baby before his or her first birthday.
“Outcomes for newborns and infants compare unfavourably with those of many peer nations,” Barua wrote. “While mortality rates are influenced by a range of factors including geography, population characteristics, and environmental factors, the consistency of Canada’s relatively poor performance across multiple indicators are cause for concern.”
Maternal Care
Data from the OECD suggests Canada faces severe shortages of both midwives and obstetrician-gynecologists (OB-GYNs), the report said.
Canada ranked last—11th out of 11 peer countries—for its maternal care workforce in 2024. It had 0.08 OB-GYNs and 0.05 midwives per 1,000 residents, with a combined average of 0.70.
Among OECD members, Canada ranked 34th among 36 countries for OB-GYNs and shared last place among 24 countries for licensed midwives.
Meanwhile, data from the Fraser Institute cited in the report indicated that the median wait for gynaecological care—from referral by a family doctor to treatment—rose to 40.6 weeks in 2025. That’s a 174 percent increase from 14.8 weeks in 2005.
“The relatively low availability of midwives and OB-GYNs combined with long wait times to care raises significant concerns about quality of care and outcomes for mothers and newborns,” Barua wrote.
A study drawing on World Health Organization data from 191 countries found greater concentrations of skilled health workers—especially nurses and midwives—were strongly linked to better outcomes, including lower maternal, infant, and neonatal mortality, the report noted.
By comparison, every other country employs far more midwives per capita relative to its OB-GYN workforce, the data showed.
Barua said it remains unclear whether this reflects a deliberate medical policy or stems from the Canada Health Act’s emphasis on insurance coverage for medically necessary hospital and physician services, which left midwife funding decisions to the provinces until recently.
The study noted empirical evidence links midwife-led care models to fewer medical interventions, including cesarean sections and instrument-assisted vaginal births. These models also have the potential to reduce health-care system costs, with no statistically significant differences in mortality rates.
“Readers should note that simply spending more money on health care is not the answer,” Barua said.
He said Canada routinely spends more on health care than the OECD average yet continues to lag behind many peer countries on several key indicators of resource availability, utilization, access, and clinical performance.
Barua said the problem stems from broader structural challenges, including how the health system is organized, how hospitals are funded, and how resources are distributed across the sector. Hospital budgets are part of the issue, he argued because they do not encourage investment in specialist services when providing them costs the hospital money.
“There may be opportunities to improve patient care by directing a greater share of health spending towards frontline services like doctors, nurses, and clinical equipment rather than on administrative expenditures,” he said. “Strengthening access to maternal health services should be a priority for policymakers.”
