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Canadian women more likely experience severe vaginal tearing during childbirth: report

A new report has found that Canadians are more likely to experience severe vaginal tearing during childbirth, but one expert is looking at the stats with caution.

Earlier this week, the Canadian Institute for Health Information (CIHI) released data showing Canada has the highest rates of obstetrical trauma among 23 countries that are part of Organisation for Economic Co-operation and Development (OECD).

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Dr. Jennifer Blake, CEO of The Society of Obstetricians and Gynaecologists of Canada, said the OECD results have been pretty consistent over the years, and have been given very serious consideration. She said it’s difficult to make an apples-to-apples comparison with other countries for a few reasons.

Canadian women are having fewer children, and the average age of first-time mothers is also on the rise. (It’s at 29.2 as of 2016, according to Statistics Canada).

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Both of these factors — being older and a first-time mother — put women at increased risk of vaginal tearing, Blake said.

When we do our reporting in Canada, we correct for how old the mother is, whether she’s had babies before, factors that really influence [the] likelihood of whether or not the tissues are going to be yielding and stretch as baby comes through or not,” Blake said.

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Minor tears are common during childbirth, Blake said. A third-degree tear is one that requires stitches, while fourth-degree tears — which are “mercifully rare” — are so severe that they affect the sphincter around the anus.

The CIHI report found that for deliveries conducted with the aid of an instrument, 16.4 per cent of women suffered third or forth degree tears, whereas the OECD average was 5.5.

For births unassisted by an instrument, the percentage was 3.1, compared with an average of 1.4 per cent internationally.

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The results were part of a much broader report comparing health care and patient outcomes internationally. Out of 57 indicators, Canada met the international average in 32 categories and exceeded it 13 others.

Canada lagged behind in some areas, including four of of five of the patient safety indicators — the category that included rates of vaginal tearing during childbirth.

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“While Canada’s health care systems are often admired, the international comparisons show that there is room for improvement,” Tracy Johnson, CIHI’s director of health system analysis and emerging issues, said in a statement on the non-profit organization’s website.

“We are lagging behind OECD countries in areas of patient safety. These are serious issues that are often preventable, and improving our performance in these areas will result in safer care for patients.”

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