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Women's Health: Pregnancy is riskier in rural Canada

Study shows outcomes are worse for women who live far from hospital

New research suggests pregnant women who live more than an hour from hospital may be at higher risk of poor outcomes than those with easier access to health care.

Dr. Shiraz Moola of the Centre for Rural Health Research in Vancouver studied information on more than 32,000 deliveries in British Columbia from 2000 to 2005. In 16 per cent of cases, women lived an hour or more away from the nearest hospital.

These women were more likely to need induction of labour than women who lived closer to hospital (24 per cent versus 21 per cent) and were more likely to have a caesarean section (30 per cent versus 26 per cent). Their babies were also significantly more likely to be born premature or to have low birth weights: Almost 10 per cent of rural women delivered before 37 weeks, compared with six per cent of women closer to hospital; and six per cent of rural women had babies weighing less than 2,500 grams, versus three per cent of those who did not have to travel far to hospital.

Because the study was retrospective, it cannot identify reasons for the disparities between the groups, Moola says. However, the researchers believe the disparities are related to travel.

“What aspect of travel that actually causes that is unclear,” he says, adding stress and socioeconomic factors associated with travel may be involved, as well as the distance itself, which may result in situations such as inductions to avoid the possibility of giving birth en route to hospital.

He says the research highlights the need to ensure that all Canadians have high-quality health care. Although about one-third of Canadians live in small communities, only three per cent of obstetricians and 16 per cent of family doctors practise in rural communities.

“It’s important that those individuals who live in small communities have the same kind of access to health care that one would expect for their urban counterparts,” Moola says.