It would be remiss to not mention the impact of COVID‑19 on the MPDRC and its reviews in 2020. The committee of maternal/perinatal experts quickly pivoted to a virtual format and for that we are grateful. Future reports will better define whether there are any recommendations arising from the COVID‑19 pandemic, related to maternal and/or perinatal mortality.

The MPDRC has, through the course of its review process in 2020, identified issues related to maternal and perinatal care. The need for a maternal early obstetric warning system in all obstetrical care facilities, the importance of fetal monitoring, planning/preparing for obstetrical emergencies and maternal transport, the need for improved maternal morbidity and mortality data collection both provincially and federally and research on maternal death have been identified as important concerns. The need for robust review of adverse events by multidisciplinary teams at the local level was also identified. As we strive towards reducing similar deaths and improving the quality of care provided to mothers and infants, it is the goal of this committee that identification of these issues will help motivate positive change and prompt action by stakeholders in obstetrical care.

Thoughts from the Society of Obstetricians and Gynaecologists Of Canada (SOGC)

Prevention of Maternal Mortality: Canada’s Toolkit for Confidential Enquiry
#savingmoms #savingbabies

Over the past four years, The Society of Obstetricians and Gynaecologists of Canada (SOGC) has been working with experts and partners to develop a system so that every maternal death in Canada is comprehensively reviewed and recommendations focused on prevention are created and implemented, in the context of Canada’s healthcare system. The MPDRC is a key participant in this system.

At the same time, The Canadian Foundation for Women’s Health, Canada's national not-for-profit fundraising foundation for women’s sexual and reproductive health, launched a campaign to support research in the area of prevention of maternal mortality in Canada as well as implementation of the Confidential Enquiry system. Mr. Paul Carr spearheaded a campaign, catalyzed by his own personal donation of $100,000 in honour of his late wife, Kitty, to support research and implementation efforts toward prevention of maternal mortality in Canada. The first Kitty Carr Research Grant will be awarded in June 2022.

The goals of these efforts are to increase awareness of the issues surrounding pregnancy-related morbidities and deaths and to promote change among individuals, healthcare systems, and communities in order to avoid every preventable case of morbidity and mortality and optimize outcomes for women and babies. Confidential Enquiry systems have been well-established in other countries and have led to reductions in maternal deaths, and improved outcomes for women, care providers and systems of care.

To facilitate implementation of a standardized approach to reviewing maternal morbidities and mortalities and to providing recommendations for prevention, a toolkit has been developed by Canadian experts, led by the SOGC and members of the Nova Scotia, Ontario, Alberta and British Columbia’s perinatal data/maternal morbidity and mortality review teams. The Toolkit consists of materials that are standardized enough to provide useful templates for maternal morbidity and mortality review, but flexible enough for each jurisdiction/committee to adapt them for their own environment. Those who are new to the review process will have the materials, tools and resources that they need to be able to initiate a process without a lot of difficulty, and with guidance from a very experienced group who are motivated and excited to provide leadership. The Toolkit, as well as education and training materials will be hosted, in both official languages, on the SOGC’s website which is being expanded to include a hub for information related to maternal mortality in Canada. The toolkit will be released in 2022.

The SOGC is also leading a research project to map the recommendations from the MPDRC that are relevant to the SOGC’s practice as well as to the level of evidence for the recommendations over the last five years in order to determine gaps in practice and evidence, required updates, or opportunities for focused educational/training initiatives.

The SOGC continues to also work with the Canadian Perinatal Surveillance System for alignment and coordinated efforts for national reporting of severe maternal morbidity and mortality, and with the provincial perinatal data systems to explore models for implementation of the Toolkit and reporting. The SOGC is also partnering on several research projects related to measurement of maternal morbidity and mortality, including studies focused on Perinatal Mental Health, and liaises regularly with the UK and the USA on topics related to maternal health.