It s Time for Action on Health Human Resources: The SOGC HHR Survey

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1 Winter 2008 It s Time for Action on Health Human Resources: The SOGC HHR Survey page 3 Looking Back, Looking Forward: Celebrating 10 Years of the International Women s Health Program page 10 A Coast-to- Coast Update on Midwifery in Canada page 12 PHAC Releases Its 2008 Canadian Perinatal Health Report page 2

2 Upcoming Clinical Practice Guidelines Below is a tentative schedule for upcoming guidelines that will be published by the SOGC. Please note that the publication dates listed below are tentative and subject to change. All guidelines are published in the Journal of Obstetrics and Gynaecology Canada (JOGC). January 2009 Initial evaluation and referral guidelines for management of pelvic/ovarian masses Menopause and Osteoporosis Update 2009 (Supplement) March 2009 Committee Opinion: Content of a complete routine second trimester obstetrical ultrasound Technical Update: Management of meconium at birth Happy Retirement, Lois Brimacombe By Marion Lapham, SOGC Archivist The SOGC would like to wish a happy retirement to its staff archivist, Lois Brimacombe. Lois joined the SOGC staff in September 2005, taking on what was supposed to be a short-term position arranging the SOGC s historical archives. For Lois, it was meant to be a fun project to keep her busy for a few months. Three years later, Lois was still here and busier than ever, the project having grown significantly in its scope. Among her other activities, Lois served as coordinator for the Archives and History Committee, developed and presented training sessions on archival principles, and lent her expertise in information science to the evolution of records management practices. Lois was also instrumental in bringing about a partnership with the Museum of Healthcare at Kingston. This sharing agreement saw immediate and concrete results with the installation of an exhibit of Dr. Rioux s Bipolar Electrosurgical Forceps in the National Office reception area. On October 30, 2008, Lois said her farewells and began a well-deserved retirement. She will be missed, not only for her hard work and dedication, but also for her friendly smile and warm personality. She worked cheerfully to preserve and document the history of the SOGCs, and, appropriately, added her own mark to it by becoming the first staff member ever to retire from the Society. Our many thanks go out to Lois for her tremendous contributions. We wish her all the best for a happy, healthy and active retirement. PHAC Releases 2008 Canadian Perinatal Health Report The Canadian Perinatal Surveillance System, an initiative of the Public Health Agency of Canada, has released its anticipated 2008 edition of the Canadian Perinatal Health Report. The report is the third comprehensive national report on maternal, fetal and infant health in Canada, containing information on 29 indicators of perinatal health. Some Key Findings of the Report Declining teenage motherhood rates: Along with an increasing trend towards delayed childbearing in recent years, the rate of live births to teenage mothers has decreased steadily between 1995 and Increases in breastfeeding: Breastfeeding initiation has steadily increased in Canada in the past few years, with up to 87% of recent mothers surveyed in 2005 reporting that they started breastfeeding their baby after birth. Decreased smoking and alcohol-use during pregnancy: Maternal smoking and exposure to second-hand smoke during pregnancy are decreasing. In the past few years, there has also been a slight decrease in maternal alcohol use during pregnancy. Rising C-section rates: In spite of concerns of the CPSS and warnings by the Society of Obstetricians and Gynaecologists of Canada about the rising trend in Caesarean delivery, the rate continues to increase in Canada. In , 25.6% of hospital deliveries were Caesarean deliveries. Increases in the percentage of first births to older women may partially explain the rise. There are also other factors at play in this complicated issue, such as rising obesity, which warrant further study. Episiotomy rates declining: The national episiotomy rate has declined dramatically in the past decade. This is likely due to the uptake of evidence-based recommendations against routine episiotomy. Rising multiple birth rate: The multiple birth rate has increased from 2.2 per 100 total births in 1995 to 3.0 per 100 total births in An increase in births to older mothers and increased use of fertility treatments and assisted conception appear to be the main reasons for this increase. Infant mortality rates and congenital anomalies: The Canadian infant mortality rate continues to decrease, with a rate of 5.1 infant deaths per 1,000 live births in Also in 2004, prematurity replaced congenital anomalies (birth defects) as the leading cause of infant mortality in Canada. SOGC members are encouraged to read the complete report available online at Millennium Fellowship Grants - Apply today! Just a reminder that thousands of dollars in grants are available to healthcare professionals through the Foundation for the Promotion of Sexual and Reproductive Health s Millennium Fellowship program. Available Grants include: Clinical Professional Development Grant for Community Physicians Clinical Professional Development Grant for University/Hospital Based Physicians Clinical Professional Development Grant for Nurses and Midwives The deadline for application is February 15, Visit the About SOGC section of for complete details on all SOGC grants, awards and fellowships. 2 Winter 2008

3 It s time for action on Health Human Resources in Obstetrics By Dr. André Lalonde, SOGC Executive Vice-President By now, it should come as no surprise to Canadians that our country is undergoing a fundamental demographic shift. The average Canadian is older now than ever before in our history. Like many developing countries, we re entering largely uncharted territory. As a result, some of our most cherished social supports are beginning to show the strain. In early December, the Society of Obstetricians and Gynaecologists of Canada released new research showing that Canada is running short of people to deliver its babies. Many of those that we do have are overworked, stressed out and unwilling to continue carrying exceptional caseloads. Based on the findings of the research, their replacements are unwilling to adopt the excessive caseloads, grueling hours and on-call hours of their predecessors. They plan to practice obstetrics in a way that enables a work/life balance and time for family responsibilities. Certainly, human resource shortages are not unique to obstetrics. All across medicine, Health Human Resources Project on Intrapartum Emergency Obstetrical Care In , the SOGC undertook its Health Human Resources Project on Intrapartum Emergency Obstetrical Care with support from Health Canada. The project is part of the SOGC s National Birthing Initiative, a seven-point action plan to address emerging concerns about the current level of maternity care women in Canada are receiving, and what needs to be done immediately to ensure that an appropriate level of care is available now and in the future. The complete report is available on the SOGC website at professionals are feeling the pressure of everincreasing demands for their services. Talk of wait time reductions has become ubiquitous a concept that is largely meaningless in the world of obstetrics. Put simply, babies can t wait. In Canada, we take for granted that we live in one of the safest places in the world to deliver a child. However, most would be shocked to know that each year roughly half a million women around the world still die from complications of pregnancy and childbirth. While the overwhelming majority of these deaths occur in the developing world, here in Canada the risks are very real. For example, if Canada s maternal death rate rose to the level of the United States, we would be looking at the deaths of an additional one thousand mothers each year. We have an obligation to the mothers of this country to ensure there are enough professionals in Canada to enable a safe and healthy labour and birthing experience. To do so will require all of us to step up and partner towards a sustainable, collaborative maternity care system for all Canadian women and their babies. Federal, provincial and territorial governments will need to set aside political boundaries and put the interests of mothers and babies first. If Canada is going to regain its stature as one of the safest places in the world to give birth, we will need governments to endorse and support a National Birthing Initiative for Canada, as well as An Aboriginal Birthing Initiative. By committing to these strategies, they will send a strong signal that the health and safety of our youngest citizens and their mothers is important, and worthy of immediate action. I urge you all to read the HHR Report featured on the SOGC website and add your voice to ours as we urge governments to take action before it is too late. Council Executive Committee: President: Dr. Scott A. Farrell, Halifax, NS Past-President: Dr. Guylaine Lefebvre, Toronto, ON President-Elect: Dr. Michel P. Fortier, Quebec, QC Executive Vice-President: Dr. André B. Lalonde, Ottawa, ON Treasurer: Dr. Mark Heywood, Vancouver, BC Vice-Presidents: Dr. Ahmed M. Ezzat, Saskatoon, SK Dr. Nicole Racette, Vancouver, BC Regional Chairs, Alternate Chairs and Other Representatives: Chair, Western Region: Dr. Sandra de la Ronde, Calgary, AB Alternate Chair, Western Region: Dr. Stephen Kaye, Vancouver, BC Chair, Central Region: Dr. Annette Epp, Saskatoon, SK Alternate Chair, Central Region: Dr. Margaret Burnett, Winnipeg, MB Chair, Ontario Region: Dr. Charmaine Roye, Brantford, ON Alternate Chair, Ontario Region: Dr. Myriam Amimi, Sault Ste-Marie, ON Chair, Quebec Region: Dr. Corinne Leclercq, Victoriaville, QC Alternate Chair, Quebec Region: Dr. Diane Francoeur, Montreal, QC Chair, Atlantic Region: Dr. Ward Murdock, Fredericton, NB Alternate Chair, Atlantic Region: Dr. Joan Crane, St. John s, NF Public Representative: Ms. Maureen McTeer, Ottawa, ON Junior Member Representative: Dr. Ashley Waddington, Halifax, NS Associate Members (MD) Representative: Dr. William Ehman, Nanaimo, BC Associate Members (RN) Representative: Dr. Margaret Quance, Calgary, AB Associate Members (RM) Representative: Ms. Michelle Kryzanauskas, RM, Kimberley, ON APOG Representative: Dr. Patrick Mohide, Hamilton, ON Corresponding Member: The Hon. Lucie Pépin, Senator, Ottawa, ON Winter

4 Upcoming Meetings SOGC Meetings 22 nd International CME March 2 6, 2009, Cancun, Mexico 19 th West/Central CME March 26 28, 2009, Banff, Alberta 5 th Ontario Gynaecology CME April 24 25, 2009, Toronto, Ontario 65 th Annual Clinical Meeting June 17 21, Halifax, Nova Scotia An accredited Continuing Medical Education (CME) program 5 th Ontario Gynaecology CME April 24 25, 2009 Toronto, Ontario Program Location: Marriott Downtown Eaton Centre Program Schedule Location Date Banff, AB March 29 30, 2009 (in conjunction with W/C CME) Toronto, ON April 26 27, 2009 (in conjunction with GYN CME) Halifax, NS June 15 16, 2009 (in conjunction with ACM) Toronto, ON December 6 7, 2009 Other Meetings Napa 2009: Urogynecology and Female Urology Course. Jointly offered by the Urology Department of McGill University, the Obstetrics and Gynecology Department of Queen s University and the Cleveland Clinic. Hosted May 21-24, 2009, in Napa Valley, California. For complete details visit Annual Human Placenta Workshop. Hosted by Queen s University (Kingston, Ontario), July 19-25, For additional information, visit or contact Mike Bilinski or Suzanne Burke at The 19 th FIGO World Congress of Gynecology and Obstetrics. Hosted October 4-9, 2009, in Cape Town, South Africa, by the International Federation of Gynecology and Obstetrics (FIGO). For complete details, please visit Register for this CME Program For on-line registration and complete program information visit Reserve your Hotel Room Book your hotel room today, standard rooms starting at $159, per night. Call Marriott at , reference group code SOGC to receive the discounted rate. Reserve before Friday, March 13, This CME program is offered in English. the society of obstetricians and gynaecologists of canada 780 Echo Drive, Ottawa, Ontario K1S 5R7 Tel: or (613) Fax: (613) Photo Toronto Tourism 4 Winter 2008

5 An accredited Continuing Medical Education (CME) program In association with the Alberta Society of Obstetricians and Gynecologists (ASOG) 19 th West/Central CME March 26 28, 2009 Banff, Alberta Program Location: Fairmont Banff Springs 2009 Marks the Birth of the Canadian Association of Nurses for Women and Newborns With the start of 2009 comes a new organization providing a uniquely Canadian, bilingual voice for nurses caring for women, newborns and families, the Canadian Association of Nurses for Women and Newborns (CANWN). The founding members of this organization, representing all regions of Canada, envision this organization as providing leadership for Canadian perinatal and women s health nurses. CANWN will advocate for women s health, provide opportunities for continuing educational development, influence nursing education to meet entry to practice standards and represent Canadian nurses regarding policy development in this practice specialty. It is envisioned that CANWN will conduct the business of the organization and provide educational opportunities, employing video-casting as much as possible. This method of communication will facilitate the participation of nurses across this vast country, and allow for nurses in rural and remote areas to participate. Photos Fairmont Register for this CME Program For on-line registration and complete program information visit Reserve your Hotel Room Book your hotel room today, Fairmont rooms starting at $239 and deluxe rooms starting at $279, per night. Call Fairmont at , reference group code SOGC to receive the discounted rate. Reserve before Friday, February 13, Benefits of Taking a SOGC CME Course Our scientific programs keep you up-to-date with advancements in Ob/Gyn. The sessions allow you to share new ideas and practices with other top minds in the industry. You will come away re-energized and inspired to meet your day-to-day challenges. This CME program is offered in English. the society of obstetricians and gynaecologists of canada 780 Echo Drive, Ottawa, Ontario K1S 5R7 Tel: or (613) Fax: (613) Dr. Jennifer Medves (Queen s University, Kingston) will take on the role of President of CANWN, with Dr. Margaret Quance (Mount Royal College, Calgary) serving as Secretary- Treasurer, and Merry Little as Communications Director. There will be three regions: West (B.C. to Manitoba), Central/North (Ontario, Yukon, Northwest Territories and Nunavut) and East (Quebec and the Maritimes/Newfoundland). Bookmark the new web address for the association: CANWN-AICFNN.CA Annual membership fees for the new society are $ GST ($52.50). Personal cheques are accepted and should be made out to CANWN. Those who are interested in joining this exciting new organization may send their membership fees to: Dr. Margaret Quance School of Nursing Faculty of Health and Community Studies 4825 Mt. Royal Gate SW Calgary, Alberta T3E 6K6 Winter

6 Reminder Call for Nominations to SOGC Council The Society of Obstetricians and Gynaecologists of Canada (SOGC) is calling for the nomination of exemplary individuals to serve on the SOGC Council for mandates starting July Deadline for nomination submissions is February 1st, The vacant positions are: President Elect (Center- Saskatchewan) Vice-President (Ontario) Treasurer Associate Member Registered Nurse Associate Member Registered Midwife Other positions on Council to be filled by appointment are: Alternate Chair (Quebec) APOG Representative Junior Member Representative Public Representative Corresponding Member Interested candidates are invited to read more about the responsibilities and the duties of the SOGC Council in the members-only section of our website at There, SOGC members can find additional information on the SOGC Bylaws, as well as documents relating to the nomination and election processes for SOGC Council. Members may also contact the Director of Corporate Affairs at for additional details. SOGC Past President Named one of Canada s Most Powerful Women Dr. Dorothy Shaw has been named one of Canada s 100 most powerful women by the Women s Executive Network. Dr. Shaw is an SOGC Past President, current FIGO President, and Senior Associate Dean of Faculty Affairs at UBC s Faculty of Medicine, and is renowned as a vocal advocate for women s health around the world. Dr. Shaw was included in the category of Trailblazers and Trendsetters, recognized for being the first woman to lead the International Federation of Gynecology and Obstetrics, or FIGO. This award could not be more well deserved. Dorothy s selfless work is helping to make pregnancy and childbirth safer for women around the globe. She has been instrumental in bringing the preventable tragedies of maternal and newborn mortality to front and centre something that all Canadians should recognize and be proud of, said Dr. André Lalonde, Executive Vice-President of the SOGC. Her work is an inspiration to all of us who practice ob/gyn, and we are very lucky to work alongside such a remarkable colleague. The Women s Executive Network (WXN) is dedicated to the advancement and recognition of executive-minded women in the work place. The 10,000 member organization invites women leaders in business, government and the not-forprofit sector to attend exclusive meetings in seven cities across Canada. It also sponsors professional development workshops and other events. This is the sixth year that WXN has given the Most Powerful Women awards, which now honors women in eight categories: corporate Dr. Dorothy Shaw executives, entrepreneurs, public sector leaders, trailblazers and trendsetters, champions, professionals, future leaders, and arts and communications. The winners were chosen by a 20-member advisory board. Dr. Shaw was nominated by a former medical resident at UBC. Among the other awards Dr. Shaw has received are: Fellow ad eundem from the Royal College of Obstetricians and Gynaecologists (U.K.); the President s Award from the Society of Obstetricians and Gynaecologists of Canada; and the May Cohen Award for Gender and Equity from the Associations of Faculties of Medicine of Canada. She also was recognized for Outstanding Contribution to the Promotion of Women s Health at the 25 th FIGO World Congress of Gynecology and Obstetrics in With files from a UBC Faculty of Medicine Press Release CSPM Welcomes New President By Marie-Andrée Harvey, MD, MSc, Past President, CSPM The Canadian Society of Pelvic Medicine (CSPM), formerly known as the Canadian Society of Urogynecology and Reconstructive Pelvic Surgery, is delighted to announce that Dr. Queena Chou has been named as the society s new President for a two-year term. Dr. Chou is currently an Associate Dr. Queena Chou Professor in the Department of Obstetrics and Gynecology at the Schulich School of Medicine and Dentistry at the University of Western Ontario. She is also Director of the Female Pelvic Floor Disorders Investigative Unit as well as the Fellowship Director in Urogynecology and Reconstructive Pelvic Floor Surgery in London, Ontario. Dr. Chou is a fellow of the American College of Obstetricians and Gynecologists and a diplomat of the American Board of Obstetrics and Gynecology. She has been actively involved with continuing medical education and with national professional organizations such as the SOGC. Her clinical and research interests involve a variety of women s health issues such as female urinary incontinence, pelvic organ prolapse, surgical anatomy and outcomes, minimally invasive surgery, female pelvic floor imaging and postgraduate education. We are extremely privileged to have Dr. Chou, a very talented and determined physician as our President. Congratulations Dr. Chou! 6 Winter 2008

7 Members Corner Junior Member News Welcome, New Members The SOGC is pleased to welcome some of the newest members of our Society: Ob/Gyn Member: Dr. Gaby Michel Khayata; Junior Member: Dr. Abeer Fahed Alkendary, II; Dr. Mohammed M. Malak; Dr. Anwar Moria; Dr. Juliette Sacks; Dr. Nicole Cohen; Dr. Juliette Sacks; Junior Member Family Practice: Dr. Andrea Robyn Hull; Dr. Melodie Roy; Dr. Angela Maria Tarazona; Associate Member RN: Ms. Janet Andrews; Mrs. Natacha Bielinski; Mrs. Norma Di Pietro; Mrs. Trudi Estey; Mrs. Shelley Gallant; Ms. Darlene Girard; Mrs. Deanna Hamill; Mr. Jacobi Haycock; Mrs. Ruth Kerr; Mrs. Laurie Loveland; Mrs. Josette Messier, RN; Ms. Maggie Newing; Ms. Darica Scollard; Mrs. Mary Lue Springer; Mrs. Bernadette Thompson; Ms. Barbara Webster; Ms. Maureen White; Mrs. Sheri White; Ms. Connie Ptolemy; Ms. E. Louise Rawluk; Mrs. Bernadette Thompson; Associate Member Midwife: Linda Bergeron; Mrs. Leslee Blatt; Ms. M. Whitney E. Bonnett, RM; Ms. Deborah Bonser; Isabelle Brabant; Mrs. Jane Elizabeth Calhoun, RM; Mrs. Maren Dietze; Ms. Jennifer Diane Duggan, RM; Emmanuelle Hebert; Johanne Savoie; Ms. Melinda Soares; Ms. Georgia Tsouluhas; Ms. Ava Vosu; Mrs. Allison Walker; Associate Member Allied Healthcare Professional: Ms. Janna Alberta Federkeil; Associate Member MD: Dr. Deborah L. Rotzinger; Dr. Hilgard Goosen; Associate Member Students in Healthcare Training: Ms. Josdalyne L. Anderson; Isabelle Beaudoin; Ms. Danielle Beausejour; Miss Heike Berger; Ms. Megan Bobier; Miss Kimberly Bremer; Ms. Sylvie Carignan; Ms. Sarah Coad; Ms. Elisabeth Codsi; Ms. TB Kate Collins; Ms. Geneviève Cournoyer-Rodrigue; Ms. Kate Demers; Ms. Helena Frecker; Ms. Meredith Giffin; Ms. Erica Goupil; Ms. Lucie Guenette-Lemieux; Ms. Sarah Hodgson; Mr. David Christopher Holden; Mrs. Sherry Katz; Ms. Katherine Kennedy; Ms. Maria Kielly; Miss Crystal King; Ms. Kaelyn Koepke; Ms. Marielle Labarre; Ms. Manon Lachapelle; Ms. Bev Ann Langlois; Ms. Nicole LeBlanc; Ms. Leanne Lubberts; Ms. Anne Maltais; Ms. Melanie Martin; Ms. Melanie McVean; Ms. Claire Osepchook; Ms. Marika Pare; Ms. Laura Parizeau; Ms. Jadine H. Paw; Ms. Shafeena Premji; Ms. Jennifer Spurr; Ms. Marie-Hélène Théberge; Ms. Laurel Anne Tien; Ms. Monica Weber; Ms. Amanda Lynne West; Ms. Diane Wu; Miss Nimrah Abbasi; Miss Kimberly Bremer; Miss Joanna Colledge; Ms. Ulrike Dehaeck; Ms. Stephanie A. Johnston; Mrs. Sherry Katz; Ms. Caitlin Keelan; Mr. Philip Aaron Pink; Ms. Diane Wu SOGC Committees are Looking for Junior Members! Would you like to volunteer as a member of an SOGC committee? These committees provide a diverse range of important services, including the development of SOGC clinical practice guidelines, policy statements, and committee opinions for publication in the Journal of Obstetrics and Gynaecology Canada. By joining a committee, you will have the opportunity to participate in important work to advance sexual and reproductive health care and policy in Canada, while earning valuable experience alongside some of Canada s foremost experts in the field. The following committees are currently seeking resident representatives. Advances in Labour and Risk Management (ALARM) Committee Coordinator: Melissa Gauthier Sub-Committee on Urogynaecology Coordinator: Sharon Giesinger Clinical Practice Gynaecology Committee Coordinator: Sharon Giesinger If you are a resident and are interested in serving on one of these committees, please contact the Committee Coordinator directly. Congratulations! The SOGC would like to congratulate the winners of our 2008 Junior Member elective grants. Junior Member Elective Grant winners - November 2008 Dr. Laurina Leyenaar Grant Sponsor: Janssen-Ortho Inc. Dr. Carole Bosse-Williams Grant Sponsor: Organon Canada Ltd. (a part of Schering-Plough Canada Inc.) Dr. Verena Kuret Grant Sponsor: Abbott Laboratories The SOGC would like to congratulate our winners, and thank our generous sponsors for their support of the SOGC s elective grant programs. Winter

8 EXPERIENCE HalIFaX at the sogc annual Clinical Meeting JUNE 17 21, 2009 Arts/Culture Experience Halifax s past and present by visiting the Maritime Museum of the Atlantic, the Art Gallery of Nova Scotia, or a multitude of other wondrous attractions that the city off ers. Outdoor Enthusiasts Enjoy the beautiful Halifax outdoors. Some activity suggestions include sea kayaking/rafting, golf or hiking. Remember to make time to explore the many provincial parks and trails, go out on a harbour tour or take a nature & whale watching cruise. Many more activities can be enjoyed on a day trip. Week-at-a-Glance (subject to CHaNGE) Wednesday, June 17 Thursday, June 18 International Women s Health Day Post-Graduate Day, Best Practice Sessions and Sub-Specialty Day Photos Destination Halifax/Nova Scotia Tourism & Culture/ W. Hayes and istock.com Theme: Bridging Culture and Medicine: A multi-disciplinary approach to improving quality of care for women 07:30 08:00 Continental Breakfast 08:00 08:15 Welcome and Opening Remarks by Dr. André Lalonde and Dr. Scott Farrell 08:15 09:30 Panel: Cross-Cultural Perspectives in the Delivery of Safe Motherhood 09:30 10:00 Health Break 10:00 10:15 Short Stories from the Field 10:15 11:30 Panel: Do No Harm: Negotiating Culture in the Delivery of Care 11:30 12:00 Theatre Play (TBD) 12:00 13:00 Lunch 13:00 13:30 Presentation of Volunteer Awards 13:30 14:30 Panel: 60 Years of the Human Rights Declaration: Achievements and Challenges Regarding Sexual and Reproductive Health 14:30 15:00 Health Break 15:00 16:00 Video Presentation and Continuation of Human Rights Panel 16:00 16:15 Update on SOGC s Involvement: QUARITÉ 16:15 16:45 Final Keynote Speaker The Way Forward 16:45 17:00 Closing Remarks 17:00 20:00 International Women s Health Reception Other meeting Open discussion group on How to Get Involved (date and time to be determined) 07:00 08:30 Breakfast Symposium 1 08:30 15:30 Post Graduate Courses (PG) Full-Day Sessions PG 1: Society of Canadian Colposcopists PG 2: Urogynaecology Pilot Project PG 3: Maternal Fetal Medecine (MFM) 08:30 12:00 Post Graduate Courses (PG) Half-Day Morning Sessions PG 4: Fetal Health Surveillance Antepartum Intrapartum PG 5: REI Endocrinology Problems in Gynaecology PG 6: Preterm Labour A to Z PG 11: SMIG Laparoscopic Hysterectomy: Principles and Practice (Didactic Session) PG 13: CSPM Surgical Pelvic Floor Anatomy: Prosections PG 15: CANPAGO Unique Challenges in Providing Care to Adolescents in Obstetrics and Gynaecology PG 17: SIGMA Menopause Osteoporosis the Aging Women 10:00 10:30 Health Break 12:00 13:00 Luncheon Symposium 1 13:00 15:30 Post Graduate Courses (PG) Half-Day Afternoon Sessions PG 7: PIH Preeclampsia PG 8: Prenatal Screening PG 9: Obstetrical Emergencies PG 10: Reproductive Mental Health in Obstetrics and Gynaecology PG 12: SMIG Hands on Lab Demonstration (Laboratory Session): Hysteroscopy and Laparoscopy PG 14: CSPM Off -Site Specimens PG 16: CANPAGO Menstrual Problems in the Adolescent Patient 13:00 15:30 Sub-Specialty Sessions (SS) SS 1: Midwifery Midwives and the Rest of the Community SS 2: Nursing Labor Support: What is it and How do We Know When it is Provided? 13:00 15:30 Research & Innovation Program Oral Presentations 15:30 16:00 Health Break 16:00 17:30 Research & Innovation Program Oral Presentations 16:00 17:30 Best Practice Sessions A (BPS) BPS 1: CMPA Medico-Legal: Gynaecology BPS 2: VBAC Is it Still an Option? BPS 3: Routine Prenatal Testing New Standards BPS 4: Normalizing Birth BPS 5: Coagulation Disorders in Obstetrics and Gynaecology BPS 6: Hysterectomy Choosing the Best Route BPS 7: Options for Managing Overactive Bladder BPS 8: Medical Abortion Update BPS 9: Impact of Food-Borne Infectious Diseases in Pregnancy Listeria Hysteria BPS 10: Vulvovaginal Abnormalities SOCIAL EVENTS Opening Reception Council Dinner (invitation only) Legend: BPS = Best Practice Session, BS = Breakfast Symposium, IS = International Symposium, LS = Luncheon Symposium, PG = Post Graduate Course, SS = Sub-Specialty Session. 8 Winter 2008

9 Shopping Halifax shopping has something for everyone. Explore Halifax s stores, vintage antique shops and shopping malls. Dining Halifax is a city where the art of food preparation is met with enthusiastic hands. The meals you d expect on the menu of a seafaring people are here in Halifax restaurants all manner of seafood along with contemporary cuisine made with local ingredients. Halifax dining is an opportunity to experience food that will entice any appetite. Children s Camp For the second consecutive year, SOGC will be contracting Kidscenes to run our subsidized day camp during the ACM. The camp will run daily during the meetings. Several day trips currently under consideration include the Citadel, the Discovery Centre, and the Maritime Museum of the Atlantic. To express your interest in the program or for further information please contact Gerri-Lynn Sendyk at The Scientific Program will be held at the World Trade Convention Centre Friday, June 19 Saturday, June 20 Sunday, June 21 International Symposia, Best Practice Sessions, Exhibits and Research and Innovation Day 07:00 07:30 Continental Breakfast (exhibit area) 07:30 09:00 International Symposium 1 09:00 10:30 International Symposium 2 10:30 11:00 Health Break (exhibit area) 11:00 12:30 Best Practice Sessions B (BPS) BPS 11: Diabetes in Pregnancy BPS 12: Have Tracing Will Travel BPS 13: CMPA Medico-Legal: Obstetrics BPS 14: Induction of Labour BPS 15: Breech Management BPS 16: When Surgery is NOT Indicated BPS 17: Approach to Pelvic Masses in Post Menopausal Women BPS 18: Surgical Abortion Update BPS 19: Antibiotic Choices in Gynaecology BPS 20: CAP Contraceptive Challenges BPS 21: e-medicine in the Palm of your Hands at the Tips of your Fingers and in Your Ears! 11:00 13:00 Research & Innovation Program Oral Presentations 12:30 13:15 Lunch (exhibit area) 13:15 14:45 International Symposium 3 14:45 15:15 Health Break (exhibit area) 15:15 16:15 International Symposium 4 16:15 18:00 Research & Innovation Program Oral Presentations SOCIAL EVENT Gala Event Featuring maritime feast with a performance by the Juno-nominated Barra MacNeil s, hailed as one of the greatest live acts in the Celtic world. Tickets for sale with a CFWH charitable receipt. International Symposia, Research and Innovation, Exhibit and Awards Ceremony and Installation of President 07:00 08:00 Continental Breakfast (exhibit area) 07:00 08:00 Annual Business Meeting 08:00 09:00 International Symposium 5 09:00 10:30 International Symposium 6 10:30 11:00 Health Break (exhibit area) 11:00 12:00 International Symposium 7 12:00 13:00 International Symposium 8 13:00 14:30 Lunch (exhibit area), Research & Innovation - Poster Presentations 14:30 15:30 International Symposium 9 15:30 16:30 International Symposium 10 16:30 17:30 Awards & Installation of President 17:30 Awards Reception SOCIAL EVENT Student Mixer Resident Fun Night National Aboriginal Day 07:30 09:00 Breakfast Symposium 2 09:00 10:00 International Symposium 11 10:00 11:00 International Symposium 12 11:00 12:00 Stump the Professor 12:00 End of ACM Hotel Reservations Reserve before Friday, May 8, 2009 Group code: SOGC Delta Halifax, 1990 Barrington St. and Delta Barrington, 1875 Barrington St. Price range from $172 to $231 depending on room type Tel.: (902) or The Prince George, 1725 Market St. Deluxe Room $219 single/double occupancy Tel.: (902) or Travel Don t forget, SOGC has negotiated with Air Canada and Westjet so that you can attend our CMEs for even less. See our website for promotion codes and further details. Register Soon! Don t miss out on the SOGC Annual Clinical Meeting Canada s premier medical education event in women s health! Visit or drop us an at Also, look for your copy of the ACM preliminary program, which will be mailed to all SOGC members shortly. We hope to see you in Halifax! Society of Obstetricians and Gynaecologists of Canada 780 Echo Drive, Ottawa, Ontario K1S 5R7 Tel: or (613) Fax: (613) Winter

10 Critical Context Understanding Women s Sexual and Reproductive Health and Rights Internationally Marking Ten Years of the SOGC s International Women s Health Program The SOGC s International Women s Health Program: 10 years of Commitment The year 2008 marked the 10 th anniversary of the SOGC s commitment to improve the sexual and reproductive health of women around the world through its International Women s Health Program. In this feature article, the SOGC News is pleased to look back on the program s accomplishments and reflect on the impacts we have made over the past decade. How it all started With a group of SOGC volunteers, the International Women s Health Committee was established in 1995 as a special interest group. The discussions that arose from these committee meetings stimulated a new awareness of women s health issues around the world, and inspired the SOGC to expand its work outside of Canada. As Safe Motherhood initiatives emerged around the globe, Dr. André Lalonde quickly realized that the SOGC, as a professional medical association, had a role to play in advancing women s health in low resource countries. Programs and accomplishments Partnership Program Shortly after the IWH Program was established, funding was obtained from CIDA to initiate the IWHP s Partnership Program and begin work with professional ob/gyn associations in Haiti, Uganda, Guatemala and more recently, Burkina Faso. The goal of these partnerships has been to strengthen the capacity of national organizations in low-resource countries, by providing technical and financial assistance for initiatives to reduce maternal mortality and morbidity. Activities included support to establish functional secretariats, revise constitutions and bylaws, draft strategic plans, develop national teams to provide emergency obstetrical care training, build capacity to conduct maternal mortality audits, and much more. The Partnership Program allows these professional associations to grow beyond the constraints of their limited resources and become champions of women s health. Although it has not been easy, all associations have made important strides in being recognized as credible leaders in the field of maternal and infant health in their respective countries, says Liette Perron, Manager of the Partnership Program, as she reflects on her 10 years of work with the IWHP. ALARM International Program After years of successfully providing the Advances in Labour and Risk Management (ALARM) course to Canadian obstetricians, the SOGC decided in 1999 to expand the course beyond the borders of Canada, developing the ALARM International Program. The five-day program targets health professionals who provide obstetrical care, reviewing the top maternal killers and suggesting tools and strategies to improve care for mothers and newborns. The course teaches evidencebased obstetrics practice, within a framework that also stresses the sexual and reproductive rights of women. In 1998, the International Women s Health Program (IWHP) was born. At the time, SOGC adopted within its mission the important goal of reducing maternal mortality and morbidity worldwide. Unless commitment to change is made, there are only promises and hopes, but no plans, says Dr. Lalonde. Ten years ago, the IWHP was created to ensure that we would deliver on this commitment. With patience and continuous dedication, the SOGC and our volunteers have spent the past decade building a program that is now recognized worldwide. A message from Dr. André Lalonde, Executive Vice-President of the SOGC As we celebrate10 years of commitment to international women s health, I think it is only appropriate that we also celebrate the 10 years of dedicated work of the dynamic SOGC staff who make up the IWHP division. Over the years, I have seen the International Women s Health Program grow from one staff member to a team of eight full-time employees. Each one has brought to the program their creative ideas, their endless energy and their professional and organizational skills. I would like to extend a special thank you to the IWHP staff for their hard work and dedication. Liette Perron, Program Manager of the SOGC Partnership Program has been with us since the beginning and deserves to be mentioned for her own 10 years of commitment to the IWHP. Congratulations to all for 10 years of success! Since its inception, the AIP course has been delivered in over 20 countries around the world. In 2008 alone, the program was implemented in five new countries, including Burkina Faso, Kurdistan, Guyana, Mali and Senegal. (Continued on page 11) 10 Winter 2008

11 with the local ob/gyn society to offer its first district initiative in Kiboga, Uganda. The SOGC is currently active with FIGO Saving Mothers & Newborns Projects in Haiti, Kosovo, Uganda, and Ukraine. Celebrating 10 years of commitment Looking back at the past 10 years of work, there is much to be proud of. (continued from page 10) As Christine Nadori, the AIP Manager explains, what invariably gets all of the participants talking is the discussions and working groups on the sexual and reproductive rights. It s like a light bulb gets switched on when they realize the direct link between those rights, their role as care givers and the ability for mothers to survive. By sensitizing participants to the social, economic, cultural, and legal factors that can limit women s access to quality care, the program works to promote women s sexual and reproductive health in a comprehensive way. QUARITE research project In 2007, it became clear that the SOGC needed a way to quantify the impacts of the ALARM International Program, in order to demonstrate its success. QUARITE, a collaborative project between le Centre Hospitalier Universitaire de Ste-Justine and the SOGC, was established to do just that. Over a four-year period, this randomized control trial will measure the effectiveness of the ALARM International Program in reducing maternal and newborn mortality in both Senegal and Mali. FIGO Saving Mothers & Newborns Projects The main goals of the International Federation of Gynecology and Obstetrics (FIGO) Saving Mothers & Newborns Projects are to reduce maternal deaths and injuries and improve access to maternal and newborn care. Conducted in 10 low-resource countries, these projects bring together ob/gyn and midwife professional associations at the national level, and promote collaboration between ob/ gyn societies in developed and low-resource countries through twinning mechanisms. This initiative builds on the first generation of FIGO Save the Mothers Projects, conducted from , in which SOGC collaborated The IWHP s past ten years of success would not have been possible without the generosity and dedication of all of our volunteers. We would like to extend a special thank you to the outstanding initiatives, who contribute their time and energy to travel to our partner countries and share their expertise in places where it is needed most. The impact So what does 10 years of commitment to international women s health mean to the SOGC? It means that we can share in the pride of knowing that our work is changing the lives of women around the world. So often we dwell on the things that seem impossible rather than on the things that are possible. So often we are depressed by what remains to be done and forget to be thankful for all that has been done. Marian Wright Edelman Here in Canada, we often take for granted the simple things in life, access to food, water, basic health care, freedom and human rights. When we think about changing the world, we are overwhelmed with the magnitude of problems that exist and often we deny how much impact our actions can have. The past 10 years of efforts by the IWHP and SOGC have shown that, with determination and collaboration, change is possible. Mothers in Haiti can now give birth in a maternity clinic with skilled birth attendants because of the generous donations of SOGC members. Obstetricians in India can now respond to complications during childbirth because of the training they received through the ALARM International Program. Health professionals in Uganda can now educate community members on sexual and reproductive health because they have been provided with educational materials through the SOGC Partnership Program. Looking forward The first 10 years of the IWHP is only the beginning. Each year brings more lessons learned, inspiring the program to constantly evolve and improve itself. As we enter a new decade of commitment, we will remember the challenges that we faced in these first 10 years and aim to expand our efforts to reach our goal of ensuring that every woman has access to safe motherhood and the freedom to exercise the sexual and reproductive rights that she is entitled to. We will not stop until this goal is reached. That is our commitment for the years to come. The way forward: Identify ways to better incorporate young people and residents into IWH programs. Address women s sexual and reproductive rights issues at different stages of their lives. Develop stronger advocacy capabilities. Create an inter-institutional group to further dialogue, exchange best-practices and lessons learned, and strengthen partnerships. Document learning experiences and make them available to others. Better incorporate monitoring and evaluation capacities into the program. Teaching and training alone are not enough. A more comprehensive strategy is needed to ensure that practices change. Winter

12 RM Report: A Coast-to-Coast Update on Midwifery in Canada By Michelle Kryzanauskas, Chair, RM Advisory Committee It has been a few issues since the RM Advisory committee has published a report in the SOGC News, so our midwife members felt it was the perfect time to catch up on midwifery across Canada. Nova Scotia has proclaimed the Midwifery Act, with establishment of the regulatory authority (Midwifery Regulatory Council of Nova Scotia) and the registration of a first cohort of midwives expected by the end of The development of regulations, standards and policies for midwifery practice in Nova Scotia is nearing completion. RMs in this province will be working in collaborative primary maternity care teams, as employees of District Health Authorities in three model implementation sites: Antigonish, Bridgewater and Halifax. In New Brunswick, the Midwifery Act received Royal Assent in the Legislative Assembly on June 18, A multidisciplinary Midwifery Regulations Advisory Committee, including consultants from other provinces, will begin work this fall to advise the Department Of Health in New Brunswick on the development of standards and regulations pursuant to the Act, and on the recruitment and retention of midwives in the province. Funding has been announced to employ eight midwives in the first year of implementation; with four per year to be added according to district needs. The PEI government has indicated interest in exploring the potential for midwifery and the possibility of legislation. The consumer s network continues to work to raise public and political awareness. The Newfoundland/Labrador government has not moved on introducing midwifery legislation, in spite of support from CEOs of health regions, other professionals, MLAs, the Status of Women, the Aboriginal Women s Health Network and the public. Lobbying efforts continue. On October 16, 2008, the Alberta Government announced that it will begin funding midwifery services starting April 1, The Alberta Health Services Board will receive $4 million for midwifery service implementation for the fiscal year. Women will have access to midwifery services in a variety of locations including hospitals, community birthing centers and in their homes. Saskatchewan s Midwifery Act was proclaimed in 2008 and Saskatchewan plans are underway now to implement midwifery starting with practices in Regina and Saskatoon. The College of Midwives has been established and a website developed. In Manitoba, demand far exceeds available midwifery care. Of interest, over 60% of midwifery clients are from priority populations that include socially high-risk women. Manitoba Health has announced funding for 11.5 new midwifery positions (30 practicing RMs in MB). The Aboriginal Midwifery Education Program through University College of the North now has students in their third year of study. A provincial midwifery evaluation and revision of the midwifery database is planned for In Ontario, consultations continue as the scope of practice is examined and changes are planned for the June 2009 regulatory review in the province. In Quebec, in the fall of 2008 Brenda Epoo and Aileen Moorhouse from the Inukjuak maternity program will have graduated along with other midwives completing their training at Laval University in Quebec City. It is the first time in Canada that graduates from an Aboriginaldesigned training program are being given full provincial certification. On another note, the RM Advisory committee is currently preparing for the SOGC Annual Clinical Meeting Sub-Specialty meeting, to be held in Halifax in June Also, a reminder for all to mark your calendars for Normal Labour and Birth: 4 th Research Conference: Normalizing childbirth through authentic collaboration. The event is hosted this June in England. Call for Abstracts 65 th Annual Clinical Meeting June 17 21, 2009 Ha l i f a x Research and Innovation Program From the Bench to the Bedside and Back The following organizations invite you to participate in the 2009 ACM Research and Innovation Program: The Society of Obstetricians and Gynaecologists of Canada (SOGC), the Association of Professors of Obstetrics and Gynaecology of Canada (APOG), the Society of Investigators in Obstetrics and Gynaecology of Canada (SIOGC), the Canadian Society of Pelvic Medicine (CSPM) and the Society of Canadian Colposcopists (SCC)., No v asc o t i a World Trade & Convention Centre The primary author of an accepted abstract will be invited to present at the 65 th Annual Clinical Meeting (ACM), being held in Halifax, Nova Scotia June 17 21, The Research and Innovation Program at the 2009 ACM will be held June 18 20, All eligible submissions will be considered for the Best Oral and Best Poster presentation. For full details, visit to download the brochure and application form. Society of Obstetricians and Gynaecologists of Canada 780 Echo Drive, Ottawa, Ontario K1S 5R7 Tel: or (613) Fax: (613) Winter 2008

13 For the management of nausea and vomiting of pregnancy (Doxylamine Succinate/Pyridoxine Hydrochloride) Delayed release tablet Because of potential drowsiness, Diclectin should be prescribed with caution for patients who must drive automobiles or operate machinery. Laval, Québec For Medical Information : Winter

14 SOGC hosts Wake-Up Call for Safe Motherhood on Parliament Hill On November 3 rd 2008, the International Women s Health Program (IWHP) of the SOGC delivered a Wake-Up Call for Safe Motherhood on Parliament Hill. As part of the IWHP s 10 year anniversary activities, this round table event aimed to break the silence regarding the half-million women who die during childbirth each year. With a focus on post-partum hemorrhage, the number one cause of maternal mortality worldwide, a panel of international health experts presented the latest information on low-cost interventions that have proven effective in saving women s lives. The Honourable Senator Lucie Pépin, hostess of the round table event, greeted a diverse audience made up of health experts, University professors and students, ambassadors of SOGC s partner countries, CIDA health specialists, NGO representatives and media. Participants enjoyed listening to presentations given by guest speakers Deborah Armbruster, Director of the Prevention of Post Partum Hemorrhage Initiative (POPPHI), Jill Durocher, Program Research Coordinator of Gynuity Health Projects, Bridget Lynch, President of the International Confederation of Midwives, and Dr. André Lalonde, Executive Vice- President of the SOGC. After learning about existing low-cost strategies that are effective in treating post-partum hemorrhage in developing countries, participants were inspired to join our efforts of accelerating the process of change and ensuring that these reasonable solutions be made available to every woman. As one participant commented: I wanted to jump up and run out into the world and tell everyone about the devastation of PPH and how there are relatively easy ways to address it IF there is political will to do so. The Honourable Lucie Pépin As part of the SOGC s Wake-Up Call for Safe Motherhood event, Dr. André Lalonde presented Senator Lucie Pépin with a commemorative gift to acknowledge her outstanding dedication to women s health and her continuous support of the SOGC, including her work as a representative on SOGC Council. FIGO launches new project to improve maternal and newborn health in low-resource countries with the support of a Gates Foundation grant FIGO Press Release The International Federation of Gynecology and Obstetrics (FIGO) is pleased to announce that it has received a US$10.5 million grant from the Bill & Melinda Gates Foundation to improve the lives and health of women and newborns in the world s most underserved regions. Maternal and newborn health constitutes a major international health and development issue in low resource countries. Concerned that Millennium Development Goal 5 (MDG 5) to improve maternal health has not made significant progress, FIGO s project Improving maternal and newborn health in low-resource countries through strengthening the role of obstetric and gynaecological national associations, will work toward the overarching goal of reducing maternal and newborn mortality and morbidity. The project will focus on 15 FIGO member associations in low- and middle-resource countries in Asia and Africa. Over five years, FIGO hopes to enable these member associations to play a catalytic role in making positive changes in policy and practice and improve maternal and newborn health services for underserved populations. While the importance of national health professional organizations in tackling maternal mortality in low-resource countries has been noted, it could be argued that insufficient consideration has been given to the readiness and capacity of these organizations to take on this role. This project will help address this, allowing FIGO and its member associations to work more effectively toward saving the lives of mothers and newborns. The first phase of the project will focus on eight countries with high rates of newborn mortality and morbidity. This phase aims to strengthen the member associations in these countries and develop advocacy activities to raise awareness of maternal and newborn health issues at the national and regional level. In the second phase of the project, seven additional countries will be introduced with the goal of developing South-South collaborations. This phase will develop communication mechanisms for knowledge and experience sharing, partnership development and exchanges of information, skills and lessons learned. Health professional associations aim to support their membership to do their best work, and to have the best skills, knowledge, practices and resources to promote maternal and newborn health effectively. They also have unique roles as advocates for maternal and newborn health at the national and international levels. This project will assist FIGO s membership in lower resource countries to take advantage of this influential position when circumstances make it difficult to do so, ultimately reducing maternal and newborn mortality and morbidity. FIGO is pleased to have the support of the Bill & Melinda Gates Foundation to accelerate its work by promoting the role of obstetric and gynaecological professional associations in improving the lives and health of women and newborns worldwide. 14 Winter 2008

15 SOGC releases results of its Health Human Resources Survey SOGC News Release The changing face of obstetrical medicine in Canada may put women and their babies who need emergency obstetrical care at risk. As the current generation of ob/gyns retires, residents and new graduates have signaled that they are not willing to sacrifice family life and put in long and demanding hours that currently characterize the practice of obstetrics. This is a key finding of a survey conducted by the SOGC released in early December Funded by Health Canada, the study surveyed ob/gyns, ob/gyn residents, and heads of ob/gyn departments in Canada s 17 medical schools. Health and Safety Concerns The delivery of obstetrical services is at a breaking point in Canada. Many people don t realize that most of the time only an ob/gyn can manage the emergencies and surgical births that are happening more and more often, said Dr. Scott Farrell, President of the SOGC who is also a professor at Dalhousie University and the Head of the Urogynaecology and Pelvic Surgery Division of the Department of Obstetrics and Gynaecology. Emergency deliveries are not predictable, and they are more common now because women are waiting longer to have children, are often significantly overweight, and have other challenging health concerns. Fewer Ob/Gyns, Greater Workload The SOGC found that there are currently only 1370 obstetricians providing prenatal, antenatal (birthing and delivery) and postnatal care, and that this number is forecasted to go down by as much as one-third over the next five years. These ob/gyns are coping with overwhelming caseloads births per year and more and putting in hundreds of on-call hours each month. They are very worried about the health and safety of the mothers and babies in their care. After a day in the office, and then 24 hours on call, even the most dedicated physician is going to be tired, said Dr. Farrell. Compounding this HR crisis are findings from the ob/gyn residents survey that shows incoming obstetricians are not intending to practice in the same way. Respondents said they are seeking more work-life balance and are planning to: work fewer hours per week than their predecessors; severely limit their on-call duty to a fraction of the hours assumed by ob/gyns practicing today; job share with other physicians, making onein, one-out retirement replacement scenarios unrealistic; and take two to three maternity and/or paternity leaves in order to fulfill parenting responsibilities. Educational Capacity The SOGC study also looked at physician education. Simply graduating more students will not, by itself, address the problem, said Dr. Guylaine Lefebvre, the SOGC s Past-President. Provincial and federal governments are going to have to work together to increase the capacity of the medical education system to address this emerging HR crisis, said Dr. Lefebvre. The survey identified a lack of teaching rooms, simulators, administrative support and e-learning capacity, along with a shortage of faculty, as factors that needed to be addressed in order to increase the number of ob/gyns joining the profession. Meeting Mothers Expectations The SOGC study also surveyed Canadian women who have recently had a baby, or who are planning to have one. Canadian women have clear priorities: they want continuity of care throughout their pregnancy by the maternity caregiver of choice; they want an integral role in prenatal and birthing decision-making; and they want to give birth as close to home as possible. This research proves there is a major disconnect between what women expect and what is actually possible, said Dr. André Lalonde, Executive Vice-President of the SOGC. Canadians assume that their local hospital can take care of them when they have a baby. Increasingly, that is just not possible; women in smaller cities, towns and in the rural areas have no choice but to travel away from their homes to ensure a safe and healthy delivery. Collaborative Care and Emergency Obstetrics While the SOGC is firmly committed to a vision of obstetrical care that draws on the skills of other health professionals, especially midwives, Dr. Farrell notes that collaborative care models, on their own, cannot address the looming crisis in maternity care. He notes that while nurses, midwives and other maternity care providers are invaluable in caring for women during a normal pregnancy and birth, they cannot replace the skill set of an ob/gyn in an emergency obstetrical situation. For example, if a so-called normal labour being attended by a midwife or a nurse practitioner becomes high risk, an ob/gyn must be called in. If a normal pregnancy becomes more complex and an operative delivery is required, an ob/gyn must perform what may be a lifesaving surgery. A National Birthing Initiative The SOGC undertook the Emergency Obstetrical Care HHR survey as part of its National Birthing Initiative, a comprehensive strategy to address the pending maternity care shortages that will have a direct and significant impact on women having babies in Canada in the future. Read the full report To read the complete report on health human resources, please visit the SOGC website at Winter

16 16 Winter 2008

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