Chapter 4: Executive Summary: What Mothers Say: The Maternity Experiences Survey – Emerging issues

Executive Summary

The Maternity Experiences Survey (MES) is a national survey of Canadian women’s experiences, perceptions, knowledge and practices before conception and during pregnancy, birth and the early months of parenthood. The MES is a project of the Public Health Agency of Canada’s Canadian Perinatal Surveillance System (CPSS), which monitors and reports on determinants and outcomes of maternal, fetal and infant health in Canada. The routine sources of data for the CPSS are administrative databases, such as national vital statistics and hospital discharge abstracts, and population health surveys. However, these sources of data either do not capture, or capture incompletely, women’s perceptions and behaviours regarding pregnancy, birth and the postpartum period. Yet, women’s maternity experiences are of great importance in understanding perinatal health and evaluating and improving perinatal policies, programs and practices. The MES was designed to address this gap.

In 1999, the Steering Committee of the CPSS convened a specialized task group, the Maternity Experiences Study Group, to develop and oversee the implementation of the MES. In addition to collecting data from Canadian women across the country, the Study Group was particularly interested in the experiences of younger mothers (15–19 years), recent immigrant mothers, and First Nations, Inuit and Métis mothers, as these women are believed to be at increased risk for adverse pregnancy outcomes.

The MES population consisted of birth mothers 15 years of age and older who had a singleton live birth in Canada during a three-month period preceding the 2006 Canadian Census of Population and who lived with their infant at the time of data collection. Using the 2006 Canadian Census, a stratified random sample of 8,244 women estimated to be eligible was identified. Of these women, 6,421 (78%) completed a 45-minute interview at five to 14 months after the birth of their baby, conducted primarily by telephone. The interviews were administered by female Statistics Canada interviewers on behalf of the Public Health Agency of Canada. The MES population excluded First Nations women living on reserve and institutionalized women. A more detailed description of the survey’s design and sample is contained in the Methods section of this report.

The MES includes more than 300 questions covering such topics as socio-economic and demographic information; reproductive history; folic acid use; prenatal care; smoking, alcohol and street drug use; stress and support; physical and sexual abuse; information received about pregnancy, birth and postpartum issues; interventions during pregnancy, labour and delivery; postpartum health and care; postpartum depression; and infant feeding.

This report presents findings on all major topics covered by the MES, grouped in three chapters covering pregnancy, labour and birth, and postpartum. In addition to national results, provincial and territorial level analyses are reported. Findings by maternal age, maternal education, parity (i.e., primiparous or multiparous), type of birth (i.e., vaginal or cesarean) and household income level (i.e., at or below vs. above the low income cut-off) are also presented. Specific results from the perspective of younger mothers (15–19 years), recent immigrant mothers and Aboriginal mothers are not contained in this report but will be disseminated by way of upcoming focused publications.

The complete MES questionnaire and data tables corresponding to the findings presented in this report are available on compact disc (CD) and on the Public Health Agency of Canada website. Two papers providing an overview of the survey methodology and findings have been published in the Journal of Obstetrics and Gynaecology Canada.^1,2

As the first survey of its kind in Canada, the MES joins other national and large-scale regional surveys that have explored women’s views and experiences in the United States,^3,4 England and Scotland,5–9 Australia,^10,11 Sweden,¹² the Russian Federation,^13–16 Lithuania¹⁷ and Azerbaijan.¹⁸ By adding to our understanding of women’s maternity experiences and perspectives, the MES contributes to identifying areas of strength and areas that can be improved within the Canadian public health and health care systems.