Preconception and Prenatal Care
Planning for a healthy pregnancy, labour and birth can start before conception and continue throughout pregnancy. Folic acid is an important nutrient for the growth and development of a fetus1 and is recommended for all women of child-bearing age. From 2013 to 2017, a higher proportion of women in Middlesex-London reported taking folic acid supplements prior to and during pregnancy compared to Ontario.
Early prenatal care can help ensure a healthy pregnancy for both the mother and baby. The proportion of women in Middlesex-London who had a prenatal care visit with a physician or midwife during the first trimester of pregnancy (up to 12 weeks of gestation) was 96.5% in 2017, compared to 91.3% in Ontario.
Pregnancy is a time of change and transition in a woman’s body and life that can lead to an increased risk of poor mental health.2 A significantly higher proportion of women in Middlesex-London reported having a mental health concern during pregnancy compared to women in Ontario from 2013 to 2017. Nearly 30% of women who gave birth in Middlesex-London in 2017 reported a mental health concern during pregnancy, compared to 18.1% in Ontario.
Gestational weight gain (GWG) is the amount of weight gained by a woman during pregnancy. Women in Middlesex-London tended to gain more than the recommended amount of weight during pregnancy from 2013 to 2017. There was no significant difference in weight gain between the urban and rural populations of Middlesex-London from 2015 to 2017.
Prenatal Substance Exposure
Maternal smoking, alcohol and other drug use during pregnancy can cause health problems for both the mother and baby.3 The proportion of women in Middlesex-London who reported smoking cigarettes, drinking alcohol, and using other drugs (including cannabis) during pregnancy was significantly higher compared to Ontario in 2017. Females under the age of 20 had the highest reported use of these substances during pregnancy and the proportion of women reporting use among this age group increased from 2013 to 2017.
While the percent of women reporting alcohol use during pregnancy increased in Middlesex-London from 2013 to 2017, much of the increase was due to more women reporting alcohol use prior to the pregnancy being confirmed. The percent of women reporting alcohol use after the pregnancy was confirmed decreased from 2013 to 2017.
Pregnancy and Fertility
Pregnancy rates in Middlesex-London were lower compared to Ontario from 2006 to 2016. Pregnancy rates across age groups in Middlesex-London followed a similar trend to Ontario and the Peer Group, and were highest among females aged 30 to 34 years. Teenage pregnancy rates in Middlesex-London decreased significantly from 2006 to 2016.
Fertility rates among women of reproductive age (aged 15 to 49) in Middlesex-London were similar to Ontario and the Peer Group between 2006 and 2017. The average number of children per female (i.e., the total fertility rate) in Middlesex-London was 1.3 in 2017, compared to 1.4 for Ontario. The total fertility rate declined slightly for Middlesex-London, Ontario and the Peer Group from 2006 to 2017.
- Greenberg JA, Bell SJ, Guan Y, Yu Y-H. Folic Acid Supplementation and Pregnancy: More Than Just Neural Tube Defect Prevention. Rev Obstet Gynecol [Internet]. 2011 [cited 2018 Nov 12];4(2):52-9. Available from: https://www.ncbi.nlm.nih.gov/pmc/PMC3218540/
- Public Health Agency of Canada. Pregnancy and Women's Mental Health in Canada: Results from the Canadian Maternity Experiences Survey [Internet]. 2014 [cited 2018 Nov 13]. Report No.: 140282. Available from: https://www.canada.ca/content/dam/canada/health-canada/migration/healthy-canadians/publications/healthy-living-vie-saine/pregnancy-mental-health-grossesse-sante-mentale/alt/pregnancy-mental-health-grossesse-sante-mentale-eng.pdf
- Cui Y, Shooshtari S, Forget EL, Clara I, Cheung KF. Smoking During Pregnancy: Findings from the 2009-2010 Canadian Community Health Survey. PloS One [Internet]. 2014 [cited 2018 Nov 13];9(1):e84640. Available from: https://www.ncbi.nlm.nih.gov/pmc/PMC3885577/ DOI: 10.1371/journal.pone.0084640
Last modified on: January 24, 2019