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What Mothers Say: The Canadian Maternity Experiences Survey

Executive Summary - Findings

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Chapter 1: Pregnancy

Reaction to Conception

Half (49.5%) of women indicated that the timing of their conception was just right, about a quarter (23.4%) would have preferred to conceive earlier, 20.0% later and 7.1% not at all. Most women reported that they were "very happy" (80.9%) or "somewhat happy" (12.1%) when they first realized that they were pregnant.

Prenatal Care Provider

The majority of women received their prenatal care from an obstetrician/gynecologist (58.1%) or family physician (34.2%). An additional 6.1% and 0.6% of women received prenatal care from a midwife or nurse/nurse practitioner, respectively.

Prenatal Care

Most women (94.9%) initiated prenatal care in the first trimester of pregnancy. Women attended 12.9 prenatal care visits on average with only 1.1% of women having four or fewer prenatal care visits. The proportion of women who indicated that they did not get prenatal care as early as they wanted varied considerably among provinces and territories. The two most common reasons for not getting prenatal care as early as wanted were: “doctor/health care provider unavailable” and “doctor/health care provider would not start care earlier.”

Prenatal Classes

About one-third of primiparous women did not attend prenatal classes, although they were more likely to attend than were multiparous women (65.6% vs. 6.0%). Younger women (15– 19 years) were more likely to attend prenatal classes while women living in a household at or below the low income cut-off were less likely to attend classes.

Prenatal Information

Women reported their most useful sources of pregnancy-related information to be their health care provider (32.2%), books (22.3%) and a previous pregnancy (17.1%). Most women reported that they had received enough information on pregnancy-related topics, but this varied by region and maternal age.

Folic Acid Supplementation

The proportion of women who took supplements containing folic acid was 57.7% in the three months before pregnancy and 89.7% during the first three months of pregnancy. Almost a quarter (22.4%) of women did not know, prior to pregnancy, that taking folic acid before pregnancy could help prevent some birth defects.

Prenatal Ultrasound

Almost all women (99.8%) reported having at least one prenatal ultrasound, with an average of three ultrasounds per woman. The proportion of women who had more than one prenatal ultrasound was 84.2%. On average, the first ultrasound occurred at approximately 14 weeks, with 66.8% of women having their first ultrasound prior to 18 weeks.

HIV Testing

Approximately three-quarters (74.3%) of women reported having a blood test for HIV during their pregnancy. In provinces and territories that recommend that HIV testing be explicitly offered to all women (“opt-in” approach), 77.4% of women reported having an HIV test. In provinces and territories where HIV testing is routinely done unless women request not to have it (“opt-out” approach), 70.3% of women reported having an HIV test. A larger proportion of women in the “opt-out” provinces and territories (11.2%) did not know if they had an HIV test compared with those in the other jurisdictions (8.4%).

Maternal Body Mass Index and Weight Gain During Pregnancy

More than one-third of women had a high pre-pregnancy body mass index (BMI), with 21.0% categorized as overweight and another 13.6% as obese. Six percent (6.1%) of women were categorized as underweight before pregnancy. The average weight gain during pregnancy was 15.7 kilograms. Women who were underweight or normal weight prior to pregnancy gained more weight during pregnancy than other women. In general, women’s BMIs had not returned to their pre-pregnancy levels at the time of the interview (five–14 months postpartum).

Smoking

Fewer women smoked daily or occasionally during the last three months of pregnancy (10.5%) than before pregnancy (22.0%). Although many women stopped smoking during pregnancy, almost half (47.0%) of those who quit had resumed smoking at the time of the interview. Women aged 24 years and younger, women with less than a high school education and women living in a household at or below the low income cut-off reported higher rates of smoking during pregnancy. During their pregnancy, about one-quarter (23.4%) of women reported living with someone who smoked.

Alcohol Use

The proportion of women who reported drinking alcohol during pregnancy was 10.5%, compared with 62.4% of women who reported drinking alcohol during the three months prior to pregnancy. During pregnancy, 92.3% of women living in a household at or below the low income cut-off reported not drinking alcohol compared with 88.2% of women living in a household above the low income cut-off.

Street Drug Use

Seven percent (6.7%) of women reported using street drugs in the three months prior to pregnancy and 1.0% reported using street drugs during pregnancy. Younger women and women living in a household at or below the low income cut-off were more likely to use street drugs both prior to and during pregnancy.

Physical Abuse

The proportion of women who reported physical or sexual abuse in the past two years was 10.9%. Women aged 24 years or younger, women with less than a high school education, and women living in a household at or below the low income cut-off were more likely to experience abuse. Compared with before pregnancy, the level of violence during pregnancy decreased for 47.0% and increased for 5.4% of women who reported abuse. The level of violence after the birth of the baby decreased for 51.6% and increased for 16.3% of women who reported abuse.

Stress and Social Support

Almost one-fifth (17.1%) of women reported experiencing three or more stressful life events in the 12 months prior to the birth of their baby. Stressful life events were more prevalent among younger mothers (15–19 years), women with less than a high school education, and women living in a household at or below the low income cut-off. Almost 13% (12.5%) of women reported that most days were very stressful in the 12 months before their baby was born. The majority (86.9%) of women had support available to them all or most of the time during their pregnancy.

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