Canada significantly undercounts maternal deaths — doctors are sounding the alarm

At five months pregnant, Claudia Wong knew it was normal to be uncomfortable some of the time. But she couldn't shake the feeling something was wrong.

The Pickering, Ont., woman had already gained about 14 pounds, significant on her small frame. She'd become so swollen her legs were "like sausages" when she tried to put on pants. Her vision sometimes blurred.

Wong, who works in health care, mentioned everything to her obstetrician, but said she was told to "watch and wait."

One night in October 2019, Wong had painful, fiery heartburn that no amount of antacid would dispel. She considered going to the hospital, but "it just felt like another thing that people would have brushed off," she explained.

Instead, she and her husband, Denis Beaulne, checked into a float spa to relax. When Wong took a long time in the change room, the attendant unlocked the door and Beaulne found his wife passed out in the shower.

They went to a Durham-region hospital and waited several hours. Suddenly, as Beaulne watched in horror, his wife's arm shot out violently. Then she began convulsing and foaming at the mouth.

Wong had eclampsia, one of the most common severe complications women experience during pregnancy. It's a blood-pressure condition that ranges in severity and sometimes leads to death. Wong had many typical symptoms that had gone untreated for weeks. 

"For someone else, my weight gain may not have been significant. For someone else, my blood pressure may not have been significant," she recalled.

"But for me, I almost died."

Near misses like Wong's happen in Canada every day, but maternal health experts say they don't have to. Deaths of mothers are less common, but doctors are sounding the alarm that there are no consistent or reliable systems here to collect and share information on maternal deaths and close calls. It's particularly tragic, they say, because most deaths and adverse outcomes are preventable. It also means mothers in Canada die from conditions like pre-eclampsia that no longer kill women in countries with better maternal health monitoring systems. 

Dr. Jon Barrett, chair of McMaster University's obstetrics department, has been advocating for such a system for two decades.

"It's like having a near-miss aircraft crash at Pearson Airport, or one of the other major airports and not … trying to find out: What have we learned from it to avoid the next time?" 

Patti Farnan doesn't know if her daughter Kayla's death was investigated, if anyone learned from it, or if it could have been prevented.

In January 2017, two and a half years before Wong's seizure in a Toronto-area ER, 25-year-old Kayla Farnan had a seizure in a Niagara-region recovery ward.