Reproductive medical care in Sweden and the Province of Ontario, Canada. A comparative study

Abstract

Reproductive medical care in Ontario, Canada and in Sweden are compared. Accurate statistical information is more readily available for Sweden. The perinatal mortality is significantly higher in Ontario. The populations are comparable in size. Except for a higher percentage of first generation immigrants in Ontario, the composition of the childbearing population is very similar. The percentage of low birth weight infants is higher in Ontario. Swedish governmental authorities realized in the 1930's that social reforms and preventive antenatal care could reduce perinatal mortality and morbidity and regionalization of perinatal care started several decades ago. A difference in attitude towards pregnant women is reflected in the fact that in Sweden, the maternal benefit is paid under the Health and Social Insurance system, whereas in Ontario it is paid by the Department of Employment and Immigration. The highly specialized neonatal and perinatal units in Ontario have outstanding results, and could serve as models to improve the care of the very low birth-weight infants in Sweden, as could the transport system for high-risk mothers and infants in Ontario. If the advantages of each of the two systems for perinatal care in Ontario and Sweden were combined excellent perinatal statistics would be expected, including a decreased incidence of handicap.