Canada has undergone a noticeable rise in maternal mortality, although it is unclear whether the trend reflects a brewing crisis or public health improvements in detecting when these tragedies occur.
The findings, part of a global maternal-mortality study published March 26, 2026, in The Lancet Obstetrics, Gynaecology, & Women's Health, reveal that Canada's maternal deaths increased 18% from 2015 to 2023, the most recent period analyzed by researchers from the University of Washington's Institute for Health Metrics and Evaluation (IHME) and their collaborators.
This uptick is in sharp contrast to peer countries. Maternal mortality—total deaths recorded during pregnancy or up to one year postpartum—declined by the same percentage or more in other high-income regions, including in Asia-Pacific, Australasia, and Western Europe.
The maternal mortality ratio in Canada, which measures the number of maternal deaths for every 100,000 live births, also grew during this period. The maternal mortality ratio provides a way to track changes in maternal health because it accounts for shifts in the size of the population and birth rates over time. Canada's maternal mortality in 2023 was 12 deaths for every 100,000 live births, or less than half that in the United States. In 2015, fewer maternal deaths occurred in Canada—approximately 10 deaths for every 100,000 live births.
Yet the increase is difficult to interpret, said Lynn Murphy-Kaulbeck, president of the Society of Obstetricians and Gynaecologists of Canada (SOGC), a maternal fetal medicine specialist, and an associate professor at Dalhousie University, who was not involved in the Lancet study. She said the trend could reflect improved reporting of maternal deaths over time.
Based on her experience, she suspects that Canada is undercounting maternal deaths and that maternal deaths are frequently missed if they occur outside the hospital. Murphy-Kaulbeck pointed to situations where people die at home from causes such as domestic violence, suicide, or medical conditions.
"Are we going up? Are we going down? You know, it's a difficult one to say," Murphy-Kaulbeck said. "It concerns me that I feel we're not capturing all of [the maternal deaths], but a caveat to that is we're probably capturing more than we did before."
Some Canadian provinces may have gotten better at recording maternal deaths that occur up to one year after childbirth, said Isabelle Malhamé, an internist and scientist specializing in cardiovascular health at McGill University Health Centre, citing the SOGC's push for provinces to better report and review maternal deaths. She coleads an initiative to improve maternal health data collection, the Canadian Obstetric Survey System. To date, the initiative's research has demonstrated the feasibility of creating a nationwide maternal health surveillance system; launched a pilot program to collect data on maternal health complications in the most populous province, Ontario; and established a national network to study and improve maternal cardiovascular complications.
"I'm not surprised to see these numbers," Malhamé added. "It's probably a gross underestimate of the true maternal mortality ratio because the vital statistics in Canada are notorious for under-capturing maternal deaths."
The study's lead author—Maegan Ashworth Dirac—acknowledges that some part of the increase could be due to more accurate data collection but cautions that there could be more to the trend. "A lot of those [data] improvements were made in the early 2000s, mid-2000s," said Dirac, an assistant professor of Health Metrics Sciences and Family Medicine at the University of Washington. Dirac explained that IHME researchers were able to adjust for similar reporting improvements in the United States, where they still found an increase during an earlier study period, 2000 to 2015.
If the more recent growing trend in Canada is real, taking a closer look at the statistics could reveal what is driving the deaths. Dirac, for example, believes some portion is related to delayed childbearing.
"For people who delay childbearing from age 20 to age 30, we don't see a big impact, especially in the United States and Canada," Dirac said. "But for people who are delaying into their 40s and 50s, we do start to see some impact."
Studies show the general risk of maternal mortality increases with age. For example, in high-income countries overall, according to the IHME-led Global Burden of Disease (GBD) study, pregnant people in their early 40s experience a threefold greater risk of dying compared to those giving birth in their early 30s.
In Canada, people giving birth at older ages has become more common over time, similar to many other locations, including the United States, high-income Asia-Pacific, Australasia, and Western Europe, according to the GBD study.
The data for Canada, available in interactive form via IHME's visualizer, yields another important clue: it shows that the maternal mortality risk is dropping in older age groups but rising among younger people in Canada. Among pregnant people in Canada in their early 20s, the maternal mortality ratio climbed more than 300% between 1990 and 2023.
"For those who are having babies [at an] older [age], it is safer to do so now than it was in 1990," said Dirac. She elaborated that over the years, many clinical guidelines have been issued by professional medical societies and government agencies to improve care for older mothers.
She posits that Canada's rising maternal mortality could stem from two scenarios. First, people could be delaying childbirth for social and economic reasons, such as pursuing higher education and career advancement. Second, people having babies at younger ages may be doing so unintentionally or because of limited access to family planning and contraceptive care.
"Those things also correlate with all of the things that make pregnancy dangerous, you know—poor health, poor access to care," Dirac said. "So it may be when we [document] this delayed childbearing, what we're revealing by looking at the younger women is disparities that were already there."
Murphy-Kaulbeck wonders whether mental health is a factor in the trends among young people. She mentioned poor mental health among young people globally that is likely worsening. Research has indicated that the COVID-19 pandemic exacerbated mental disorders, particularly among youth, and that social media use may be linked to anxiety and depression in young people.
"Populations that have been historically marginalized from the medical system continue to be facing these more hostile health environments for them… aspects of care related to language barriers, difficulty in accessing resources closer to home, issues related to mistrust because of historical precedents," Malhamé said.
Speaking to historical precedents that have generated mistrust and have made people wary of seeking medical care from the government, Canada forced Indigenous people into the Indian Residential School System for roughly 150 years, removing Indigenous children from their homes and attempting to suppress their language and culture, subjecting them to physical and sexual abuse and poor nutrition. It is estimated that thousands of Indigenous children in Canada died while attending these schools.
Malhamé stressed the importance of working directly with people who have lived experience of pregnancy to develop better solutions for improving maternal health in Canada. She led an effort to boost McGill University Health Centre's recognition of and response to high-risk situations among pregnant people in collaboration with patients, their support people, and clinicians. The McGill program, called the Pregnancy-adapted Early Response System, is modeled from obstetric early warning systems that have shown effectiveness in improving maternal health outcomes.
Murphy-Kaulbeck thinks Canada needs a maternal health program that makes it easier for pregnant people to access health care, especially in rural areas. Another way to save lives is for the health system to more closely follow mothers and birthing people once they take their baby home from the hospital—she noted that this phase is a high-risk period for complications. Murphy-Kaulbeck also stressed the need for a national system, similar to those in Australia and the United Kingdom, focused on accurately tracking maternal deaths and deciphering the contributors, as well as investigating near-misses, such as mothers who almost die from complications after giving birth.
Recent news coverage has spotlighted harrowing experiences. After giving birth to her first child at age 30, Beatrice Mikkola visited the emergency room several times over two months for heavy bleeding until doctors found a small piece of placenta stuck in her cervix, according to an interview with the Investigative Journalism Bureau. Four years later, in 2026, Mikkola had to visit the emergency room soon after the birth of her third, when she once again experienced severe bleeding and underwent surgery to remove a portion of placenta from her cervix.
By tracking and learning from close calls such as Mikkola's experience, Murphy-Kaulbeck said, "you're going to have a much [more] robust, much broader look at what needs to be addressed."
