Health IQ: The push to end birth evacuations, Ontario health data hack

The emotional and personal costs of birth evacuations

In remote Indigenous communities across Canada, many healthy, low-risk pregnant women are forced to give birth hundreds of kilometres away from their families, culture and language.

The practice, which is also known as “birth evacuation,” was put in place by the federal government decades ago, with the intention of reducing infant mortality rates, according to a 2021 study published in Women and Birth. 

However, it often comes with great personal and emotional costs. With more rural hospitals closing and the ongoing physician shortage in Canada, many Indigenous women are having to travel farther distances to access care during their pregnancy.

The ongoing practice of birth evacuations not only raises safety concerns for the mother, but also can cause isolation, stress and a profound disconnect from community and cultural traditions, explained Alisha Julien Reid, a Mi’kmaw midwife and co-chair of the National Council of Indigenous Midwives (NCIM).

“NCIM has been very open with strongly condemning the routine and blanket evacuation of pregnant people. And we’ve been demanding the return of birthing services to all Indigenous communities,” she said.

One way Indigenous people are hoping to bring traditional birth back to their community is with the help of midwives, who are able to help deliver and offer spiritual and emotional guidance during delivery at home.

Read more about birth evacuation and how a First Nation in Saskatchewan is rekindling the age-old tradition of home births within its community.

What to know about the BORN Ontario data hack

A massive cybersecurity breach has exposed the health information of around 3.4 million people who sought pregnancy care and advice in Ontario between January 2010 and May 2023.

The Better Outcomes Registry and Network Ontario (BORN) on Monday said the security breach happened on May 31, 2023, and led to the exposure of the data of 1.4 million people seeking pregnancy care and 1.9 million infants born in the province.

BORN, an agency funded by the province, is responsible for gathering data related to pregnancies and births in Ontario.

The breach happened after the agency used a file transfer software called MOVEit, which was then breached by hackers who copied certain files from one of BORN’s servers.

The health-care information that was stolen may have included data such as names, addresses, date of birth, health card number (with no version code), lab results from screening and diagnostic testing, pregnancy risk factors, type of birth and procedures and birth outcomes, BORN said in a statement posted Monday.

Read more about how the cyberattack happened, what went wrong and what the Office of the Information and Privacy Commissioner of Ontario plans to do about it.

— THE TOPIC —

At-home HPV tests now available in Canada

— WHAT EXPERTS ARE SAYING —

New guidelines released this week in the Canadian Medical Association Journal say self-screening tests for human papillomavirus (HPV) could be one way to improve access for women facing barriers.

That comes as several provinces are phasing out the Pap smear in favour of the HPV test for cervical cancer screening.

The guidelines offered 15 screening and other recommendations, and one policy recommendation on improving access to primary care.

A day after the guidelines were published, the launch of a new at-home test for HPV was announced in Canada.

The $99 testing kit by Switch Health can be bought online and is available across the country except for the northern territories and Prince Edward Island.

It screens for high-risk genotypes of HPV, including subtypes HPV 16 and 18, which account for 70 per cent of cervical cancer cases, according to the company’s website.

The test allows anyone with a cervix to collect a sample of vaginal specimen with a brush before it can be sent for processing by accredited labs.