Latest News at the SOGC

SOGC Statement – Access to Medical Abortion in Canada: A Complex Problem to Solve

A series of recent news articles have shone a light on the challenges surrounding access to medical abortion across the country, pointing out some of the major differences between provinces, the concentration of access at clinics that currently provide family planning and/or surgical abortion, and the disadvantages faced by those in smaller and remote communities.
 
As physicians, a key priority of the Society of Obstetricians and Gynaecologists of Canada (SOGC) is to try to reduce the number of women with an unplanned pregnancy. Research suggests that unintended pregnancies remain high, with as many as 61% of Canadian women having had at least one unplanned pregnancy. Free access to effective contraception has been shown to reduce abortion rates. We are strong advocates for awareness and access, and a national contraception access plan is required to reduce barriers to access as well as to support a range of family planning services with safe, modern methods of contraception. The personal, health care, and social costs of a single unintended or mistimed pregnancy are substantial. A comprehensive but targeted plan would address women in need of contraception who are not covered by private insurance or government assistance plans, and who could not otherwise afford contraception.
 
We believe that Canadians would be well served by a policy for national, equitable access to contraception and healthy family planning, and the promotion of gender equality and empowerment of women and girls to have full control over their bodies and lives, consistent with the important commitments that Canada has made globally.
 
Regardless of the situation, it is always a woman’s choice whether to continue with a pregnancy or not. When this choice is limited by personal resources or by where in the country she lives, her access to care or choice is clearly neither easy nor equitable and we have a problem requiring action.
 
Pregnancy and pregnancy termination are complex decisions not entered into lightly. Abortion is a necessary option; the only question is whether it will be accessible and safe, or restricted to those with means. Our goal is to ensure equal access to safe abortion for all Canadians and to have well-trained and prepared health care providers offering a choice of medical or surgical termination in a secure network of care, close to home. The SOGC, the College of Family Physicians of Canada (CFPC), and the Canadian Pharmacists Association worked together to create a comprehensive online training course for health care providers and, upon completion, the clinician is invited to join a network of providers to be able to consult, share clinical experience, and learn about research advances. So far, 2,904 providers have completed training. Both the SOGC and the CFPC have offered well-attended workshops at our annual conferences, which were open to licensed health care providers in Canada.
 
Although the health care providers who have taken this course come from all parts of the country, currently, access to medical abortion is predominantly in existing clinics providing family planning services. The entry of Mifegymiso into the Canadian market was attended by numerous restrictions and, initially, mandatory training. While this may become more normal in the future, it was the first medication to have such requirements thereby creating an aura of complexity and risk. Those restrictions have been eased as experience has shown the safety of the medication. It is not going too far to suggest that that safety record may, in part, be due to the cautious introduction, with a small cadre of doctors – family doctors and gynaecologists – and nurse practitioners that gained the necessary knowledge and experience, which now needs to be widely shared.
 
Adoption of change is slow. Although education and training are necessary, they are not sufficient to effect a major change. We need to work across many sectors to understand the local environment and those factors that will support or inhibit the introduction of medical abortion services, and find solutions specific to each community. Safe care requires a team. We recognize the reality that, while those living in small or large, urban or remote communities have the same need for access to pregnancy termination, there may be deeply felt opposition to abortion that impacts both women’s willingness to seek, or practitioners to provide care in the smaller communities. 
 
If we only focus on clinical skill, we will see slow progress. To expedite implementation, we need to attend to all the dimensions; at a community, facility, and health systems level. Professional societies play a key role in continuing medical education, but the provincial government does indeed have a major opportunity to improve access, as it has done with procedures such as hips and knees.
 
Canada has long been at the forefront of ensuring its population has the freedoms, opportunities, and equalities that all people seek. However, we believe that we can do better in this case and must do what is right to provide sexual health education, free access to contraception, and access to all pregnancy options by removing barriers to access for medical termination of unwanted pregnancies.
July 24, 2019
SOGC Statement – Access to Medical Abortion in Canada: A Complex Problem to Solve
 

SOGC Infectious Diseases Committee Statement on Syphilis

Syphilis, caused by Treponema pallidum, is a sexually transmitted disease mainly acquired through oral, anal or vaginal sexual contact. Classically, it presents as a painless ulcer, with more systemic symptoms in the secondary stage. If untreated, a latency period of varying lengths precedes tertiary syphilis with pathology determined by where the spirochetes have concentrated in a given individual’s tissues. Importantly, many patients do not experience classic signs and symptoms of primary and secondary syphilis and most cases of syphilis are being detected in asymptomatic individuals or in latent stages of disease. 

Rates of syphilis infection are increasing dramatically across the entire country and a number of provinces are currently experiencing a syphilis epidemic. In 2018, British Columbia reported 925 cases of infectious syphilis representing a 33% increase from 2017. In Manitoba, final syphilis counts for 2018 are estimated at 750-1000. Similar epidemiologic trends have also been reported in the east of the country, for example Ontario is reporting over 20% increase in the number of cases of syphilis for 2018 compared to 2017. 

Of particular concern to prenatal care providers is the proportion of cases occurring in reproductive aged women. With a 50% increase in infectious syphilis among females 20-39 years old we are also seeing a resurgence of congenital syphilis across the country. Two cases of congenital syphilis have been documented this year in British Columbia, the first since 2013. Alberta has also reported 10 cases of congenital syphilis for 2018. In Manitoba, 10 confirmed and 9 probable cases of congenital syphilis have been reported since January 1st, 2018. In Quebec, 7 cases of congenital syphilis were reported between 2016-2018. 

When a pregnant woman has syphilis (acquired either prior to or during pregnancy), it can be transmitted to the fetus. While the highest rate of vertical transmission occurs with primary and secondary syphilis, it may occur with any stage of syphilis during pregnancy leading to congenital syphilis. Congenital syphilis can cause miscarriage, stillbirth, intrauterine growth restriction, fetal hydrops, fetal malformation, and neonatal death in more than a third of cases. Moreover, if unrecognized and untreated, congenital syphilis can have important health consequences for a child’s health and development. 

Congenital syphilis is preventable.  Prevention can be achieved through adequate screening and antibiotic treatment during pregnancy.  Routine screening for sexually transmitted infections, including syphilis, is standard of care at the first prenatal visit in Canada; however, given the current epidemiology, enhanced screening during pregnancy should be considered. If there is an outbreak declared within your province, increased screening should be considered. Please refer to your provincial public health department to determine if an outbreak has been defined. 

Unfortunately, social risk factors alone often have poor sensitivity for risk of STI acquisition and may miss individuals with subtle or undisclosed risk factors. As such, local epidemiology may dictate a need for universal implementation of enhanced syphilis screening during pregnancy (e.g. at three time points for all pregnant women). 

A multidisciplinary approach for both prevention and management of syphilis in pregnancy is necessary to help control the epidemic. Engagement of local public health services, particularly for patients who are having difficulty connecting with care, is important to ensure thorough partner identification, testing and treatment. Communication with pediatric and pediatric infectious diseases services for evaluation and newborn management planning is warranted for all infants born to mothers with syphilis during pregnancy. Guidance for newborn management in cases of syphilis infection during pregnancy can be found here.

It is time for increased action in order to prevent future cases of congenital syphilis. Detection and treatment of syphilis as early as possible during pregnancy is critical to preventing congenital syphilis. Education of colleagues, trainees and patients of the importance of screening for syphilis and other STIs is paramount. 
July 8, 2019
SOGC Infectious Diseases Committee Statement on Syphilis
 

Congratulations to the 2019 ACSC Showcase Showdown and the Abstract Program “Best of Three” Winners

The winners of the “Best of Three” abstract presentation categories:

Best oral presentation

SOGC Members – Obstetrics

Mark Walker – Effect of high does folic acid supplementation throughout pregnancy on preeclampsia (FACT): a double blind, randomized controlled multicenter trial

SOGC Members – Gynaecology

Amanda Black – The Cost of Unintended Pregnancies in Canadian Adolescents and the Potential Impact of Increased Use of Long-Acting Reversible Contraceptives

SOGC Junior Members – Obstetrics

Jayesh Tigdi – Cervical length as a predictor of latency to labour in twin pregnancies complicated by preterm prelabour rupture of membranes (PPROM): a retrospective study

SOGC Junior Members – Gynaecology

Jennifer Mateshaytis – A Predictive Model for Postoperative Venous Thromboembolism (VTE) in Patients with Endometrial Cancer

Best poster presentation

SOGC Members – Obstetrics

Christy Pylypjuk – 25 years later – must macrosomic fetuses be delivered by routine Cesarean section? A cross-sectional study.

SOGC Members – Gynaecology

Sara-Michelle Gratton – Is laparoscopic visualization sufficient for the diagnosis of endometriosis?

SOGC Junior Members – Obstetrics

Andréanne Chaumont – First-line antihypertensive treatment for severe hypertension in pregnancy: a systematic review and network meta-analysis

SOGC Junior Members – Gynaecology

Andrea Mosher – Melatonin receptor expression and localization in endometriosis

Best video presentation

SOGC Members – Obstetrics or Gynaecology

Andrew Zakhari – Approach to Uterine Artery Occlusion at Myomectomy

The Showcase Showdown winners:

Elizabeth Miazga, Eliane Shore, & Cheyanne Reed

Counseling patients on mode of delivery following previous caesarean sections: Three videos
Counselling a patient regarding the options for mode of delivery when they have had a previous caesarean section can be a long, complex discussion. This can be difficult to have in a busy antenatal clinic. Our team created three short online videos to aid patients and clinicians with this conversation. The videos cover three topics: (1) trial of labour after caesarean section (TOLAC), (2) elective repeat caesarean section (ERCS) and (3) induction of labour (IOL) with a previous caesarean section. They discuss the risks and benefits of each option and offer helpful insights for patients when considering their birth options. There is a paper companion guide to the videos that goes into more detailed information for patients who have different learning styles. The handout also contains a decision aid to help patients weight their priorities to make an educated decision on what is best for them. Previously many institutions held “VBAC classes” to provide information to women but due to financial constraints and scheduling or travel barriers most have been discontinued. Having a series of online videos patients can watch allows them to go through this information at their own pace, on their own schedule and discuss any questions with their obstetrical care provided in clinic.

The videos are uploaded onto YouTube so they can be displayed on any internet connected device and utilized by patients and providers from across Canada. 

You are invited to participate in a survey study which will examine knowledge of and attitudes of obstetrical care providers towards trial of labour after caesarean section (TOLAC)/vaginal birth after caesarean section (VBAC). Here is the link to the survey: https://www.surveymonkey.com/r/J7JJ3CQ

Congratulations to all of our winners and to each of our presenters for all your hard work!

Many thanks to all of our dedicated judges and planning committee for making this program such a success.
June 28, 2019
Congratulations to the 2019 ACSC Showcase Showdown and the Abstract Program “Best of Three” Winners
 

About the SOGC

The SOGC is one of Canada’s oldest national specialty organizations. Established in 1944, the Society’s mission is to promote excellence in the practice of obstetrics and gynaecology and to advance the health of women through leadership, advocacy, collaboration, and education.

The SOGC has over 4,000 members, comprised of obstetricians, gynaecologists, family physicians, nurses, midwives, and allied health professionals working in the field of sexual reproductive health.


Learn More Meet the Board Academic Council
Guidelines and JOGC

About the JOGC

The Journal of Obstetrics and Gynaecology Canada (JOGC) publishes original research, reviews, case reports, and commentaries by Canadian and international authors, pertinent to readers in Canada and around the world. The Journal covers a wide range of topics in obstetrics and gynaecology and women’s health covering all life stages including the evidence-based Clinical Practice Guidelines, Committee Opinions, and Policy Statements that derive from standing or ad hoc committees of The Society of Obstetricians and Gynaecologists of Canada.

The Journal emphasizes vigorous peer-review and accepts papers in English and French. Abstracts for all papers are available in both languages. JOGC is indexed in Medline.

Members - You MUST sign in below before proceeding to JOGC.com to access member-only content published in the JOGC.


Access to the JOGC is a benefit of SOGC membership.

Sign in to take advantage of this member benefit or join the SOGC to enjoy the Journal by clicking on ‘Become a Member’ below.

Latest SOGC Guidelines

Upcoming SOGC Guidelines

Video Corner

Dr. Bill Ehman on the SOGC's Newest Online Course: "Vaccination in Pregnancy"

"Should my pregnant patient get a flu shot?" "My patient has received a Tdap vaccine before - does she need another one in this pregnancy?" "How can I make a strong recommendation about vaccination to my vaccine-hesitant patients?"

We sat down with Dr. Bill Ehman to review these considerations. Find the answers to these questions and more in the SOGC’s newest online course : "Vaccination in Pregnancy". Registration will be available soon - keep checking our Online Courses page.

Resources

GRADE | EndNote

 
Online Courses
Premier medical education combined with the convenience of online study.

Online Courses

Designed by SOGC experts and employing the most current medical knowledge, our accredited online courses combine premier medical education with the convenience of online study. 

These courses are designed specifically for improving the learning experience and to tailor your educational experiences to meet your personal learning objectives.

Courses

Go to SOGC Online Platform

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ALARM Courses
Improving care provided to women, babies and families during pregnancy, labour and delivery.

ALARM Courses

The SOGC places the utmost importance on improving intrapartum care, from the process to its outcomes. One way to achieve that objective is through offering continuing education programs like the ALARM course (Advances in Labour and Risk Management).

Welcome and Overview

ALARM was developed by obstetricians/gynaecologists, family physicians, midwives and nurses, who jointly continue to maintain and teach the course. Backed by the SOGC, the ALARM course arose out of our work to improve the care provided to women, babies, and families during pregnancy, labour, and postpartum.

  • The content of the course is evidence-based and incorporates the Canadian practice guidelines, so participants who complete the course gain an understanding of the latest best practices for providing care.
  • The ALARM course objective is to evaluate, update and maintain the competence of obstetricians/gynaecologists, family physicians, midwifes and nurses.
  • This two-day course offers case-based and hands-on workshops.
  • This course is not intended to certify attendees in any procedural skills. It provides education and hands-on experience, but this is not a substitute for clinical exposure and mentorship.
  • The courses have a ratio of approximately 6 participants to 1 faculty member to ensure a highly interactive and educational course.
The ALARM certificate will be awarded only to those who pass the written examination and who attend the course in its entirety.

If you are unable to attend an ALARM course but would like to purchase an ALARM manual, please download this form and submit it by email to alarm@sogc.com.

Upcoming Courses

Please note that there are upcoming ALARM courses planned that are not yet listed below. They will be added as soon as logistical aspects are finalized.


If you would like to hold an ALARM course in your community, please contact us at alarm@sogc.com. Please note that a minimum of 12 participants is required.

Should you have any questions about your registration, please do not hesitate to contact us at alarm@sogc.com.

Instructor Courses - Overview

The ALARM program would not be possible without the efforts of specialists, physicians, nurses and midwives trained to teach this course to their peers. In order to maintain the quality of this highly recognized program, the ALARM Committee has identified specific requirements for instructors throughout Canada.

In order to be eligible to take the instructor course, you must:
  • Have participated in an ALARM course in the past 4 years
  • Be currently registered as an MD (Family Physician or OB/GYN), Registered Nurse or Registered Midwife
  • Be actively providing intrapartum obstetrical care

If you meet the above requirements and wish to participate in the ALARM instructor course, please submit an application at the link below. Please note, a letter of recommendation from your employer, department head or a current ALARM Course Director is required.


If you are selected, you will be sent a registration link for the course. At this point, you will be able to pay your registration fees ($650 plus applicable taxes for OB/GYN and FP doctors; $500 plus applicable taxes for Registered Nurses and Registered Midwives) and receive access to the course materials.

Your participation at the ALARM instructor course is not a guarantee that you will become a qualified ALARM Instructor. 

To become a qualified ALARM instructor, you must:
  • Complete the Instructor course
  • Teach a course
  • Receive a favourable evaluation from the Course Director

Please note you will be required to teach once every three years to maintain your status as an active instructor following a successful completion of the evaluation process. If you fail to do so, you will have to take another ALARM course or Instructor course to maintain your active instructor status.

Space is limited to 24 participants per course. 

There are currently no scheduled Instructor courses available. 
 

Become a Member

The SOGC is the leading voice in women's health in Canada. We are a strong and vibrant society with an active and growing membership. We are here to support you in providing the best care possible to women in Canada and around the world. That's why so many health care providers have become members of the SOGC. Let us be your partner in practice.

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Upcoming Events

Link
October 3 - 4
FMC du Québec 2019
Ville de Québec, Quebec
 
November 28 - 30
Ontario CME 2019
Toronto, Ontario
 

Public Education Resources

The SOGC believes that good healthcare is built upon many partnerships and that improving healthcare requires a collaborative, holistic approach.

Providing the public with the information needed to make informed health decisions removes one barrier to improved health.

SexandU.ca

Rated one of the top 5 e-health projects in the world, SexandU.ca provides credible and up-to-date sexual health information for teens, adults, parents, teachers, and health care providers.

Visit

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Brand Recognition Program

The SOGC Brand Recognition Program aims to assist Canadian consumers to make informed choices when selecting over-the-counter products. 

Learn More