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Fig 1.

Simplified cohort creation diagram of liveborn deliveries in Ontario.

Cohort was created using the discharge abstract database (DAD). A detailed cohort creation diagram can be found in the S3 File. a chart number (person who delivered) = MNCN (newborn). b MNCN (person who delivered) = chart number (newborn). c admit date (newborn) is within the admit and discharge dates for person who delivered (inclusive). MNCRN – Maternal/Newborn Chart Registration Number.

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Table 1.

Trends of sociodemographic characteristics over time.

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Fig 2.

Age-standardized incidence rate of the number of births performed in-hospital.

Using direct standardization, age-specific rates were applied to the female population in Canada from 2025.

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Fig 3.

Incidence of select disorders.

A-B) Percentage of all deliveries where the person who delivered was diagnosed with some complication or condition. Shaded region represents the COVID-19 period.

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Fig 4.

Measures of healthcare usage and delivery.

A) Total hospital length of stay associated with the person who delivered, by mode of delivery. B) select indicators of access and healthcare utilization. C) select indicators of healthcare delivery. Shaded region represents the COVID-19 period in B-C.

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Fig 5.

Funnel plots for hospital-level variation in caesarean section delivery for complex (A) and non-complex (B) deliveries, midwife involvement (C), and epidural use for vaginal deliveries (D).

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Fig 6.

Measures of outcomes.

A) Rate of obstetric/birth trauma and hemorrhage by mode of delivery over time. B) Rate of select newborn indicators over time. Shaded region represents the COVID-19 period.

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