Live Births
Leeds Grenville and Lanark (LGL) continued to experience a decline in the annual number of live births over the period 1996-2000 according to data derived from the birth registration process (fig1_reproductive). The majority of births continue to be come from the 20-29 year age group (fig2_reproductive).
More recent birth data from the Perinatal Partnership Program of Eastern and Southeastern Ontario is available for 2000-2003 (fig5_reproductive). It is difficult to conclude from these data whether the number of births is stabilizing in LGL.

Low Birthweight (less than 2500 grams)
Low birthweight is a concern whether it occurs in a pre-term baby or when a baby is small for gestational age or both. 

The Health Information Partnership Eastern Ontario Region looked at the rates of low birthweight in eastern Ontario over the period 1991 to 1997¹. Leeds Grenville and Lanark showed fluctuations from year to year. Looking at the average in LGL for the 1995-1997 period, the rate for mothers under the age of 20 was in the vicinity of 7% compared to a rate for mothers age 20 and over of around 5%.
The three year moving average for all births was fairly stable from 1997-1999, between 5.3 and 5.4%.

Another data source for up-to-date information on births in our region is the Perinatal Partnership Program of Eastern and Southeastern Ontario. According to these data, the low birthweight rate in LGL in 2003 was 5.4%. Of singleton births, 4.7% were low birth weight. Of multiple births, 40.6% were low birth weight².
Low birthweight babies were more common among women who smoked. In 2003, the proportion of women who smoked after 20 weeks gestation who had a low birthweight baby was 6.5% compared to 4.1% for non-smokers².
Similarly, women who smoked were more likely to have a small for gestational age baby (<10 percentile) - 14.8% of singleton births compared to 4.6% for women who didn't smoke after 20 weeks².

Teen Pregnancy
The pregnancy rate for females age 15-19 has declined over the years 1996-2000 (fig3_reproductive) The rate in 2000 was 31.5 pregnancies per 1000 population. The rate for LGL has appeared to be consistently lower than that for Ontario as a whole.

Abortions
There are limitations to the data available on abortions. These data do not provide a complete picture of abortion. For example medical abortions are not included, nor are surgical abortion procedures conducted in private abortion clinics. Noting these limitations, the following trends are observed. The abortions rate for teens fell gradually over the period 1996-2000 from a rate of 21.5 per 1000 population in 1996 to a rate of 12.2 in 2000 (fig3_reproductive). The adult rates were more stable with a five year average of 7.5 for the period 1996-2000 (fig4_reproductive).

Infant and Fetal Mortality
Infant mortality refers to a death within the first 365 days from birth. In LGL, the average infant mortality rate for the five year period 1993-1997 was 6.7 per 1000 births, higher than the provincial average of 5.8.¹
The stillbirth rate for the three year period 1995-1997 was 6.2 for LGL compared to 6.5 for Ontario. 
The Perinatal Partnership of Eastern Ontario² reported a stillbirth rate of 6.5 for the year 2003.

Tobacco and Alcohol Use in Pregnancy
A significant proportion of women in Leeds Grenville and Lanark (LGL) smoke during pregnancy. The Perinatal Partnership Program of Eastern and Southeastern Ontario provides information on the tobacco use of women within the areas served by their program². In 2003 in LGL, 17.9 % of women reported smoking after 20 weeks of pregnancy.
The smoking rate was highest among younger pregnant women - 46.6% for women under 20 years of age and 37.4 % for women age 20-24. The lowest smoking rates were observed for women over 30 - 10.9% for women age 30-34 and 10.4 % for women 35 and over. 
Smoking rates were also seen to differ by parity of the mother. For women having their first baby, the smoking rate was 16.0% compared to a rate of 25.5% for women delivering for the fourth or more time.
There is limited information on the use of alcohol during pregnancy in LGL. 
A survey of four health units in southeastern Ontario,³ including LGL, found that more than 40% of the sample drank alcohol during their pregnancy, though 74% stopped once they knew they were pregnant.

Breastfeeding
Statistics from the Perinatal Partnership Program of Eastern and Southeastern Ontario indicate that 84.4% of new mothers in LGL reported intending to breastfeed at the time of birth². Intent to breastfeed was highest in the 35 and over age group at 88%, and lowest in the 20-24 age group at 77.3%. Women having their first baby were most likely to plan to breastfeed (89.6%) and those having their fourth or more baby the least likely (78.6%).
The Perinatal and Child Health Survey³, a survey of parents in selected eastern Ontario health units, similarly found that almost 85% of mothers did indeed initiate breastfeeding, but breastfeeding was often stopped in less than 6 months.

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¹ Health Information Partnership Eastern Ontario Region. The Health Status of Children and Youth in Eastern Ontario. March 2002.

² Perinatal Partnership Program of Eastern and Southeastern Ontario, Perinatal Statistics 2003 Leeds, Grenville & Lanark District Health Unit Note: reports on women who live in Leeds and Grenville or Lanark and who gave birth in eastern and southeastern Ontario, including home births.

³ Perinatal and Child Health Survey of Four Southeastern Ontario Health Unit Areas, February 2004.

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