TORONTO - Ontario's Liberal government scrambled Thursday to clarify it will not force pregnant women to pay for caesarean sections, after suggesting earlier this week that the procedure would no longer be covered by medicare.

Health Minister Deb Matthews said Wednesday that research shows Ontario doctors perform more C-sections than colleagues in other jurisdictions, and suggested the procedure could be delisted from OHIP to help save money and trim a $16-billion deficit.

Matthews clarified her position at a news conference Thursday, but left the door open to having C-sections covered only when they are deemed to be medically necessary.

"I want to make this very clear: we are not delisting caesarean sections," she told reporters.

Matthews declined to comment on the suggestion the government would always pay for a C-section recommended by a doctor, but doesn't want to pay when the procedure has been scheduled for convenience sake.

"We are not delisting caesarean sections," she said when pressed.

The province's health quality council will talk with experts and review all the evidence before recommending what services should or should not be publicly funded, added Matthews.

"Health Quality Ontario is doing their work in consultation with the most brilliant people around the world," she said.

"We rely on evidence to make decisions. We will increasingly need to rely on evidence to making decisions about health care."

The Ontario Association of Midwives wants the government to fund the creation of free-standing birthing centres, which it says would have to perform far fewer C-sections than hospitals and give women a community-based option for having their baby.

The Institute for Clinical Evaluative Sciences indicates more than 28 per cent of hospital births in Ontario are C-sections.

The midwives association says reducing Ontario's rate of caesarean sections to 15 per cent — it's as high as 40 per cent in some hospitals — would save $50 million a year.

Matthews wouldn't comment directly on the need for more birthing centres, but said she supports the idea of doing more health procedures outside a hospital setting.

"What I can say is that when we can move procedures out of hospitals, that’s better health care, better quality of care at a lower cost," she said.

The health minister also declined to say if she thinks there are too many C-sections performed in Ontario or if there would be fewer of the procedures after the Liberals are finished with their changes to the system.

"I can’t say that," said Matthews.

"What I can tell you is evidence will guide our decision making."

The opposition parties note the Liberals delisted several services in 2004, including chiropractors, optometrists and physiotherapists, and fear the government's talk of reform is code for more cuts.

Matthews will outline some of the government's plans for what it says will transform Ontario's health-care system during a speech Monday to the Toronto Board of Trade.

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