Is Natural Birth A Luxury in Canada?

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Is Natural Birth A Luxury in Canada?
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• Asking the Question
• Rivka Cymbalist, BA, CD(DONA)
• Director, Montreal Birth Companions
• montrealbirthcompanions_at_gmail.org

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Montreal Birth Companions

• is a registered charity that has provided free
  doula services for women in need since 2004. We
  believe that all women should have the right to
  prenatal education and informed choice during
  their childbearing year, wherever they are from,
  whatever their circumstances, whatever they can
  pay.

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• Our clients are refugees, refugee claimants,
  recent immigrants, non-status women, and other
  marginalized women.

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• This population NEEDS midwife-assisted,
  woman-centered care.

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Grace

• came to us from a country in Africa. She was an
  orphan. When her uncle raped her, she decided to
  flee. She worked as a prostitute to make money
  for her flight. She arrived here pregnant and was
  granted refugee status.

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• Grace had a vaginal birth in a hospital with a
  family physician and a doula.
• She went home after 24 hours with no postpartum
  support and did not know about changing diapers.
  Her baby developed a UTI and was hospitaized.

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Lynette

• lived here for 12 years working illegally as a
  domestic. When she got pregnant, her employers
  told her to leave. She moved to a friends couch
  and tried to find prenatal care.

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• Lynette had patchy prenatal care due to the cost.
• She had a doula who accompanied her to the
  hospital, where her labor was disturbed by
  repeated requests for payment.
• Lynette gave birth by C-section for failure to
  progress and left the hospital AMA early so as to
  avoid paying extra.

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Fatima

• came here on a visa with restricted health care.
• She had two children, and had very fast labors.
• The hospital she contacted wanted a deposit of
  ten thousand dollars.

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• Fatima didnt know midwives were available in
  Canada.
• Fatima gave birth on her own, at home, while her
  husband took the children to a neighbors place.

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• Marginalized women women without healthcare
  women without homes or partners, have a great
  need for a good birth experience. Cesarean birth
  is expensive and requires longer recovery time.
  Birth trauma can lead to postpartum depression.

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Numbers

• From July 2012 to July 2013, 24 MBC clients gave
  birth vaginally.
• During that same period, 10 MBC clients gave
  birth by cesarean section.
• And four women gave birth prematurely (under 34
  weeks).
• The average cesarean section rate for MBC clients
  over the past ten years hovers at 40.

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• Midwives for everyone? In Quebec, only a small
  fraction of women who WANT a midwife can actually
  FIND one.
• Women who cannot find a registered midwife are
  paying up to 2500 for an unregistered (illegal)
  one.

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• in Montreal, 4 women out of 5 can't get a
  midwife, Midwives are assisting about 3 of
  births in Quebec.
• Claudia Faille, president, RSFQ, personal
  communication.

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Let Them Hire Doulas!

• Doulas in the major centers in Canada can cost
  from 300 to 1400.
• MBC clients often cant afford to buy a used
  winter coat. Does that mean they dont deserve a
  natural birth?
• A volunteer birth companion is free if there is a
  program in the community. And if the marginalized
  pregnant woman can find her.

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What to do Baby Steps

• Can you donate any time to working pro bono?
• Do you have a quota system in place in your
  practice for women without health insurance?
• Do you have resources for this population Which
  are the cheapest hospitals? Where are there cheap
  clinics for blood tests and other exams?
• Do you support a volunteer doula organization in
  your area?

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