Immigrant Access to Pregnancy Care-In a Physician Shortage
-Kaitlyn Traber
Imagine you are a new to a country, pregnant, and trying to navigate a foreign healthcare system. How would you go about obtaining adequate pregnancy healthcare? Having a family doctor can mitigate some of the barriers that often come with accessing healthcare as an immigrant-but obtaining one has become increasingly difficult.
Care with Your Own Family Doctor vs Without
A University of Lethbridge student, looking to obtain citizenship tells us of her experience with prenatal care having a family doctor. Her pregnancy journey has been smooth sailing as:
there is no language barrier (her and her doctor both speak English)
she was able to to see her family doctor within the first trimester
she has routine checkups where any questions are answered
Though this isn’t the most common experience immigrants have accessing prenatal care. People may even experience discrimination in the healthcare system. When asked if she has had any discriminatory experiences with healthcare professionals during her pregnancy she told Pro-Choice that -
“I have had no discriminatory experiences with healthcare professionals during my pregnancy but others have different stories to tell, I am one of the lucky ones”
Without a family doctor it is highly likely that whoever is readily available to deliver a baby when one goes into labour, is who will do it. This means that someone could see a doctor/multiple doctors during pregnancy, and have a different one for delivery. This makes it harder to form and follow a birth plan as this information has to be communicated between multiple physicians. This can intensify cultural barriers because a person would then have to explain the potentially non-traditional western expectations of childbirth and postnatal support that they expect, to a handful of people. It can intensify language barriers as well if they have to do this with service providers who only speak English.
Medical Care in a Different Language
It is already difficult enough to interpret medical information in the language one speaks. Now imagine trying to interpret it in a second, or foreign language. Not easy.
This highlights the importance of interpreters in medical settings. This is crucial for the pregnant person to be able to express their concerns and have them addressed, leading to increased patient and provider satisfaction. Many hospitals and clinics provide translators, but if that is not the case, there are other options as well.
Translators can be obtained through immigration services for in person language translation during medical appointments as well as virtual-though it may require a fee.
Literacy can also be a barrier. Some people are illiterate which makes written instructions a challenge. A solution to this is if health care providers having picture instructions and diagrams readily available as well as exercising the option to use audio recording during the appointment on one’s personal device so they can listen to the instructions again. Ask the doctor in your next visit if they have visual instructions available!
Prenatal and postnatal expectations
There can be different cultural expectations between patients and medical providers regarding prenatal and postnatal care. Western medicine has it’s own models of care, but that does not include a vast majority of options preferred globally when it comes to pregnancy, which can make the healthcare system feel foreign or strange to immigrants.
For example, in some cultures:
the father is not supposed to be in the room during delivery
different birthing positions like a squatting or sitting position are favoured over giving birth on one’s back
some foods may be avoided during pregnancy and postpartum for different reasons
there may be special rules following birth, like having to be in bed for a few days
Healthcare providers are responsible for completing training or and/or staying informed about different cultural values, beliefs and practices in order to properly treat the diverse populations they serve.
Immigrant women are 4x more likely to experience postpartum depression, and refugees are 5x more likely to experience it than Canadian-born women. This can be due to factors such as :
language barriers, cultural barriers
delayed access to healthcare
family separation, uncertainty regarding legal status, lack of social supports
poverty, food insecurity
trouble navigating a new country
Obtaining a family doctor is a social support in itself. Though that is harder to come by these days, it may be the case that a person can see the same physician throughout the majority of their pregnancy. To utilize this further, immigrants can talk to immigration services to know what to ask those physicians for in terms of referrals and outside medical supports, sometimes physicians may not think to offer them without being prompted.
It is important to have increased early intervention and advocacy for those at high risk of experiencing postpartum depression. Easily accessible mental health supports that support challenges unique to immigrants and refugees are necessary! It can make postpartum depression feel less lonely and more manageable.
Black, African and Caribbean access to care
Being a Black, African, or Caribbean immigrant seeking care in Southern Alberta can come with it’s own set of challenges. Unfortunately, racism can lead individuals to face discrimination when accessing the healthcare system, such as medical concerns not being taken seriously. Canada also has a history of forced steralization amongst Black women which aimed to strip them of bodily autonomy (taking away the power to choose when to have, and when not to have a baby). In turn, it has caused many people to distrust healthcare professionals which pushes them away from continuing to seek the healthcare they need.
As we remain in a doctor shortage, many people have to jump through hoops to receive proper care. (Having to book appointments through different clinics, seeing different doctors, long wait times, rushed visits). This can make advocating for oneself in a medical setting more challenging.
Navigating pregnancy in a foreign country can be hard, and there is a lot of work to do to make this easier. The good news is there are organizations in Southern Alberta you can access in person and/or virtually that are here to help!
Are you living in Calgary? Hands Lifting Hearts is a Black-Led non-profit that helps women and families (mostly from African countries) to navigate parenting and pregnancy in a new culture with support and advocacy!
Here is a comprehensive list of resources in the Alberta area from the African Canadian Civic Engagement Council.
Don’t know which clinics will offer services without a healthcare card? Find out which clinics near you allow walk-ins without a healthcare card, and which ones require fees and/or only accept uninsured patients by referral at chabac.ca
It is absolutely necessary that healthcare professionals stay up to date on cultural competency to ensure adequate care is received across cultures. Improving the quality of healthcare that immigrants and newcomers receive starts with the people working in the healthcare system! Completing training and educating yourself on different cultural values, beliefs and practices makes a huge difference in working towards this goal.
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You can make an appointment at a prenatal clinic. (Can be found within hospitals or seperate) Wait times vary between 1-4 weeks.
Visit a walk in clinic to be seen by a doctor. Walk in clinics are open to everyone. If you do not have a healthcare card there may be a fee for different services.
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If you do not have international health insurance, or provincial insurance in Canada, childbirth alone may cost between $5,000-$12,000.
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Pro-Choice YQL can refer you to a doctor that can prescribe medication abortion or can perform a procedural abortion if that is what you seek.
We can also connect you to financial aid for gas, a hotel stay, and food if you have to make a trip to be able to get an abortion.
