Maria crossed the border into Canada afraid, exhausted—and pregnant. She’d been travelling for months from her native Colombia and had never received any medical care for herself or her unborn child. “I’ve been worried about it,” the 27-year-old said.
Her fears were eased one day this fall. Stepping into a clinic at a downtown residence for asylum seekers, Maria* was greeted by the smiles and reassuring welcome of Annie Léger and Soheir Ghellai, midwives with CIUSSS West-Central Montreal.
These professionals are part of a life-changing initiative by our CIUSSS to ensure that pregnant women who seek asylum in Canada get the medical care they need. Coordinated by PRAIDA and the Côte-des-Neiges Birthing Centre, the project builds bridges with vulnerable newcomers who have often experienced trauma on their perilous journey to Canada. Thanks to our CIUSSS, they can count on being safely accompanied on their next journey—the one to motherhood.
“They have so much to manage when they arrive in this country. We orient them to the right place in the healthcare network,” says Ms. Léger, adding that many of the women are alone or with their other children, and speak neither French nor English. “I feel a lot of compassion for them. We want to offer as much as we can.”
The project overseen by our CIUSSS’s Frontline Directorate grew out of necessity. Canada has witnessed a surge in asylum seekers—a growing number of them pregnant women—since reopening the border with the United States a year ago. Yet these women were receiving no medical attention until many of them, already in labour, began turning up in hospital emergency rooms in Montreal.
Our CIUSSS devised an approach to remedy the situation. Since March, the women have been able to receive an initial evaluation from a CIUSSS midwife, and then be referred for a medical follow-up to one of nine Montreal hospitals with a birthing centre, including the Jewish General Hospital.
“These women are extremely vulnerable, so early intervention in their pregnancies can mean better outcomes for both the mother and the child.”Marie-Eve Boulanger, PRAIDA
The arrangement, developed in conjunction with the Quebec Ministry of Health and Social Services and the Montreal hospitals, not only promotes maternal and baby health, it benefits our partners in the healthcare system.
“These women are extremely vulnerable, so early intervention in their pregnancies can mean better outcomes for both the mother and the child,” says Marie-Eve Boulanger, Coordinator of the Regional Program for the Settlement and Integration of Asylum Seekers (PRAIDA), which is overseen by our CIUSSS.
“But this also has an impact on the healthcare system,” Ms. Boulanger explains. “It relieves pressure on Montreal emergency rooms while offering women the right service at the right time.”
To date, 50 to 60 women a month have been aided by the project, half of them with at-risk pregnancies. Midwives from our CIUSSS’s Côte-des-Neiges Birthing Centre offer their services in two Montreal shelters and a series of federally operated hotels that temporarily house asylum seekers. The midwives take the women’s medical history, perform a physical exam and listen to the fetal heart; they can also prescribe blood tests and a fetal ultrasound.
“They know they’ll get a smile when they arrive here. It’s the first thing they need—to feel safe after the difficult and traumatic things they’ve lived through.”Midwife Soheir Ghellai
“We’re often the first face of the medical system the women see,” says Ms. Ghellai. “They know they’ll get a smile when they arrive here. It’s the first thing they need—to feel safe after the difficult and traumatic things they’ve lived through.”
Plans are underway to assess the impact of the project, but the scientific literature has already demonstrated the health benefits of early intervention in pregnancy, says Maëcha Nault, Head of Midwife Services for our CIUSSS. Far from home, without a mother or sister or friend to offer advice, the women feel supported by the midwives and other healthcare providers involved in the pregnancy, she says.
Some return to see the midwives after they give birth, carrying their newborns in their arms. “They’re grateful and express a lot of appreciation,” Ms. Nault says. “It reassures them that we were there to accompany them along the way.” *Her name has been changed to protect her identity.