Sarah Stone’s view from Canada

Sarah Stone is a Canadian post-partum nurse who takes care of mothers in the hospital after delivery. She’s also a mother and long time activist for ONE.org.

Sarah stopped by EMC’s offices recently to talk about the maternal health differences and similarities she sees between the U.S. and Canada.

Every Mother Counts: Sarah, you’re involved in maternal health in several ways. Tell me a little about who you are and what you do.

Sarah: I work as a nurse in hospital-based postpartum care. I’m also a mother with three teenage daughters and I’ve been a ONE activist for ten years. As you know, ONE is an international advocacy organization that’s working to end extreme poverty and preventable disease, particularly in sub-Saharan Africa. Conditions and programs that impact women and mothers are a big part of ONE’s focus.

EMC: What is maternal healthcare like within Canada’s universal healthcare system?

Sarah: Essentially all women have access to healthcare in Canada whether they’re Canadian or not. We have a lot of immigrants and new Canadians who are waiting for immigrant status. They have access too. Most women see their family doctor during their pregnancy up until about 27 weeks when they transition to an obstetrician. That’s because up until that point prenatal care is fairly routine and, as specialists, obstetricians have high patient volumes.

EMC: Do many women see midwives for maternal healthcare?

Sarah: Many patients see midwives throughout their pregnancies. Everything is essentially covered including ultrasounds, routine prenatal tests, and genetic screenings. Whether you deliver at hospital or home (about 2% of births occur at home), have an un-medicated birth or an epidural, there’s no cost for women. It’s all covered except for any medications and prescriptions, which may be required after delivery. They’re very well integrated into our health systems and hospitals and many women want midwifery care. Even women who want epidurals and hospital deliveries are opting for midwives because they want that one-on-one, TLC care and they want that midwife to come to their home after they deliver.

EMC: A midwife comes to your home after you deliver?

Sarah: Yeah, that’s how it works here. With hospital deliveries a midwife goes to the home after they’re discharged to make sure mother and baby are doing well and then weekly for up to a month. If they have any problems with breastfeeding or other issues, they’re seen more frequently and then transferred back to their family doctor at a month.

EMC: What other support services do Canadian moms receive?

Sarah: We have a substantial social services network. If a mom can’t afford medications or other resources like diapers, we have social workers on our interdisciplinary team to help them. There’s limited, subsidized day care assistance for low-income mothers too. Breastfeeding is well promoted here in Canada and we have certified lactation consultants available while moms are in hospital and after discharge. If Moms choose to formula feed we support that informed decision. I know that in the US, maternity leave benefits are very short and I suppose that’s why fewer mothers breastfeed.

EMC: We have the Family and Medical Leave Act that allows employees take 12 weeks off after a birth but nothing on a federal level guarantees pay.

Sarah: Wow… the U.S. isn’t really promoting breastfeeding if they don’t provide paid maternity leave. Canadian moms get a full year through employment insurance benefits. It only pays 55% of your paycheck, but some employers top off benefits to cover up to 92%. It’s mindboggling that the richest country in the world has such poor maternal support and healthcare access. The U.S. is our closest partner but it never ceases to amaze me how different it is.

EMC: What other differences do you see?

Sarah: I find the influence that politics and religion have on women’s healthcare in the U.S. fairly shocking. I know reproductive rights and birth control access are hot button issues in the U.S. I’m guessing that the fact that American women have to pay for prenatal care, hospital stay, postpartum care and daycare impacts many women’s decisions about whether or not to become mothers. As a person of Christian faith, I would be identified differently in America. The term “Christian” is so loaded in the U.S. It means something entirely different up here. Many of the people I associate with in the Christian community are absolutely not against birth control and health care, but it appears that in the U.S., it’s contentious. I wonder if Christian and other faith communities could be part of the solution there. Faith communities have always been out in front in terms of poverty and humanitarian issues and essentially, that’s what this issue is all about.

EMC: What are some of the universal issues you think need to be addressed in terms of motherhood?

Sarah: As much as we focus on and advocate for women and mothers in the developing world, we face similar issues in the developed world in terms of isolation, poverty and lack of access to healthcare, even in Canada. There are a lot of mental health issues that we never address either. Of course, men are also part of this conversation because often, they’re the decision makers. But, I feel a strong pull to reinforce our global sisterhood and be part of a global community to build each other up.

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