Gaps in Health Care System
The experiences of the women that we spoke to, overall, revealed large gaps in maternal health services and mental health/psychiatric care approaches. Many women were disappointed with the barriers and gaps in care they encountered when looking for help, but most found supports, services and providers that lead to recovery. Not being able to find the right help or having to wait for long periods of time without proper support left some women feeling ignored and alone. Kalli said “I wasn’t prepared for the feeling of not being heard. I wasn’t prepared for that at all. Yeah. That – I think that was, like, one huge thing. And I think that’s also something that’s probably, like, you know, triggered the, you know, the increased anxiety in me as well”. Several women expressed frustration with a medicalized approach to maternal health care, where services are delivered in time-limited ways and as if pregnancy is a medical event. Joan felt that “Doctors treated you like you have an illness when you’re pregnant”.
Julie advocates a whole-person approach to the pregnancy journey.
Written testimony
I think we need to take a really transformative, whole-person approach when it comes to thinking about the whole, you know, notion about becoming pregnant, the experiences of being pregnant, and post-pregnancy, and – yeah. I just think it’s just been so medicalized for so, so long and I think we need to kind of go back to historical – the ways in which we were as humans as being a part of community-based care, and compassionate care
Aurore was disappointed that her care was not more holistic.
Transcript
That’s what wasn’t so good was – it was very helpful to have the referrals; it was very helpful to know about the different resources because I didn’t know about them, where I live. What I had wanted, which is what I had thought I would get, was more of […]
Access
Having no access to postpartum or perinatal mental health resources was a common experience among the people we talked to whether because of geography, funding or long waitlists. Finding specialist psychiatric care for perinatal mental health was difficult, as was locating formal support services that were run by professionals, especially if women lived outside of urban areas.
Joan could not find services that were easy to access.
Written testimony
There was nothing out there too that was easily accessible, right. And that’s the other thing too, like there’s a lot of – we lack supports that come to houses, but there’s not a lot of supports in like the suburbs and places like this. Like everything you have to – there is at like the drop-in level.
Andrea is angry that she had no access to a perinatal mental health specialist.
Transcript
It makes me very upset. It makes me angry. The fact that no one even brought up the words postpartum. Look, I know medical practitioners are very busy. They’re very stressed out in this province also, but the fact that – you know, there was just no access to any […]
There are not enough professional resources in Tara's region.
Transcript
But in terms of resources in our area there is kind of none. Everything is volunteer based. They got rid of all the maternal mental health re – like, department here in [my region] and rural area. And so now it’s up to this committee to provide, like, groups or, […]
Emma says there is nothing for mental health for moms.
Transcript
There’s nothing in the mental health that I know of, which I find very odd. I hope someday there will be. I’m in school right now actually getting my master’s in counseling psychology, because I would like to have a trauma program for moms. But there’s nothing like that. And […]
Private Pay Support Services
Many women said that psychological counselling or cognitive behavioural therapy (CBT) was very helpful to them, but most had to pay privately since these services are often not funded by provincial health plans. Women who could afford the costs got care, while others with less means suffered. Michelle1 paid for private counselling because there was none available from the hospital: ‘I actually did end up going to a clinical psychologist only because I had benefits that could cover it. They don’t have one on staff which I think is a travesty.’
Erin2 found her publicly funded CBT program really helpful.
Transcript
And then through her, I got in touch with a cognitive behavioural therapy program that was government funded which was really fantastic. And that’s when I started to learn about how to like change your thought patterns when you’re having those repeating and like really anxious thoughts. And like how […]
Genna used savings to pay for counselling supports.
Transcript
My partner and I were both on Unemployment Insurance so our income was less than 50% than it normally was. Fortunately, we had savings that we could rely on for times like this but it would be a very different story if we didn’t have the financial situation that we […]
Emma feels that she suffered because she could not pay out-of-pocket for counselling.
Transcript
There is one organization that provides private care, but it’s pay for – there’s a fee for service, which I think is another barrier. You’re on maternity leave, you’re not making as much money, the last thing on your list is you. You know, I always tell my husband, ‘I’m […]
Waitlists
Some women told us that their symptoms escalated to crisis levels, as they waited for services. Even women who experienced severe symptoms such as auditory hallucinations waited months before being seen by anyone. Krysta “was pretty open with, you know, the possibility of having post-partum depression and anxiety and even when I had it I feel like many doctors saw the red flags but just I feel like it wasn’t until I was screaming like, ‘I’m really, really, really suffering. I need help’ – then only did I get support”.
Joan waited for months for care, despite serious red flags.
Transcript
So what ends up happening is, so she refers me to one hospital. The hospital and I play phone tag. So now months are going by, no one’s seeing me. And this is the main reason why I chose to do this study is because of this experience. So she’s […]
Tara feels lack of support services spirals into bigger problems.
Transcript
I’m just so disappointed that women have to find Facebook groups. And go through Facebook groups to find resources – to find groups. It’s hard to find information then. It’s hard to find – the implication is, mothers are isolated. They aren’t able to deal with their depression. It can […]
Myriam waited for help for months.
Transcript
Qui fait que, bon, c’est ça, mon médecin je lui ai parlé de la psychiatre en particulier, qui faisait des suivis de grossesse, parce qu’une de mes amis avait été suivie à la même place. Ma meilleure amie, puis elle me disait là que t’sais c’était une bonne place et […]
Crisis Services
Psychiatric crisis services for post-partum women experiencing psychosis were not tailored for nursing mothers and were viewed as traumatic by some of the women we spoke with. Sophia went to the emergency department in a crisis state but no expert care was available until the next day.
Sophia describes her admission for emergency care.
Transcript
Oui! Bien là, j’ai été chanceuse parce qu’il y avait quelqu’un qui s’était libéré, parce que ça va arriver souvent que des gens vont passer des journées sur une chaise à attendre. Mais ils ont trouvé une place, ils m’ont enlevé tous mes effets personnels, ils ont mis ça sous […]
More & Longer Perinatal Health Care Support
The need for more frequent mental health check-ins over a longer time period was echoed by many women. They appreciated responsive and accessible phone, virtual or in-home personal contacts. Some women were fortunate to connect with the right providers and services at the right time but others like Julie said “it’s completely like you’re falling off a cliff and you’re completely abandoned once you leave the hospital. And I felt completely abandoned during that period of time”.
Christine advocates for more maternal health care after delivery.
Transcript
Well, I think, I think, whether you choose to go with a midwife or an OBGYN, there should be more maternal healthcare after the baby’s born. The number one thing I think that needs to change is more healthcare after more maternal healthcare after the baby comes one appointment six […]
Karmin had no support for months after the birth of her child.
Transcript
I do wish that maybe my care providers postpartum would have been a bit maybe more trauma informed. And as well as the – I could have been maybe directed to more resources, because I found the support group and informal support group fairly later on postpartum, maybe, like, at […]
Aurore accessed support services by phone.
Transcript
Besides my partner, I have some friends that I would reach out to, and usually do either a phone- or a Skype conversation. The public health services, they have a 1-800 number. I would reach out to one of the public health nurses. What I’ve experienced with them is a […]