Canada's universal health care system covers and encourages midwifery care.

Written by Melissa @PermissionToLive

When I moved to Canada in 2008, I was a die-hard conservative Republican. So when I found out that we were going to be covered by Canada’s Universal Health Care, I was somewhat disgusted. This meant we couldn’t choose our own health coverage, or even opt out if we wanted too. It also meant that abortion was covered by our taxes, something I had always believed was horrible. I believed based on my politics that government mandated health care was a violation of my freedom.

When I got pregnant shortly after moving, I was apprehensive. Would I even be able to have a home birth like I had experienced with my first 2 babies? Universal Health Care meant less choice right? So I would be forced to do whatever the medical system dictated regardless of my feelings, because of the government mandate. I even talked some of having my baby across the border in the US, where I could pay out of pocket for whatever birth I wanted. So imagine my surprise when I discovered that midwives were not only covered by the Universal health care, they were encouraged! Even for hospital births. In Canada, midwives and doctors were both respected, and often worked together.

I went to my first midwife appointment and sat in the waiting room looking at the wall of informational pamphlets. I never went to the doctor growing up, we didn’t have health insurance, and my parents preferred a conservative naturopathic doctor anyways. And the doctor I had used for my first 2 births was also a conservative Christian. So I had never seen information on birth control and STDs. One of the pamphlets read “Pregnant Unexpectedly?” so I picked it up, wondering what it would say. The pamphlet talked about adoption, parenthood, or abortion. It went through the basics of what each option would entail and ended by saying that these choices were up to you. I was horrified that they included abortion on the list of options, and the fact that the pamphlet was so balanced instead of “pro-life.”

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During my appointment that day, the midwife asked her initial round of questions including whether or not I had desired to become pregnant in the first place. Looking back I am not surprised she asked that, I was depressed at the time, (even though I did not list that on my medical chart) and very vocal about my views on birth control (it wasn’t OK, ever.) No wonder she felt like she should ask if I was happy to be having this baby. But I was angry about the whole thing. In my mind, freedom was being violated, my rights were being decided for me by the evils of Universal Health Care.

Fast forward a little past the Canadian births of my third and fourth babies. I had better prenatal care than I had ever had in the States. I came in regularly for appointments to check on my health and my babies’ health throughout my pregnancy, and I never had to worry about how much a test cost or how much the blood draw fee was. With my pregnancies in the States, I had limited my checkups to only a handful to keep costs down. When I went in to get the shot I needed because of my negative blood type, it was covered. In fact I got the recommended 2 doses instead of the more risky 1 dose because I didn’t have to worry about the expense. I had a wide array of options and flexibility when it came to my birth, and care providers that were more concerned with my health and the health of my baby than how much money they might make based on my birth, or what might impact their reputation best. When health care is universal, Drs are free to recommend and provide the best care for every patient instead of basing their care on what each patient can afford.

I found out that religious rights were still respected. The Catholic hospital in the area did not provide abortions, and they were not required too. I had an amazing medically safe birth, and excellent post-natal care with midwives who had to be trained, certified and approved by the medical system.

I started to feel differently about Universal government mandated and regulated Health care. I realized how many times my family had avoided hospital care because of our lack of coverage. When I mentioned to Canadians that I had been in a car accident as a teen and hadn’t gone into the hospital, they were shocked! Here, you always went to the hospital, just in case. And the back issue I had since the accident would have been helped by prescribed chiropractic care which would have been at no cost to me. When I asked for prayers for my little brother who had been burned in a camping accident, they were all puzzled why the story did not include immediately rushing him to the hospital. When they asked me to clarify and I explained that many people in the States are not insured and they try to put off medical care unless absolutely needed, they literally could not comprehend such a thing.

I started to wonder why I had been so opposed to government mandated Universal Health care. Here in Canada, everyone was covered. If they worked full-time, if they worked part-time, or if they were homeless and lived on the street, they were all entitled to the same level of care if they had a medical need. People actually went in for routine check-ups and caught many of their illnesses early, before they were too advanced to treat. People were free to quit a job they hated, or even start their own business without fear of losing their medical coverage. In fact, the only real complaint I heard about the universal health care from the Canadians themselves, was that sometimes there could be a wait time before a particular medical service could be provided. But even that didn’t seem to be that bad to me, in the States most people had to wait for medical care, or even be denied based on their coverage. The only people guaranteed immediate and full service in the USA, were those with the best (and most expensive) health coverage or wads of cash they could blow. In Canada, the wait times were usually short, and applied to everyone regardless of wealth. If you were discontent with the wait time (and had the money to cover it) you could always travel out of the country to someplace where you could demand a particular service for a price. Personally, I never experienced excessive wait times, I was accepted for maternity care within a few days or weeks, I was able to find a family care provider nearby easily and quickly, and when a child needed to be brought in for a health concern I was always able to get an appointment within that week.

The only concern I was left with was the fact that abortion was covered by the universal health care, and I still believed that was wrong. But as I lived there, I began to discover I had been misled in that understanding as well. Abortion wasn’t pushed as the only option by virtue of it being covered. It was just one of the options, same as it was in the USA. In fact, the percentage rates of abortion are far lower in Canada than they are in the USA, where abortion is not covered by insurance and is often much harder to get. In 2008 Canada had an abortion rate of 15.2 per 1000 women (In other countries with government health care that number is even lower), and the USA had an abortion rate of 20.8 abortions per 1000 women. And suddenly I could see why that was the case. With Universal coverage, a mother pregnant unexpectedly would still have health care for her pregnancy and birth even if she was unemployed, had to quit her job, or lost her job.

If she was informed that she had a special needs baby on the way, she could rest assured knowing in Canada her child’s health care needs would be covered. Whether your child needs therapy, medicines, a caregiver, a wheelchair, or repeated surgeries, it would be covered by the health care system. Here, you never heard of parents joining the army just so their child’s “pre-existing” health care needs would be covered. In fact, when a special needs person becomes an adult in Canada, they are eligible for a personal care assistant covered by the government. We saw far more developmentally or physically disabled persons out and about in Canada, than I ever see here in the USA. They would be getting their groceries at the store, doing their business at the bank, and even working job, all with their personal care assistant alongside them, encouraging them and helping them when they needed it. When my sister came up to visit, she even commented on how visible special needs people were when the lady smiling and waving while clearing tables at the Taco Bell with her caregiver clearly had Downs Syndrome.

I also discovered that the Canadian government looked out for it’s families in other ways. The country mandates one year of paid maternity leave, meaning a woman having a baby gets an entire year after the birth of her baby to recover and parent her new baby full-time, while still receiving 55% of her salary and their job back at the end of that year. Either parent can use the leave, so some split it, with one parent staying at home for 6 months and the other staying at home for 6 months. I could hardly believe my ears when I first heard it. In America, women routinely had to return to work after 6 weeks leave, many times unpaid. Many American women lost their jobs when becoming pregnant or having a baby. I knew people who had to go back to work 2 weeks after giving birth just to hang onto their job and continue making enough money to pay the bills. Also every child in Canada gets a monthly cash tax benefit. The wealthier families can put theirs into a savings account to pay for college someday (which also costs far less money in Canada by the way), the not so wealthy can use theirs to buy that car seat or even groceries. In the province we lived in, we also received a monthly day care supplement check for every child under school age. I made more money being a stay at home mom in Canada than I do in the States working a close to a minimum wage job. And none of the things I listed here are considered “welfare” they are available to every Canadian regardless of income. For those with lower incomes than we had there are other supports in place as well.

If a woman gets pregnant unexpectedly in America, she has to worry about how she will get her own prenatal care, medical care for her child, whether or not she will be able to keep her job and how she will pay for daycare for her child so she can continue to support her family. In Canada those problems are eliminated or at least reduced. Where do you think a woman is more likely to feel supported in her decision to keep her baby, and therefore reduce abortions?

Since all of these benefits are available to everyone, I never heard Canadians talking about capping their incomes to remain lower income and not lose their government provided health coverage. Older people in Canada don’t have to clean out their assets to qualify for some Medicare or Social Security programs, I heard of inheritances being left even amongst the middle classes. Something I had only heard about in wealthy families in the USA.

And lest you think that the Canada system is draining the government resources, their budget is very close to balanced every year. They’ve had these programs for decades. Last year Canada’s national debt was 586 billion dollars, the USA has 15.5 trillion dollars in national debt. Canada has about one 10th the population of the US, so even accounting for size, the USA is almost 3 times more indebted. And lest you think that taxes are astronomical, our median income taxes each year were only slightly higher than they had been in the States, and we still got a large chunk of it back each year at tax time.

In the end, I don’t see Universal health care as an evil thing anymore. Comparing the two systems, which one better values the life of each person? Which system is truly more family friendly?

Former Quiverfull believer, Melissa is a member of the Spiritual Abuse Survivor Blogs Network at No Longer Quivering – she blogs at Permission to Live.