Montreal health-care services work to improve asylum seekers' journey to parenthood after Roxham Road

When she crossed the Canadian border via Roxham Road last year, Géraldine Bertrand felt a deep sense of relief.

"When I got there, I was at peace, I felt safe, it was the first time in my life that I had that feeling," she said. "It was the best day of my life. I slept like a child."

From Haiti, she crossed Latin America before spending 10 months in Mexico. Her journey was full of pitfalls and memories she sometimes struggles to convey.

An asylum seeker, Bertrand is focusing her energy on giving birth to her baby with the support of the Centre de pédiatrie sociale de Saint-Laurent/Au cœur de l'enfance, a community health centre that provides resources to vulnerable families.

Midwife Amélie Lamarche, an employee of CIUSSS du Nord-de-l'Île-de-Montréal, hears the stories of many migrant women every week.

"These are women, who carry an extraordinarily heavy burden — heavy by their history, by their migratory journey, by their situation in their country," Lamarche said. "No one wants to leave their country because things are going well."

Virginie Cadet, co-ordinator of the perinatal clinic at the centre, said that asylum seekers have more support available to them now than they did three years ago.

"If I draw a parallel between a mother who was welcomed here in 2019, an asylum seeker, and a mother who is welcomed in 2022, there is a big difference in the gravity of the situation and the intensity of the service we must offer her," Cadet said.

Despite the improvement in birthing services to asylum seekers, the women face many other hurdles after arriving in Montreal, she added.

"The mother in 2022, who comes to us is still in a hotel, so the priority becomes finding her an apartment. She has no furniture, she sleeps on the floor, we have to look for a mattress, and we haven't had time to talk about childbirth."

That also doesn't take into account months of waiting to get a work permit from the federal government or access to the Interim Federal Health (IFH) program, which provides provides health insurance coverage to some refugees, Cadet said. 

Since the end of 2021, the number of asylum seekers arriving at the border has increased significantly, to the point that the Montreal-area health network has set up a mechanism to ensure proper care and followup for pregnant asylum seekers.

According to data obtained by Radio-Canada, from March to November 2022, approximately 640 pregnant women were receiving care.

When they are taken into care, asylum seekers get free perinatal support.

For most of them, the delivery cost of about $3,500 will be covered by a federal program (IFH) or RAMQ, Quebec's public medical insurance but about 20 per cent of them have no coverage.

"It certainly creates financial anxiety for them," said Lamarche.

The midwife cited a recent case where a patient left the hospital after delivery because she could not afford to stay in there three or four days.

During a Radio-Canada visit to the Centre de pédiatrie sociale de Saint-Laurent, a young couple who had fled Kuwait was present for a followup with their newborn.

"They helped me a lot to learn how to take care of him, and they also offered me material help," said Sarah Mahmoud Ab-Hassan.

Her husband said he was also very grateful.

"This place is a lifeline," Mohamed El Sayed said. "Everyone is showing the best of themselves."

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