Immigrant women call for better interpreter access during births in Quebec City hospitals

An organization that supports pregnant immigrant women in Quebec City says patients do not have enough access to interpreters during births in hospitals. The director of the organization that provides pre-natal accompaniment says she is concerned that women are receiving care without giving full consent.

Understanding what is happening during a birth is "the base," says Marielle M'Bangha, the director of the Service de référence en périnatalité pour les femmes immigrantes de Québec.

She wants to see staff at Quebec City's university hospital centre, the CHU de Québec-Université Laval, offer interpretation services "systematically" and provide translated versions of consent forms and other documents to patients.

"It's absolutely crucial. Consent to care is given. If it's unclear what we are signing or why, there's a problem when it comes to making a free and informed choice," she says.

According to the Act respecting health services and social services in Quebec, English speakers have the right to receive services in English. Social and health-care services networks can use a different language when delivering services if it's recognized by Quebec's language watchdog. However, access is conditional on the health institution's available staff, funding and organizational resources.

M'Bangha made a complaint to the CHU last year following the experience of an unaccompanied English-speaking mother who did not have access to a hospital-provided interpreter when she underwent an emergency caesarian and a subsequent week-long hospital stay.

The president of the regional access committee to health and social services for English speakers in the Quebec City area, Brigitte Wellens, says there is still a lot of work left to do. Wellens says staff are not well informed about the rights of English speakers and users don't insist on being provided with translators.

Demand for interpreters doubled

The administrative responsibility to ask for an interpreter at the hospital falls on staff from the CHU de Québec. Since last fall, requests have been made to a provincial bank managed by Santé Québec, rather than a regional bank. In-person, virtual or telephone interpretation services are offered in more than 100 languages.

Situations are judged on a "case by case" basis, and "we do what we can to make sure to respond to the needs of users as quickly as possible," explains a spokesperson for the CHU de Québec.

In emergency situations or if an interpreter is not immediately available, staff can rely on "alternative methods" such as asking for help from a multilingual colleague, the use of "validated" translation applications, or agreements with private suppliers.

According to statistics provided by Santé Quebec, between 2020 and 2025, requests for interpreters doubled from 2,057 to 4,184 and were offered in 55 different languages.

Giving birth alone without a translator

Mary harbours painful memories around the birth of her first child. The single mother, who has no family in Canada, planned on giving birth accompanied by a doula. CBC is using a pseudonym to protect her identity because she fled her country for security reasons.

A routine check-up in May 2024 found the fetus was in distress and she was whisked away for an emergency C-section. Staff handed her French consent forms and warned her not to delay the potentially life-saving intervention when she asked to wait for her doula who could also act as an interpreter.

Mary, who speaks English but very little French, says she does not feel as if staff made sure she understood what was going on.

"I think they were not caring of anything, they didn't give me time to think twice for anything, maybe even understand what the form was talking about," she says.

Once the baby was born, she says she didn't know if he was dead or alive. Despite understanding that she would be able to see him, he was transferred to a specialized neonatal unit in another hospital before she could. Shortly afterward, doctors discovered Mary suffered from a severe health complication and was herself transferred to a third hospital.

Physicians were able to speak with her in English, she says, but other staff generally could not. The CHU de Québec did not provide her with an interpreter.

I think they were not caring of anything, they didn't give me time to think twice for anything.- Mary

Helene Lepage, a volunteer with the organization that supports pregnant immigrant women, visited Mary regularly during her stay and acted as an interpreter when she was present.

Lepage saw staff make efforts to communicate with Mary in English, but some "provided care without really explaining what they were doing." She remembers feeling "very frustrated" and claims to have asked for the hospital to provide an interpreter and English documentation.

Nearly a year later, talking about her experience still brings Mary to tears.

"Being hospitalized in the hospital where you can't explain what you want, especially in that critical situation, you don't have even the force to speak," she says, adding that making the effort to speak a language you don't know is a "huge barrier." 

"Instead of treating the patient as if there isn't any other option, they have to do better."

Official complaint made

With Mary's approval, M'Bangha made an official complaint to the CHU de Québec. According to M'Bangha, staff from the complaint commissioner's office said during a phone call that mistakes had been made in Mary's care and that an interpreter should have been provided.

The CHU de Québec declined to comment, saying it can't speak to specific cases for confidentiality reasons. Mary's experience in May 2024 occurred before the province took over the bank of interpreters.

Despite the change, M'Bangha says her organization has not seen more access to interpreters for birthing mothers. "We would know," M'Bangha says, adding her organization accompanied families for more than 300 births last year.

"If there are obstacles for English [interpreters], what's the situation for a mother from the Central African Republic, for example?" she says.

Very little documentation in English

Wellens isn't surprised to hear about Mary's situation, but says it shouldn't have happened.

"Someone somewhere should have raised a red flag and said, 'No, we have to make sure that this person understands completely what is going to happen,'" she says.

According to Wellens, the 36 requests for an English interpreter made in 2024-25 is a testament to the difficulties in accessing care for English speakers, especially given that 17,000 people in the Quebec City region identify themselves as having learned English as a first language, or English-mother-tongue in the last Canadian census.

"It tells me people are not completely aware of their rights, it tells me the establishment, clearly, doesn't always make the request for an interpreter when it's in English", she says. Wellens believes government directives on when to provide services in English caused confusion among staff, and some of them opt not to offer it because they don't understand users' rights or fear of getting in trouble.

According to Wellens, very few documents such as consent forms, or pre- and post-procedure instructions at the CHU de Québec are translated. She believes poor access to care in languages other than French is a public health concern as patients will "inevitably" require more care if they misunderstand a diagnosis or how to care for themselves at home.