Ungava policy change catches pregnant women unawares

Nikita Etok, 17, of Kangqsualujjuaq is excited about the upcoming birth of her baby next month— but upset that her boyfriend can’t be there unless he’s willing to pay hundreds of dollars to join her. (PHOTO BY PASCAL POULIN)

Pregnant women who live in Nunavik’s seven Ungava Bay communities no longer have to fly hundreds of miles to give birth in a hospital, which could be a reason to celebrate.

But, instead, some pregnant women are outraged that travel costs will no longer be reimbursed when they choose to ignore the midwifery services now offered at Kuujjuaq’s Tulattavik hospital and fly to Montreal.

And they say it’s a step backwards for the government to no longer pay any at all transportation expenses for their patient escorts, whose travel was previously covered by the health care system— even when women from other Ungava Bay communities give birth in Kuujjuaq.

Like many young couples, Nikita Etok, 17, and Jackie Etok, 23, of Kanqisualujjuaq are looking foward with excitement to the birth of their first child on Jan. 9, 2011.

And they want to share this experience together.

But to do this, they must now pay their own way to Montreal.

The Tulattavik health board has decided to stop paying transportation and housing bills for women who want to deliver in Montreal instead of Kuujjuaq, as well as for their patient escorts, unless there are urgent medical reasons for them to travel to Montreal.

The decision to stop offering Ungava Bay women the choice of delivering in Montreal instead of Kuujjuaq was made unanimously by the Tulattavik’s board of directors in September, but it’s only now being applied.

Nikita, who plans to deliver in Montreal, was surprised to learn that to have her boyfriend with her at her delivery, he must pay for his own ticket south.

“I find it upsetting that they wouldn’t pay the ticket. I need him there. It’s an ‘I-need-thing,’” she said. “It’s very disappointing.”

As for future father Jackie, he says he “just wants to see the birth,” even if it takes away money that could be spent on items needed for the baby.

Nikita only learned Dec. 7 that she’ll also have to cover her own ticket to Montreal — she had previously been told this would be covered due to her youth and her mother’s history of difficult deliveries.

This recent change enrages Nikita’s mother Anne Lanteigne.

“It’s Christmas time. The flights are booked. Not only are they expensive, but it’s so inconsiderate to say yes and then say no,” she said.

In Montreal, Nikita will deliver at a hospital that offers full obstetrical services during childbirth to avoid the emergency caesarians she herself experienced, Lanteigne said.

Tulattavik has no capacity to perform any surgery that requires an anesthetist.

“There’s no way I’m putting Nikita at any risk of trauma,” Lanteigne said.

If Tulattavik was equipped to perform a caesarian, she’d be there “with bells on,” she said.

Lanteigne also said there’s “no way she’s [Nikita] is going to be alone without someone to hold her hand,” so she and Jackie will also go to Montreal.

However, until Dec. 7, Lanteigne thought the cost of Nikita’s ticket would be covered by the government.

Lanteigne, a teacher in Kangiqsualujjuaq for the past 23 years, has the means to cover Nikita’s ticket— but she said many pregnant women will have difficulties paying for their own tickets and for their patient escorts.

Lanteigne said the change in policy for pregnant women and patient escorts was motivated by a desire to clamp down on bad behaviour by patient escorts — who often frequent bars bring booze back to their communities — and to reduce patient loads at the Nunavik house boarding residence in Montreal.

But if that’s the reasoning, Lanteigne said it won’t work.

She said the health board ought to reward couples who have a clean living style, rather than punish everyone for the bad behaviour of some.

As a teacher, Lanteigne said positive reinforcement is a better way of improving conditions than handing out punishments.

And she said the social impact of the move will backfire.

“We’re in the age of uniting families, trying to rectify the social problems in Nunavik and here they are separating fathers from babies,” she said. “It’s so archaic. It dates back to the old days when they excluded fathers from the room.”

Lanteigne plans to file a formal complaint with a health and social services ombudsman and circulate a petition protesting the changes in policy.

Although the policy was changed two months ago, many pregnant women are only now finding out about the change.

“Why is it that our Inuit husbands are not allowed to be present at the birth of their children? I am proud to have a very active, supportive husband and this policy goes against their rights as parents,” says a pregnant woman in Kuujjuaq.

Dr. Nathalie Boulanger, the director of medicine for Tulattavik, confirmed that the new policy for pregnant woman and their escorts is now in effect and that medical staff along the Ungava Bay coast have no choice but to apply it.

Boulanger suggested that critics file a formal complaint with Quebec’s health and social services department.