Birth Program Supports Immigrant Women

A team of Vancouver health professionals is providing support both physically and emotionally for pregnant immigrant women who might otherwise be going through the childbearing process alone. For women who don't speak the language and have no friends or family in their newly adopted country, giving birth can be an unnerving experience, and that's where the South Community Birth Program (SCBP) comes in.

South Vancouver has a large population of people whose first language isn't English. It also has the highest birthrate in the city and the greatest number of low birth-weight babies and single parents. Because of a shortage of family doctors and other caregivers in the area, health officials are concerned that some immigrant women may go without proper healthcare during pregnancy. SCBP is working toward filling that need.

"Far too often in this day and age women go through the whole process of childbearing in isolation," says Linda Knox, a midwife with SCPB. "We don't have large extended families any more. So our program is a way for women to create community for themselves and it's working beautifully."

Opened in 2004 and unique in Canada, the program provides a full range of pregnancy care, from family doctors and midwives to doulas, community health nurses and obstetricians if needed. Doula is a Greek word, meaning "caregiver" or "woman-servant." Doulas are trained childbirth professionals who provide comfort and support throughout the pregnancy. When women come into the program they're cared for either through clinic appointments or they can join what's called a Centering Pregnancy Group—a relatively new concept in Vancouver, says Knox. The group offers a combination of pre-natal care and childbirth education to expectant parents, and is facilitated by a physician or a midwife as well as a community health nurse.

The women in the group, who all have anticipated delivery dates within the same month, are encouraged to be self-sufficient and to share any knowledge they have already acquired through past experience. They're also shown how to check and record in a "mum's notebook" their pre-natal findings such as blood pressure, weight and the baby's heart rate.

"It's an incredible way for women to learn," says Knox. "For me as a care provider, the most important outcome of this is that the women build community—they become very bonded with one another. One of our very first groups is still communicating with each other and occasionally meeting."

Sawinder Randhawa, who was a maternity nurse in India before moving to Canada, trained as a doula with SCBP two years ago, and since then has overseen about 10 pregnancies and eight deliveries. Randhawa says she stays with the mother as long as the labour takes and does follow-up visits at the home later.

"The clients really appreciate what I do and feel happy when I can answer all their questions. Two days ago I helped a lady who had a baby boy. She has no family here. She's only 21 and her husband 24. I stayed with her for 24 hours and visited them again at the home today. They felt really happy and kept thanking me."

Randhawa, who also works as a care-aid, says if she happens to be at work when a client goes into labour, SCBP provides a backup doula. Proponents believe that doula support benefits expectant mothers in many ways, including shorter labours, less likelihood of a caesarean section and less necessity for pain medication. SCBP's doulas speak 15 languages, including Mandarin, Cantonese, Hindi, Tagalog, Urdu, French, Spanish and Indonesian.

Knox calls the program a "model in collaboration" because there's no competition between the SCBP health professionals for clients, and they learn, teach and support both each other and the clients. Knox says the women appreciate having equal access to the midwives and physicians—something not often available outside the program.

Saroj Jhanji joined the program when she became pregnant with her fourth child early last year. Jhanji says she enjoyed being in the group and meeting other women who were at the same stage in their pregnancy as she was. Visiting the clinic was very convenient for her as she lives in the South Vancouver area.

"The program is really great, very helpful, I wish I could have had my other kids with them as well" says Jhanji. "It's a great comfort to have a doula with you all the time when you're going through the pain. Doulas are wonderful because they put 100 percent of their heart with you…."

SCBP's office and clinic are at the South Health Unit at the Coastal Health Authority, and all the births take place at the B.C. Women's Hospital. The program is funded by the federal government, B.C. Women's Hospital and the Coastal Health Authority. There's no cost for those with provincial health insurance.