For countless generations, women have been giving birth in the Bella Coola Valley, but scores of babies born to Valley residents in recent years can’t claim the Valley as their birthplace. This is because, for the past decade women have been required to travel outside to give birth — a practice that doesn’t seem to be ending anytime soon.
Until 2008, Bella Coola was the smallest community in the province that performed caesarean births (c-sections), emergency procedures used in particularly difficult births, involving a highly skilled team of an obstetrician and an anesthesiologist, and a trained obstetrics nurse.
Since the termination of that service women are now requested to leave the community at 36 weeks. If they’re lucky they’ll have family outside of the community to stay with, reducing the financial and emotional burden, but that is definitely not always the case.
Candace Knudsen and her partner Bjorn Samuelsen just welcomed their first son — Knut Kristian Samuelsen — on June 11 in Kamloops, B.C. While Candace was well-aware of having to leave her home community to give birth, she said she was unprepared for how difficult the experience ended up being.
She had planned to deliver in Williams Lake, which is a solid five-hour trip (with no cell service) from Bella Coola. However, due to staffing shortages, maternity services in that community had been suspended. And, since her pregnancy was considered high-risk, she was sent to Kamloops. She spent the majority of the time there alone until her partner arrived.
“I felt really isolated,” she shared. “I know of at least 10 other pregnant women here in the Valley right now and they are going to have to go through the same thing.”
This requirement to leave the Valley poses a considerable financial hardship to new families who must pay out of pocket for a month’s accommodation, food and travel, except for those covered by the First Nations Health Authority.
Even in such cases, the expenses are not covered for much needed support people, such as family and partners of the pregnant mother.
With the average hotel bill being $137 per night, families can expect to pay over $4000 just in accommodation costs. Add food, parking, incidentals and other extras and the bill climbs ever higher.
“I was lucky that my food and accommodation costs were covered through a program for high-risk deliveries by Interior Health,” Knudsen noted. “But that doesn’t happen normally, and I know other families who have not been as fortunate.”
Knudsen said that they experience was so overwhelming it has left her questioning when she will have a second child. While she has always wanted more children, she said the emotional drain of the experience – on top of the normal stresses of pregnancy and birth – has been difficult.
“It’s hard to think about doing this all over again,” she said. “Do I pay for someone to come with us? Do we take him out of school? I’m worried about going through that isolation again and making Knut go through it as well.”
Fundraising for trips out to deliver are common in the Valley, as demonstrated by the countless activities undertaken by expectant parents and their families throughout the years.
“Families are holding bake sales, bingos, and fund-raising events to support mom while she is away for four weeks,” MLA Jennifer Rice told CMNews in a 2016 interview. “Mothers should be returning to the Valley with car seats and baby supplies, but they are not because all the money has been spent on accommodations and surviving away from home for a month (or more).”
In a written statement, Vancouver Coastal Health said that it “recognizes the difficulties in providing health services to residents of remote and rural communities. This issue is not unique to British Columbia, or even to Canada for that matter. Bella Coola Hospital does not have full maternity services, due to the size of its population.”
As for parental support, Vancouver Coastal Health offers pre and postnatal programs through the community health office and with contracted agencies including: parenting programs, Healthy Beginnings programs for parents/babies, and clinical physician support throughout the pregnancy and follow up after birth.
“Pregnant women work with their physicians to plan for delivery in their preferred location of choice, whether it be Williams Lake, Kamloops or Vancouver. Many people will choose a location where they have family,” said Carrie Stephanson, VCH Public Affairs Leader. “VCH has established two programs to assist eligible residents living in larger Central Coast communities with their medical travel costs—the Travel Assistance Program and the Health Connections Program.
“While it is not feasible to cover all medical-related travel costs or all travel needs, these programs provide support to eligible patients needing to travel to access health care.”
The Travel Assistance Program (TAP) is a corporate partnership between the Ministry of Health and private transportation carriers. It is coordinated by the Ministry of Health and the transportation partners who agree to waive or discount their regular fees.
The program is limited, however, to carriers who have agreed to sign on. It does not cover meals, accommodation, mileage, fuel and local transportation expenses: these are the responsibility of the patient.
Stephanson also said that the decision as to when individuals leave the community to give birth is a “medical decision based on individual circumstances.”
While Knudsen says she places no blame on the local staff and doctors in Bella Coola for the situation, she is hoping that by sharing her story will help encourage more financial and emotional supports for women who are facing the same challenges.
“I just want people to be aware of what families are facing,” said Knudsen. “Some financial support or assistance program would be amazing.”