Mr. Minister Dubé,
We are urgently calling on you to guarantee access to free health services for uninsured pregnant women living in Quebec.
In August 2023, following a broad mobilization of organizations, institutions and professionals in health, law and social services, a ministerial committee that you have mandated, including Médecins du Monde and seven other stakeholders , has given you a program proposal for this purpose. The latter aims to provide free prenatal and postnatal care to women without health coverage, regardless of their migration status, in order to ensure safe pregnancies and births.
Despite our numerous reminders, we have not received any news on the progress of this crucial issue on which we have been actively working with your Ministry of Health and the Régie de l’assurance santé du Québec (RAMQ) since 2021.
Refusal
Every year, hundreds of women living in different regions of Quebec, but excluded from RAMQ coverage by their precarious immigration status, give birth without having had access to essential prenatal care, thus endangering their health and that of their children. their child. This is, for example, the story of Maria (fictitious name), pregnant and originally from Latin America, living in Montreal with a temporary work permit. Faced with complications during her pregnancy, she hesitated to go to the hospital for fear of exorbitant costs, thereby risking her life and that of her child, leading to normally avoidable complications for both herself and her baby.
In addition to being denied essential prenatal care, these women find themselves in heavy debt after giving birth. An uncomplicated delivery can cost $15,000, while a complicated delivery can increase the bill to more than $150,000.
For several years, numerous reports, research and reports, as well as a growing number of testimonies from health and social service professionals, have revealed similar stories, highlighting the challenges and injustices that these women face. Examples are described in the report Precarious immigration status, precarious health by Médecins du Monde, and in the study Care pathways of immigrant women without access to the Quebec health insurance plan, conducted in collaboration with the SPOT Clinic.
The urgency to act
These women, already vulnerable due to their precarious migration status, find themselves in situations of great physical, financial and emotional distress, often without family or community support. Their children are born in precarious conditions, increasing the risks of birth complications and long-term health problems.
Each day that passes without a decision sees the situation of these women, who nevertheless contribute to the development of the province, deteriorate.
The lack of a concrete solution penalizes not only these women and their families, but also our public health system. By delaying or avoiding prenatal care, medical complications become more frequent and more serious, thus requiring more expensive, complex and time-consuming interventions. This increases the workload of healthcare personnel, who must bear the responsibility of meeting the avoidable vital needs of these women alone and without resources, and leads to sub-optimal public health policies.
Over the past three years, all the expert stakeholders on this issue, as well as the three opposition parties, have repeatedly expressed their support for a policy to guarantee access to essential sexual and reproductive health services. for migrant women with precarious status living in Quebec.
Given the urgency and importance of this situation, as well as the broad consensus on this issue, we ask you, Mr. Minister, for a clear and favorable decision in favor of a program of free prenatal and postnatal care. for all uninsured pregnant women in Quebec. It is crucial to act to enable front-line workers to meet the needs of these women in line with the standards of their profession and to ensure their safety and that of their children.
Nadja Pollaert, general director of Médecins du Monde Canada
1. Association of doctors specializing in fetal-maternal medicine of Quebec, DD Suzanne Demers, Vice-President
2. Association of obstetricians and gynecologists of Quebec, Dr Dominique Tremblay, President
3. Association of specialists in preventive medicine of Quebec, DD Marie-Laure Hemery, President
4. College of Physicians of Quebec, Dr Mauril Gaudreault, President
5. Fédération des femmes du Québec, Sara Arsenault, Responsible for political files
6. Federation of women’s shelters, Manon Monastesse, Acting Director General
7. Quebec Federation for Family Planning, Jess Legault, General Coordinator
8. Quebec Interprofessional Health Federation, Françoise Ramel, Vice-President
9. Quebec physician for the public system, DD Isabelle Leblanc, President
10. CHUM, Department of Obstetrics and Gynecology, DD Carole Kamga-Ngande, head of department
11. Quebec University Hospital, Perinatal Department of Saint-François d’Assise Hospital, DD Véronique Pelchat, Head of Department
12. CHU Sainte-Justine, Mother-Child Infectiology Center, DD Isabelle Boucoiran, Director
13. CHU Sainte-Justine, Adoption and International Health Clinic, DD Jean-François Chicoine
14. CHU Sainte-Justine, Department of Obstetrics and Gynecology, DD Lucie Morin, Head of Department
15. Pointe-Saint-Charles Community Clinic, Martial Mainguy, General Director
16. Clinique Maizerets GMF Universitaire, Cécile Jeanmart, Medical Director
17. Public health department of the CIUSSS de l’Estrie-CHUS, DD Isabelle Samson, Director of Public Health
18. Public health department of Gaspésie and Îles-de-la-Madeleine, Dr Yv Bonnier Viger, Director of Public Health
19. Marie-Paule-Lanthier birth center, Marie-Pier Mainville, Manager of midwifery services
20. Interdisciplinary Center for International Health Development of the University of Sherbrooke, Sarah Stecko, Director of Operations and Partnerships
21. Claire-Bonenfant Chair – Women, Knowledge and Societies, Isabelle Auclair, Holder
22. Faculty of Medicine and Health Sciences of the University of Sherbrooke, Dr Dominique Dorion, Dean
23. Faculty of Medicine of the University of Montreal, Dr Patrick Cossette, Dean
24. Intersectoral health research group of the University of Quebec, Cathy Vaillancourt, Director
25. Allaitement Québec, Christine Marcotte, General Director
26. ARO CoopérAction InterNational, Colette Lavergne, president and founder
27. Cooperative Home Economy Association of Northern Montreal, Émilie Laurin-Dansereau, budget advisor
28. Association for Public Health of Quebec, Anne-Marie Morel, Director of perinatal projects
29. CALACS de Charlevoix, Sophie Fortier Mallette, coordinator
30. Crossroads for Intercultural Action, Laurie Arsenault-Paré, Director
31. Crossroads for animation and participation in an open world, Yves Carrier, coordinator
32. Family crossroads for disabled people, Capitale Nationale women’s disability committee, Julie Montreuil, co-director
33. Bon Courage Community Center, Kadiétou Savadogo
34. Multi-ethnic community center of Montreal-North, Guillaume André, Director
35. Montreal-North Social Pediatrics Center, Édith Sauvageau, General Director
36. Saint-Laurent Social Pediatrics Center – At the heart of childhood, Christine Durocher, General Director
37. Lowertown Women’s Center, Laura Santamaria, Co-coordinator
38. Haute-Ville Family Center, Aurélie Mélot, Director
39. Portneuf Women’s Center, Victoria Beaulieu
40. Beauport Women’s Resource Center, Marie Céline Domingue, President
41. Chantelait, Isabelle Poulin, Director
42. Saint-Roch proximity clinic, Isabelle Hautbout, Coordinator
43. Clinique SPOT, Marie-Pier Landry, General Coordinator
44. Collective for Free Choice, Johanne Bilodeau, co-coordinator
45. Committee of Immigrant Women of Quebec, Lorena Suelves Ezquerro, President
46. SABSA solidarity cooperative, Amélie Bédard, General Director
47. Breast-Pathique Mutual Aid, Jan Kelly, Director
48. Women, Politics and Democracy Group, Esther Lapointe, General Director
49. Le Pont – APPI, Arthur Durieux, Director
50. Les Perséides, Janie Tremblay, General Director
51. Maison de la Famille-MRC Bonaventure, Josée Barlow, coordinator
52. Heart House for Women, Kathy Mathieu, Director
53. Maison Marie-Rollet, Cynthia Roussel, Clinical Coordinator
54. House for immigrant women, Samia Belkhir, Coordination Assistant
55. Mamie-Lait, Gaétane Cliche, General Director
56. Médecins du Monde Canada, Nadja Pollaert, General Director
57. Nouri-Source Montréal, Sophie Morel, General Director
58. LUNE Project, Gabrielle Vaudry, Speaker responsible for feminist struggles
59. RÉCIF 02, Gisèle Dallaire, coordinator
60. Regroupment of women’s groups of the Capitale-Nationale, Élise Landriault-Dupont, co-coordinator
61. Network of Regional Tables of Women’s Groups of Quebec (RTRGFQ), Audrey Gosselin Pellerin, feminist political organizer
62. Family resources the old barracks of Montmorency (Re-Fa-Vie), Marie-Ève Bouchard, Social perinatal worker
63. SOS Pregnancy, Intervention worker and support for termination of pregnancy
64. Perinatal Reference Service for Immigrant Women of Quebec (SRPFIQ), Marielle M’Bangha, Director
65. Laval consultation table on the status of women, Marie-Ève Surprenant, General Coordinator
66. Consultation table of women’s groups from Gaspésie and Îles-de-la-Madeleine, Nastassia Williams, coordinator
67. Consultation table of women’s groups of Montérégie (TCGFM), Linda Crevier, general director
68. Consultation table of organizations serving refugees and immigrants, Stephan Reichhold, Director
69. Mauricie women’s movement consultation table (TCMFM), Joanne Blais, Director
70. Consultation table of the women’s movement of Centre-du-Québec, Maryse St-Arneault, Deputy Director
71. Table of Montreal women’s groups, Marie-Ève Desroches, Responsible for consultation and community life
72. Violence Info, Nathalie Igonène, Director
73. Viol-Secours, Julie Tremblay, General Director
74. YWCA Quebec, Stéphanie Lampron, Lorinne Larouche, director of social programs
75. Annick Larochelle, gynecologist-obstetrician
76. Béatrice Cormier, gynecologist-obstetrician
77. Caroline Lachance, gynecologist-obstetrician
78. Carolyne Gervais, gynecologist-obstetrician
79. Catherine Taillefer, gynecologist-obstetrician
80. Emilie Gorak Savard, gynecologist-obstetrician
81. Emily Brander, obstetrician-gynecologist
82. Emmanuelle Dennie-Filion, Midwife
83. Éric Paradis, gynecologist-obstetrician
84. Esther Bélair-Kyle, obstetrician-gynecologist
85. France Durocher, gynecologist-obstetrician
86. Geneviève Bertrand, gynecologist-obstetrician
87. Gregory Courtoy, doctor specializing in internal medicine
88. Isabelle Vachon, gynecologist-obstetrician
89. Joelle Paquin-Marcotte, gynecologist-obstetrician
90. Karine Girard, gynecologist-obstetrician
91. Kateri Lévesque, obstetrician-gynecologist
92. Katherine Thériault, gynecologist-obstetrician
93. Liliane Brassard, gynecologist-obstetrician
94. Marianne Chevrette, gynecologist-obstetrician
95. Martine Bernard, gynecologist-obstetrician
96. Meggie Lallier Beaudoin, gynecologist-obstetrician
97. Mélissa LeBlanc, gynecologist-obstetrician
98. Nathalie Ouellet, gynecologist-obstetrician
99. Pascale Gaudet, gynecologist-obstetrician
100. Philippe Sauthier, gynecologist-obstetrician
101. Valérie Kingsbury, obstetrician-gynecologist
102. Vanessa Picard Fortin, gynecologist-obstetrician
