Arabnews24.ca:Sunday 4 December 2022 01:12 PM: This story is part of Situation Critical, a series from CBC British Columbia reporting on the barriers people in this province face in accessing timely and appropriate health care.
Giving birth to her first child cost Darci Kostiuk almost $4,000.
Kostiuk lives in Port McNeill, near Vancouver Island's northern tip, which lacks a health facility with maternity and birthing services.
In the weeks leading up to her first child's birth in 2019, she had to travel almost 200 kilometres southeast to Campbell River, where the closest health facility with maternity services is located. There, she had to live temporarily out of a hotel.
Kostiuk is one of over a thousand expecting parents from rural communities in British Columbia who are advised to relocate, at their own expense, in the weeks before giving birth due to a lack of maternity care where they live.
According to B.C.'s Ministry of Health, rural maternity services have disappeared at an alarming rate: 20 rural maternity sites have closed in the last 20 years.
Being away from home took a financial and mental toll on her family, Kostiuk says, as her husband had to stay in Port McNeill for work and could only visit on weekends.
"Every time my husband left it was like I was getting more and more emotional about it ... it felt wrong the last time he left," she said.
A day before her husband was scheduled to arrive, Kostiuk needed an emergency C-section — and he couldn't make it on time.
"To think I'd be rolling into an operating room without my husband, I'd never even imagined that would happen."
There are only 15 remaining sites with maternity services in rural areas across the province, says the ministry, forcing many pregnant people to travel for maternity care and birth.
Emotional isolation and a plane ticket to Alberta
Alissa Ewen, who was six months pregnant when she moved to Port McNeill from Edmonton in 2020, says she was forced to return to Alberta to give birth.
Ewen was told by her doctor to relocate to Campbell River a month before her due date, because her previous baby had also come early and required a C-section.
But the only support available to her was a grant of up to $1,000 for travel costs, she says, offered by the non-profit Children's Health Foundation of Vancouver Island.
"Well, $1,000 isn't going to cut it for a month," said Ewen, referring to accommodation fees that would add up.
She ended up paying for her own flight to Edmonton, while her husband had to stay behind in Port McNeill for work.
"It's very isolating," she said. "Emotionally, it was very hard."
While some families can access the province's travel assistance program — which offers free or discounted fees with transportation partners, such as B.C. Ferries, for health-related travel within the province — the program does not cover meals, accommodation or gas, according to the Health Ministry.
When Kostiuk gave birth to her second child in April this year, she says she cut expenses down by staying at the Qwalayu House in Campbell River, a charity-run, low-cost accommodation for pregnant women waiting to give birth.
The importance of birthing locally
Among the many reasons maternity services shut down in rural areas is there aren't enough births each year to retain and train staff, says the ministry.
But giving birth locally is vital for a baby's health, says Jude Kornelsen, an expert in rural maternity care at the University of British Columbia.
She cites a study she conducted in 2011 that found infant mortality rate is three times higher for those whose parents have had to travel more than four hours for delivery.
For parents who've had to drive over two hours for delivery, they found a higher instance of pre-term births and babies having lower birth weights.
The Health Ministry says they are working on expanding midwife-run maternity care in rural communities.
One currently operates in Port Hardy, about 43 kilometres west of Port McNeill.
But it only accommodates deliveries for low-risk pregnancies, leaving out parents who are carrying multiple babies, those with pre-existing health conditions, pregnancy complications and, in some cases, even first-time parents.
All this, to give birth, result in higher stress rates for people during their pregnancy, says Kornelsen.
"The last thing we want to do is be stressing out people who are about to give birth."