Act early: two words which alone sum up the crucial importance of pregnancy and the first months of life in the development of the child and which, in Quebec, are today the subject of a large mobilization of the civil society.
Acting early is also the name of a recent initiative in preventive medicine deployed under the leadership of Minister Delegate for Health and Social Services, Lionel Carmant, with the aim of detecting developmental vulnerabilities in children as early as possible. children in order to intervene and thus prevent even greater difficulties.
Among the other advances in this area, let us also highlight the actions taken in response to Commissioner Régine Laurent’s call for prevention, the restoration of front-line perinatal services and the strengthening of local community services.
Finally, we welcome the entry into force of Bill 83, which allows all children, regardless of the immigration status of their parents, to have access to the Régie de l’assurance maladie du Québec (RAMQ).
Lack of follow-up
Although we are delighted with the direction taken, there remains a gaping hole in this safety net: the difficulties of access to pregnancy follow-up and the absence of RAMQ coverage of childbirth costs for women with migratory status. precarious.
Every year in Quebec, hundreds of women become mothers without having access to the protection offered by the RAMQ. Among those who live in very precarious situations, some will have the chance to have pregnancy monitoring or nutritional support thanks to organizations such as Au coeur de l’enfance, Médecins du Monde or the Montreal Diet Dispensary. Others will go through their pregnancy without medical follow-up, or will only consult at the very end of pregnancy.
This lack of prenatal follow-up has consequences on the development of the fetus and increases the risk of premature birth, babies with low birth weight or congenital malformations. Malnutrition during pregnancy is associated with the development of chronic diseases and delays in the child’s cognitive development.
Giving birth without being covered by RAMQ in Quebec also means living with intense financial stress. It’s going to the hospital with $1,200 in an envelope to pay for the cost of an epidural, if the pain ever becomes unbearable. It means entering into an agreement to pay $20,000 or more for childbirth costs, and carrying the financial and psychological burden of this debt for a long time, when you are already living in a situation of vulnerability.
The first 1000 days
During pregnancy, every day, every hour, every minute influences the future health of the child. The scientific consensus is solid: the period of the first 1000 days of life, from pregnancy to the first two years of the child’s life, is a crucial period for its development, but also for its overall health throughout its life. . This is why we support the recommendations made in the memorandum published by Médecins du Monde and supported by a coalition of organizations that demand that all women living in Quebec have access to pregnancy-related care, but also to other essential services. sexual and reproductive health they need throughout their lives.
If, as a society, we want to act early and with the most vulnerable, we must open wide the doors of the health system to pregnant migrant women with precarious status. The RAMQ must cover pregnancy follow-up and delivery costs. Close collaboration must be encouraged between the health network and the community. We must offer all those who need them services such as Olo follow-up, the first objective of which is to give families an equal chance of giving birth to a healthy baby.
The lack of care during pregnancy has consequences for the health of children, which entails significant costs for the health network. The lack of care also goes hand in hand with the progression of preventable diseases, which then leads to heavier and more costly treatments for society. RAMQ’s coverage of pregnancy and childbirth costs is an excellent return on investment. Completing the safety net is therefore in all of our interests!
Elise Boyer, CEO, Olo Foundation
Dr. Marie-Laure Durand-Hemery, Association of Preventive Medicine Specialists of Quebec
Christine Durocher, Executive Director, At the Heart of Childhood
Julie Paquette, Executive Director, Montreal Diet Dispensary