'Emotionally, it was very hard': Parents from rural B.C. community share challenges relocating to give birth

This story is part ofSituation 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 childcostDarci Kostiuk almost $4,000.

Kostiuk lives in Port McNeill, near Vancouver Island's northern tip, which lacks a health facility withmaternity and birthing services.

In the weeks leading up to her first child's birth in 2019, she had to travel almost 200kilometres southeastto Campbell River, where the closest healthfacility which performs C-sections is located. There, she hadto live temporarily out of a hotel.

Kostiuk is one of over a thousand expecting parents from ruralcommunities in British Columbiawho are advised to relocate, at their own expense,in the weeks before giving birthdue to a lack ofmaternity 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 hometook 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, Kostiukneeded an emergency C-section and hecouldn'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 siteswith maternity servicesin rural areasacross the province, says the ministry,forcing manypregnant people to travel for maternity care and birth.

Emotional isolation anda plane ticketto 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.

Ewenwas 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 forwork.

"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 covermeals, accommodation or gas, according to the Health Ministry.

When Kostiukgave birth to her second child in Aprilthis year, she says shecut expenses down by staying at the Qwalayu House in Campbell River, a charity-run, low-cost accommodation for pregnant womenwaiting 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 ababy'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 expandingmidwife-run maternity carein rural communities.

One currently operates in Port Hardy, about 43 kilometres west of Port McNeill.

But it only accommodates deliveriesfor 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."