Health Accord N.L. doesn't do enough to address reproductive health care, say advocates

Advocates say the Health Accord N.L. final report doesn't adequately address barriers to reproductive and sexual health care in Newfoundland and Labrador.

In an open letter addressed to Health Accord N.L. co-chairs Dr. Patrick Parfrey and Sister Elizabeth Davis, Birth Justice N.L.expressed disappointment in the final report.

"There was no mention of midwifery services and there was very little mention of reproductive health careor sexual health care," said Birth Justice N.L. co-chair Deirdre Maguire in an interview with CBC News.

Birth Justice N.L. participated in consultations with Health Accord N.L. last year,and Maguire saidshe was disappointed their recommendations didn't make it into the final document.

"We really need to make sure that sexual and reproductive health care is a part of this provincewide health-care transformation," she argued.

The 266-page report is touted as a decade-long health transformation, with 57 recommendations covering everything from poverty to the province's aging population.

A strategy for implementing those recommendations, titled "The Blueprint," is set to follow later in March. In a statement provided to CBC News, a spokesperson for Health Accord N.L. said the implementation plan will include reproductive health care.

Health Accord N.L. recommends integrating some services and removing emergency services from some communities. Maguiresaid she hopes that integration will not involveremoving birthing services from rural and remote areas.

"People deserve to give birth close to their home. Travelling long distances to give birth can be isolating, stressful and logistically challenging for families," she said.

N.L. midwifery program in a lull

Health Accord N.L. also recommends forming 35 community-care teams, which would include family physicians and nurse practitioners. Jaclyn Hynes, also a co-chair of Birth Justice N.L., said she'd like to see the province include midwives as part of primary care.

Midwives provide care for low risk pregnancy and birth, though they aren't accessible in most parts ofNewfoundland and Labrador. The province's only midwifery clinic located in Gander has just four positions. Hynessaidmidwifery programs are more common in other provinces;in Ontario, for example, 15 per cent of all births are attended by midwives, according to the Association of Ontario Midwives.

When the Gander midwifery clinic opened in 2019, Health Minister John Haggie said the province was looking to bring midwifery programs to other communities too. More than two years later, Hynes said, those other programs have yet to materialize, andthe Gander clinic is operating with limited capacity.

CBC News has asked the Department of Health for comment.

Hynes said increasing access to midwifery care could help reduce health interventions and allow more parents to give birth close to home.

"They have really positive and long-lasting impacts on growing families and the health-care system at large," she said.

Sexual health care and rural N.L.

Nikki Baldwin, the executive director of Planned Parenthood Newfoundland and Labrador, another group involved in the consultation phase of the Health Accord N.L., said she was also disappointed by the final report.

While she was pleased with some of the recommendations, like pharmacare, Baldwin wanted to see a plan for increasing access to sexual health care across the province.

"We're hearing that people couldn't get access in their communities to things like [pap smears] or birth control or abortions, gender-affirming care."

Baldwin notedpatients in Labrador who need an abortion usually have to travel to St. John's an expensive and difficult process.

Baldwin said Planned Parenthood has become busier since the pandemic hit the province in 2020; she said the clinic has signed up more than 1,000 patients over the past year. Whiletelehealth appointments have helped improve access to sexual health care for some living in rural and remote parts of the province, she said, she'd like to see more.

"We worry for the rest of our province. We worry for the people who can't get an appointment here," she said. "It's getting worse all the time and we really need the government to step in and help."

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