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Hilary Agro 💊 @hilaryagro
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What it's like, and what it costs, to go through a (complicated) pregnancy in the Canadian health care system: a thread.

This is very personal, but also political. And it's especially for anyone trying to gaslight Americans into thinking that socialized health care is bad. #m4a
In early January, my partner and I started trying for our first baby. On January 15, I took a pregnancy test and was shocked and delighted to have a doctor confirm it. Holy shit, it was happening! And so quickly! 

I surprised my partner with a cake I decorated myself on the bus:
We were SO excited. I registered with an amazing midwifery clinic in Vancouver. Had initial appointments, blood tests and genetic screenings. Ultrasound at 10 weeks showed a healthy, wiggly little peanut. Everything was looking good.

Total medical costs so far: $0.
In February I went to Costa Rica to run the Women's Safer Space as part of the harm reduction team for a festival. From there I went to present a research paper at a conference in Mexico.

What do those two countries have?

The Zika virus.
When I got back, I was referred to the Infectious Disease clinic at the amazing BC Women's Hospital (@BCWomensHosp). I had two appointments, two blood tests and an ultrasound to make sure I was Zika-free.

Total medical costs so far: $0.
In March, I got the flu. It sucked, a lot. The first trimester is both the most unpleasant and the most dangerous time to get a fever. Midwives & a doctor made sure my temp stayed low and I recovered, though it took a long time to stop coughing.

Medical costs so far: $0.
In late March, my midwife asked me how I was doing, and I collapsed into tears.

I'd stopped taking my #ADHD medication in Jan because of potential fetal risks, and I was not coping well. School & other things were falling apart. I was very depressed and basically non-functional.
She referred me to the BC Women's Reproductive Mental Health clinic (WHICH IS AN ACTUAL THING) and I saw a psychiatrist and a counselor. Both were amazing. I have continued regular appointments with both throughout my pregnancy.

Total medical costs so far: $0.
My partner and I signed up for an optional pregnancy group run by my midwifery clinic. Nine 2-hour sessions over six months, with 8 other couples, learning all the things. It cost $300.

So, total medical costs so far (though still nothing mandatory): $300.
The second trimester was a relative breeze. Normal 20-week ultrasound. I felt good despite ongoing anxiety battles.

I went to festivals and danced, felt so much love from friends & family, made some lit review progress, read all the natural childbirthing books (Ina May 4 lyfe).
And then, at week 31, I finally got around to doing the standard Gestational Diabetes test they give to everyone.

That's when the rug was pulled out from under me, again.
Despite having no risk factors or symptoms, I tested positive. What? What does that mean?! What happens now? Have I been hurting my baby with what I've been eating? Only 7% of pregnant women get this, how did it happen to me?

I crashed. I spent a week crying and googling.
Gestational Diabetes is a special type of Haha You Thought This Would Be Easy Lol Screw You that you can only get when you're pregnant. With GD, the placenta interferes with insulin production, & all that extra spiking blood sugar goes straight to your baby, who can grow too big.
There are other risks too. In my case, an ultrasound confirmed that our beloved baby girl was measuring pretty big, especially in her belly.

I was referred to the Diabetes Clinic and went through the whole song and dance: glucometer, dietitian appointments, endocrinologist etc.
Thanks to all that help, I was able to stabilize my blood sugars using a strict (and awfulllll) low-carb no-sugar high-protein diet, so avoided having to take insulin. The glucometer was free, I paid about $20 for ketone strips.

Total medical costs so far: $320.
Meanwhile, this whole time, another concern is slowly mounting: Baby girl is breech. Butt down, head up near my right ribs, feet near her head.

She's been breech for a while, and shows zero signs of wanting to move.
"She's still got lots of time to flip," everyone reassures me. "Only 4% of babies are breech by the end."

I hear this, but in one of the only cases of real intuition that I've had during this pregnancy, I strongly doubt it. I think she's staying put. And I was right.
Around week 36, they refer me to yet another clinic at BC Women's, to talk about my options: vaginal breech birth, or c-section. Both are risky.

First though, we can try an ECV (a maneuver to manually attempt to turn her head down), performed by an OB at the hospital.
We tried the ECV. It hurt, a lot. My partner squeezed my hand and distracted me with memories from Burning Man while I tried to breathe through it.

It didn't work. Baby girl won't budge. She likes it where she is (or there's a cord or uterine-shape issue in the way).
The kind and informative OB & nurse stayed with us as we waited for baby's heart rate to go back down. They answered all our questions and booked me another ultrasound to check baby's weight, to see if I can actually try for a breech birth.

Total medical costs so far: $320.
Actual labour and delivery, or c-section surgery, will cost us $0 plus parking, so maybe $40. We also are choosing to get a doula, subsidized through our midwifery clinic, which involves a $250 donation (AKA a fee that can be waived for people with financial need).
I'll be going into labour sometime in the next 1-3 weeks, and odds are that it'll end up in a C-section, despite how much I really, really wanted to avoid one. But in the end, baby will be alive & healthy, and the care I've gotten over the last nine months has been amazing. #m4a
So, my prenatal care in the Canadian system included the following:

#m4a #medicare4all
Obviously this is just one person's experience. But cost-wise, this is about how much it would be for any Canadian citizen or permanent resident.

At no point was I asked for anything but my provincial health card when I showed up for an appointment.
I can't believe how amazingly well this system works. How beautiful it is that my fellow citizens want everyone to have health care, and help pay to maintain it. It's unreal.

Or... is it exactly how it should be? #medicare4all
Isn't this what every pregnant woman in the world deserves?

Isn't this what every family deserves?

What are we as a country if we can't come together and make sure that babies are born healthy, and their mothers are cared for?

What else is collective wealth good for?
These are questions that I'm lucky my country has answered with some sense. I am so grateful to live in a place where people care enough about each other to maintain a system like this. My heart swells when I think about it.

But not everyone is so lucky, and that is infuriating.
What the fuck is the point of society if we can't pool our extra resources to make sure everyone is healthy? If the literal continuation of our species through pregnancy and childbirth is seen as a personal choice and responsibility rather than a social necessity?
My partner and I literally might not have been able to afford this baby, or I might have had to make some terrible sacrifices to my health, if we didn't have the privilege of living in a place where we've agreed that since every human needs care, we should all help pay for it.
I'm filled with rage at anyone who is against #m4a in the US. Where maternal death rates are rising. Where people literally die from a lack of insulin. Where people make medical decisions based on whether or not they can afford something, not whether or not they need it.
I can't imagine how much all my prenatal care would have cost in the US, even with insurance. (I'd be curious if anyone looks it up.)

But my guess is that it would be a lot more than $180 or $730, and my health would have been further compromised by financial stress & anxiety.
So, you can pry my socialized health care system from my cold dead hands.

But because of that socialized health care system keeping me and my child alive and well, you won't.
For the record: the Canadian health care system isn't perfect. Rural and remote areas, especially First Nations, are underserved. Urban hospitals in Toronto are overwhelmed. There are gaps in care and these gaps still fall along socioeconomic and racial lines for various reasons.
But the system still works, usually fairly well, and often extremely well.

It did for me, and I will never stop being grateful, or fighting for other peoples' right to the same things I have access to. #m4a #healthcare
PS despite the free health care, we're still a low-income couple living in the most expensive city in Canada, and babies (& diabetes) come with tons more costs, so if you want to help us out by sending us some diapers, we have an online registry :)…
For context, read this article on birth costs in the US today, and the awful effects they have on parents’ stress levels. #m4a #MedicareForAll #Medicare4All…
In case anyone is stumbling on this thread after the fact:

I ended up having the baby via C-section (cost: $0) after ANOTHER *unrelated* complication came up because of course that's my luck, but she is perfect and wonderful and amazing!
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