Sask.'s decision to end widely criticized practice of birth alerts doesn't go far enough: experts

Indigenous women traumatized by birth alerts continue to be haunted by them long after the alerts were first entered into the health-care system, says Mary Ellen Turpel-Lafond (Aki-Kwe) — and she's not alone in saying simply ending the practice doesn't go far enough. 

"We have to repair the harm. [Government] has to acknowledge it," said Turpel Lafond, who was the first Indigenous woman appointed to the bench in Saskatchewan.

She is now a professor at the University of British Columbia's school of law and recently headed an intensive study that found widespread racism and discrimination against Indigenous peoples in B.C.'s health-care system.

Saskatchewan posted an anouncement online Monday saying it would stop using birth alerts on Feb. 1.

Under the practice, social workers or health-care workers would place an alert on the file of a mother-to-be — in Saskatchewan, most often an Indigenous woman, according to government data — considered high-risk before they entered labour. The baby would often then be seized by government and put into provincial care. 

Turpel-Lafond says women who were flagged were labelled as bad parents, drinkers or drug seekers. 

"Instead of working prenatal and postnatal with mums and families, it was just putting the alert in the system, doing the harsh removals [of babies]," she said. 

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She's spoken to women affected years after having an alert placed upon them. 

"They're so traumatized to this day … they will not access the health care because they don't feel it's culturally safe," she said. "All of this extremely hostile profiling that came with the child welfare … goes with them, especially through the emergency departments." 

Turpel-Lafond said the data should be deleted and the government should apologize, acknowledging the harm caused by birth alerts.

"There wasn't really appropriate attention to whether that was even legal, and in my respectful view as a lawyer, a law professor, I don't think it is legal to take private information and blast it through the health-care system." 

The government did not apologize in its recent announcement.

"Our decision aligns with recommendations from the Missing and Murdered Indigenous Women and Girls Inquiry, the Truth and Reconciliation Commission Calls to Action and the federal Indigenous child welfare legislation," Janice Colquhoun, executive director of Indigenous Services with child and family programs at the Ministry of Social Services, said in a statement Tuesday. 

The TRC's final report was released in 2015.  In 2019, the Saskatchewan government said it would continue using birth alerts, despite calls to immediately abandon the practice from the National Inquiry into Missing and Murdered Indigenous Women and Girls. 

B.C. announced an end to birth alerts in 2019, with Manitoba and Ontario following in 2020. 

Saskatchewan's Ministry of Social Services said its latest decision came after "recognizing concerns raised by various Indigenous partners and community stakeholders across Saskatchewan."

Between Jan. 1 and Dec. 31, 2020, Saskatchewan issued 76 birth alerts — 53 involving Indigenous women, according to a Ministry of Social Services spokesperson. Data dating back to 2016 shows Indigenous moms had their children taken away at rates far higher than non-Indigenous moms. A spokesperson said the ministry is actively working on reunification.

Gaps in support for expecting moms

Jamesy Patrick, interim executive director at Sanctum Care Group in Saskatoon, said the alerts were essentially another discriminatory extension of colonial programs such as residential schools and the Sixties Scoop.

Patrick, who holds a master's degree in law and focused her research on Indigenous children and youth in the child-welfare system, says the government needs to turn focus to supporting vulnerable women who would have been flagged.

"There are significant gaps for prenatals in our community who interface homelessness, addiction, substance abuse, who are potentially HIV-positive or at risk of becoming, and also who have other children in care," she said. 

Patrick said they've served 54 moms (most postnatal) in a two-year period, and consistently have dozens of women on the wait-list. She advocates for the province to develop prenatal case management teams to connect vulnerable women to agencies providing support.

She said case workers could help make women feel more comfortable accessing health care. 

"We know that many of our moms don't access prenatal care because they're worried about being alerted or they're worried that they're going to be discriminated against or marginalized, or they're going to face stigma in accessing care."

Turpel-Lafond said anecdotes indicate Saskatchewan Indigenous women in the province receive less health-care in pre- and post-natal periods.

"I think this is also connected to this tradition of birth alert, judging, shaming and segregating Indigenous health care," she said.

Patrick said stronger prenatal supports for vulnerable women are needed province-wide. She said this should be supported by government, but led by Indigenous leadership and frontline community organizations.

The Ministry of Social Services said it will work with the Ministry of Health, the Saskatchewan Health Authority and other partners to ensure supports are available. 

Turpel-Lafond said in addition to supporting vulnerable moms-to-be, much more work is needed to make the health-care system as a whole accessible for Indigenous women who no longer feel safe accessing it. 

"Let's hope people in Saskatchewan will begin to use anti-racism tools in their workplace, in health and social services and child welfare, and eradicate the scourge of racism that is in the system."