Facts and Stats: Multiple Births in Canada (2017 Update)

Did you know that there were approximately 12,000 multiple births in Canada every year over the past decade? Parents of multiples have unique experiences before, during and after they welcome their twins, triplets or higher order multiples into this world. With National Multiple Births Awareness Day just around the corner on May 28, we’ve updated our fact sheet on multiple births in Canada.

Download Facts and Stats: Multiple Births in Canada (2017 Update) from the Vanier Institute of the Family.

Learn more about diverse childbirth experiences in Canada with In Context: Understanding Maternity Care in Canada.

 


Published May 23, 2017.




New Resource for School Counsellors Working with Military and Veteran Families

The Canadian Counselling and Psychotherapy Association (CCPA), in partnership with the Canadian Military and Veteran Families Leadership Circle, have released the second in the series of awareness publications, School Counsellors Working with Military and Veteran Families.

Canada’s military and Veteran families are highly diverse, and their unique perspectives enrich schools, communities and workplaces across the country. Within this diversity, however, there are a number of experiences shared by these families related to military life, such as high family mobility, recurring periods of separation and higher levels of risk for serving members of the Canadian Armed Forces (CAF). These realities have an impact on the 462,000 children and youth growing up in military and Veteran families, most of whom attend civilian schools with peers, teachers and educational professionals, such as school counsellors, who may have little or no experience with, understanding of or training on military and Veteran life.

The Vanier Institute of the Family, CCPA, Veterans Affairs Canada, Military Family Services and other key members of the Canadian Military and Veteran Families Leadership Circle collaborated to publish School Counsellors Working with Military and Veteran Families. This bilingual resource has been designed to increase military literacy((“Military literacy” refers to one’s awareness of the experiences of military and Veteran families, including (but not limited to) frequent periods of separation from family, higher family mobility and the possibility of higher risk for serving CAF members.)) in schools to foster inclusion, provide support and optimize services for children and youth growing up in military and Veteran families.

School Counsellors Working with Military and Veteran Families answers four key questions:

  1. What is the military and Veteran lifestyle? 
     
  2. What resources are available to school counsellors to assist them in their work with children and youth of military and Veteran families?
     
  3. How can school counsellors promote mental health and advocate for students of military and Veteran families in schools?
     
  4. How can school counsellors support classroom teachers in their work with students of military and Veteran families?

“Children in military and Veteran families are diverse, resilient and strong, and they – like their families – demonstrate a high degree of adaptability,” says Vanier Institute CEO Nora Spinks. “Resources such as this can help ensure family health and well-being so that children and youth reach their full potential.”

Download School Counsellors Working with Military and Veteran Families. Print copies are available from the CCPA, MFS or local MFRCs.

About the Working with… series

School Counsellors Working with Military and Veteran Families is the second in the Working with… series, following the publication of Family Physicians Working with Military Families in November 2016.

About the Canadian Military and Veteran Families Leadership Circle

The Canadian Military and Veteran Families Leadership Circle is a component of the Military and Veteran Families in Canada Initiative, a partnership between the Vanier Institute of the Family and the Canadian Armed Forces to build awareness, capacity, competency and community regarding military and Veteran families in Canada.

About the Canadian Counselling and Psychotherapy Association

The Canadian Counselling and Psychotherapy Association (CCPA) is a national bilingual association of professionally trained counsellors engaged in the helping professions. CCPA’s members work in many diverse fields of education, employment and career development, social work, business, industry, mental health, public service agencies, government and private practice. CCPA develops and cultivates formal and informal relationships with similar health and mental health organizations in Canada and internationally.

For more information:

 

Published May 18, 2017




In Context: Understanding Maternity Care in Canada

If it takes a village to raise a child, it certainly takes one to bring a child into this world. New and expectant mothers receive care from many people throughout the perinatal period, and the networks and relationships that support them can play a major role in ensuring the health and well-being of new mothers and their newborns.

Childbirth is a milestone, an exciting time when the family grows and a new generation begins. It’s also a period of significant child development – a time of great vulnerability but also of great opportunity to benefit from healthy nurturing.

The experience of pregnancy, childbirth and postnatal care continues to evolve through the generations. Rates of maternal mortality (women dying as a result of pregnancy and childbirth), maternal morbidity (women developing complications as a result of childbirth) and infant mortality all saw significant declines throughout the 20th century following medical advances and improvements in maternal care, nutrition and general living standards.

Maternal and Infant Mortality in Canada

Maternal mortality dropped from 508 deaths per 100,000 live births in 1931 to 7 per 100,000 in 2015.

Infant mortality rates fell from an average of 76 deaths per 1,000 live births in 1931–1935 to 4.9 per 1,000 in 2013.

In the 1800s to the mid-1900s, maternity care in Canada typically took place in the local community and birth occurred in the home, with families and midwives routinely providing care to new and expectant mothers. However, with the development of medicare throughout the 20th century, births and maternity care gradually moved into hospitals and medical clinics, with care being delivered primarily by medical professionals such as doctors and obstetricians – a trend sometimes referred to as the “medicalization of childbirth.”

By the early 1980s, the vast majority of births occurred in regional hospitals, where family physicians or obstetricians were present and assisted by obstetrical nurses. Partners and other family members became largely left out of the childbirth process, often relegated to waiting rooms. Following birth, babies were placed in nurseries, separated from their mothers – a situation that was sometimes traumatic for mothers and their newborns.

Hospitals eventually started allowing the rooming in of mother and baby to facilitate mother–infant attachment and support breastfeeding for the health and well-being of both. During the rooming-in period, nurses would provide new mothers with information for the recovery period, such as instruction about breastfeeding and postnatal care. Throughout this transition in postnatal care practices, the length of time women spent in hospital after having a baby decreased significantly, from an average of nearly five days in 1984–1985 to 1–2 days after vaginal delivery today.

Today, partners are more involved in the birthing process and the perinatal period generally than in the past. Most are present for births, taking on a greater role in these first moments of their children’s lives and in the child rearing in the years that follow. It is more common for couples today to conceptualize childbirth as a shared experience, and many people use language that reflects this trend (“We’re expecting,” etc.).

 

What is maternity care?

Maternity/perinatal care (hereafter referred to as maternity care) is an umbrella term encompassing a continuum of care provided to the mother and child before, during and after birth. This includes prenatal/antenatal care (care during pregnancy), intranatal care (care during labour and delivery) and postnatal/postpartum care (care for the mother and newborn following birth). Since both mothers and infants undergo major changes throughout the perinatal period, maternity care entails a diverse range of health monitoring and care.

Prenatal/antenatal care (hereafter referred to as prenatal care) monitors and supports the health and well-being of mothers and the developing fetus prior to birth. Fetal health is monitored through screening and diagnostics, such as ultrasounds and blood tests. Health providers also closely track the mother’s health during this period; expectant mothers are provided with information about pregnancy, fetal development, physical comfort, testing, planning for delivery and preparing for parenthood.

Most women (87%) say they were supported by a partner, family or friends throughout the prenatal period.

According to the 2009 Canadian Maternity Experiences Survey, most women (87%) say they were supported by a partner, family or friends throughout the prenatal period. This support, as well as the care provided by health practitioners, can be particularly important during this time when many (57%) women report most days as being stressful. During pregnancy, maternal stress can have an impact on the well-being of the baby, leading to premature birth and/or low birth weight.

Nearly all expectant mothers (95%) report that they started prenatal care in their first trimester. Certain groups were more likely than others to report that they did not start prenatal care in the first trimester, however, such as women aged 15–19 years, those with less than high school education or those who live in low-income households. One of the main reasons cited for not starting care early in the pregnancy was lack of access to a doctor or health care provider.

Intranatal/intrapartum care (hereafter referred to as intranatal care) refers to the care and assistance provided to mothers during labour and childbirth. This involves facilitating the delivery itself in a safe and hygienic manner as well as monitoring the health of mother and child throughout the delivery process. This care is most often provided in hospitals, with mothers receiving care from a variety of health practitioners including obstetricians/gynecologists (reported as the main health care provider during labour and birth by 70% of surveyed mothers), family doctors (15%), nurses or nurse practitioners (5%) or midwives (4%).

Whether provided by a spouse, partner, friend, family member, midwife or doula (or some combination thereof), emotional support during this time is important. Research shows that women who receive continuous social support are more likely to have a shorter labour (i.e. fewer hours) and a vaginal birth, are more likely to report feeling happy with their labour and birth experience and are less likely to use pain medication.

Research shows that women who receive continuous social support are more likely to have a shorter labour and a vaginal birth, and are more likely to report feeling happy with their labour and birth experience.

Postnatal/postpartum care (hereafter referred to as postnatal care) supports mothers and newborns following childbirth, and involves health monitoring and routine assessments to identify any deviation from expected recovery following birth, and to intervene, if necessary.

The postnatal period accounts for the first six weeks of a child’s life – a “critical phase” in which examinations and care from health practitioners play an important role in ensuring the well-being of the mother and child, according to the World Health Organization (WHO).

In their 2013 postnatal care guidelines, WHO outlines best practices including postnatal care in the first 24 hours to all mothers and babies (regardless of where the birth occurs), ensuring that healthy women and their newborns stay at a health facility at least 24 hours and are not discharged early, and have at least four postnatal checkups in the first 6 weeks following childbirth.

According to the Maternity Experiences Survey, more than 7 in 10 women (73%) rated their health as “excellent” or “very good” by 5 to 14 months postpartum. However, more than 4 in 10 women in Canada (43%) said they experienced a “great deal” of problems with at least one postpartum health issue during the first three months following childbirth, such as breast pain (16% of women), pain in the vaginal area or in the area of the caesarean incision (15%) and back pain (12%).

Postnatal support can be important in mitigating postpartum depression, which is reported by 10%–15% of mothers in developed countries. Research has shown that maternal stress during pregnancy, the availability of social support and a prior diagnosis of depression are all significantly associated with developing postpartum depression. Studies have also shown that emotional support from partners and other family members throughout the perinatal period can reduce the likelihood for postpartum depression and emotional distress for mothers and newborns.

Postnatal care services vary across regions and communities in Canada. These can include informational supports, home visits from a public health nurse or a lay home visitor, or telephone-based support from a public health nurse or midwife.

Privately delivered postnatal services have become more prevalent over the past several decades, with postpartum doulas advertising high-intensity supports such as newborn care, breast- and bottle-feeding support, child-minding services, meal preparation, household chores and more. However, these private services often involve out-of-pocket costs that can limit accessibility for some families.

 

Who provides maternity care?

In addition to the care and support provided by family members and friends, modern maternity care is delivered by a range of health practitioners including family physicians, obstetricians/gynecologists, nurses, nurse practitioners, midwives and birth doulas – all of whom make unique contributions in the continuum of care.

Family physicians provide care to most new mothers throughout the perinatal period and can be involved in all stages of maternity and infant care, though not all provide the full range of care. Fewer physicians across Canada are providing maternity care than in previous decades: the share of family physicians in Canada delivering babies declined from 20% in 1997 to 10.5% in 2010. Today, a growing number of care tasks and responsibilities are being delivered by other medical practitioners, such as obstetricians and midwives.

Most family physicians who report being involved in maternity and newborn care provide “shared care,” offering prenatal care to a certain point (often between 24 and 32 weeks), after which they transfer care to another provider (e.g. obstetricians, midwives or another family physician who delivers babies). Some attend deliveries, but rates vary widely between provinces and the availability of other health providers.

Obstetricians and gynecologists (OB/GYNs) are providing a growing amount of intranatal care in Canada – though not all do so, and rates vary across the provinces. With specialized knowledge and expertise in pregnancy, childbirth and female sexual and reproductive health care (including surgical training, such as caesarian sections), many also serve as consultants to other physicians and are involved in high-risk pregnancies.

Nurses constitute the largest group of maternity care providers in Canada. They can be involved throughout the entire perinatal period, providing a range of care services including childbirth education, pre-birth home care services to women in high-risk situations, assistance during childbirth and sometimes follow-up care to new mothers. Following childbirth, nurses often provide information to new mothers while preparing them for discharge, educating them about topics such as breastfeeding, bathing, jaundice, safe sleep, postpartum mental health, nutrition and more.

Nurse practitioners (NPs) are registered nurses who play a wide variety of roles in health care. They sometimes serve as primary care providers for low-risk pregnancies, performing a variety of tasks such as physical examinations, screening and diagnostic tests, and postnatal care. When providing or facilitating maternity care, NPs often work in interdisciplinary teams with other health professionals such as physicians and midwives. In hospital settings, they also work in labour and delivery units, postpartum units, neonatal intensive care units and outpatient clinics. Due to the breadth of their training and expertise, NPs play important roles in rural and remote communities, where many provide a full range of health care services.

Due to the breadth of their training and expertise, nurse practitioners play important roles in rural and remote communities, where many provide a full range of health care services.

Midwives provide primary care to expectant and new mothers throughout the entire perinatal period, and are playing a growing role in modern maternity care in Canada. They provide a range of care services, including ordering and receiving tests, accompanying women at home or in birthing centres, admitting women for hospital births, as well as assisting with breastfeeding, the early days of parenting and monitoring postpartum healing. Midwives work collaboratively, consulting with, or referring to, other medical professionals when appropriate.

The role of midwives has evolved over the past several decades, with a growing number assisting in all settings where care may be needed – at home, in the community and in hospitals, clinics or health units. There has been increasing emphasis on specialization and training, as midwives have become recognized by and incorporated into most (but not all) provincial/territorial health care systems across the country.

Doulas provide non-clinical/medical support, working with new mothers and their families as well as health care practitioners such as physicians, midwives and nurses. Doulas are not regulated; they focus largely on emotional and informational support, and they do not provide direct health care or deliver babies.

There are different types of doulas for different stages in the childbirth process. Antepartum doulas provide emotional, physical and informational support during the prenatal period. This can include informing new mothers and their families about support groups, techniques for enhancing physical comfort and helping with home care tasks such as errands and meal preparation. Birth doulas support new mothers and their partners during labour and delivery, including emotional and informational assistance and supporting physical comfort. Postpartum doulas support new mothers after the baby is born, providing information about topics such as infant feeding and soothing techniques, and sometimes helping with light housework and childcare.

Perinatologists provide care in the event of high-risk pregnancies (e.g. pregnancy in the context of chronic maternal health conditions, multiple births or genetic diagnoses). They are trained as OB/GYNs and then receive specialized education to facilitate complicated pregnancies. OB/GYNs refer patients to perinatologists when needed, but continue to work collaboratively to support maternal health.

 

Unique experiences: childbirth in rural and remote areas in Canada

Maternity care in rural and remote areas (including Canada’s northern regions) faces unique challenges due to distances from medical facilities and specialized equipment, less peer support for care providers, as well as a limited number of physicians available for on-call services, and fewer caesarean section and anaesthesia capabilities/services compared with urban centres.

Rural maternity care is most often provided by teams of family physicians, nurses and midwives – in fact, in some communities, they’re the only health practitioners providing maternity care. Rural family physicians are far more likely to provide obstetrical care than their urban counterparts, though over the past several decades, many rural communities have seen a reduction in the number of family physicians providing maternity care and closures of maternity wards.

Due to the limited availability of maternity care providers and services in rural and remote regions, many expectant mothers travel to urban centres to give birth. According to a 2013 report from the Canadian Institute for Health Information, more than two-thirds of rural women in Canada (67%) report that they gave birth in urban hospitals, 17% of whom travelled more than two hours to deliver their babies. Rates are far higher in the North: two-thirds of surveyed mothers in Nunavut and half of those in the Northwest Territories report that they gave birth away from their home community.

Two-thirds of surveyed mothers in Nunavut and half of those in the Northwest Territories report that they gave birth away from their home community.

This has an impact on the well-being of many Indigenous women living in northern regions, many of whom have had to fly to hospitals far from their homes, land, languages and communities to receive maternity care at tertiary or secondary care hospitals (see Indigenous Midwifery in Canada textbox). When surveyed, the majority of mothers reported that leaving home to have their babies was a stressful experience and that it had a negative impact on their families. In April 2016, the federal government announced that it would provide financial compensation to allow someone to travel with Indigenous women who need to leave their communities to give birth.

The number of community hospitals offering obstetrical care in northern regions has fallen since the 1980s. However, a number of birthing centres have opened to fill this care gap, such as in Puvirnituq (Nunavik), Rankin Inlet (Nunavut) and in Inukjuak (Quebec). These facilities have helped women with low-risk pregnancies remain in their communities; however, those with complications or requiring a caesarian birth often still have to travel to give birth. 

 

Unique experiences: new and expectant mothers new to Canada

Canada is home to many immigrant families, which have represented a growing share of the total population. In 1961, 16% of people in Canada reported that they were born outside the country – a rate that increased to 21% by 2011.

Immigration has an impact on the maternity experiences, such as when women decide to have children. Research shows that immigrants have relatively fewer births in the two-year period before migration, which is often followed by a “rebound” in fertility afterward. According to researchers Goldstein and Goldstein, “Fertility preferences of movers may more closely resemble those of the destination country than those of the source country even before they arrive.”

Studies have explored a number of reasons why fertility can be affected by the immigration experience, including temporary separation of spouses during the migration process, a conscious decision to delay childbearing until access to supports such as child allowances is ensured and economic disruption during migration and in the early period (while parents are securing paid employment).

Recent immigrants are significantly more likely than their Canadian-born counterparts to live in multi-generational households (those with three or more generations living under one roof); 21% of immigrants aged 45 and older who arrived in Canada between 2006 and 2011 reported that they live in shared homes, compared with 3% of the Canadian-born population. As such, new and expectant mothers in multi-generational homes may benefit from having more family members nearby to provide care and support.

With regard to accessing maternity care services, research has shown that many immigrant women generally have the opportunity to receive the necessary maternity care services, but rates of satisfaction with maternity care vary greatly across Canada. Some report having faced barriers to accessing and utilizing maternity care services, including (but not limited to) a lack of information about or awareness of the services (sometimes the result of language barriers), insufficient support to access the services (i.e. navigation of the health care system) and discordant expectations between immigrant women and service providers. In some areas, doulas provide valuable emotional, informational and navigation support to immigrant women during the perinatal period.

Social support (e.g. from family, friends and community members) has been identified by immigrant parents as a key factor in accessing maternity care. This circle of support can play an important role in connecting new and expectant mothers from outside Canada with maternity care, and can work with health care and service providers to ensure these women receive “culturally congruent and culturally safe” maternity care.

 

Maternity care: supporting Canada’s growing families

Pregnancy and childbirth are major life events, not only for new mothers, but also for their families, friends and communities. While there have been many changes in family experiences over the generations regarding pregnancy, childbirth and the postnatal period, there have also been some constant threads: the value and importance of quality care, the diversity of experiences across Canada, and the joy and excitement that can accompany this memorable and life-changing milestone.

 


Download this article in PDF format.

This content was reviewed by Dr. Marilyn Trenholme Counsell, OC, MA, MD, retired family physician and former Lieutenant Governor (New Brunswick), former Minister of Family (N.B.) and Senator (N.B.).

All references and source information can be found in the PDF version of this article.

Published May 11, 2017




Perspectives: Test Anxiety Through a Student Lens

Shweta Govilkar

An all-too-familiar scene: I would walk into geometry class feeling confident and at ease. As soon as the test was handed out, however, the dreaded tugging in my stomach began. It will be fine, I thought. I had studied, done all of my homework and paid attention in class – what was I worried about? Breathe in, breathe out. After finishing the test, I would leave with my mind full of doubt and a feeling of nausea creeping into my system.

After reflecting on the feeling of anxiousness I experienced during every math test, I decided to try to do something about it. I did some online research to find out what exactly was happening and how I could better manage my anxiety. As I was researching, the answer became clear: I’ve been experiencing test anxiety. I had heard about it a few times but never really thought much of it. Now that it was affecting me directly, I knew I had to educate myself about test anxiety and how to effectively manage it. Soon after, I went from getting 70%–80% to 90%–100% on my tests. I continued to wonder, if addressing my test anxiety helped me, how many other students could it help?

The British Journal of Psychology defines test anxiety as a physiological condition in which people experience stress, anxiety and discomfort during and/or before taking a test.((Bernice Andrews and John M. Wilding, “The Relation of Depression and Anxiety to Life-stress and Achievement in Students,” British Journal of Psychology 95:4 (November 2004), DOI:10.1348/0007126042369802.)) Common symptoms include nausea, headaches, sweaty palms and “butterflies” in the stomach. Due to the resulting high stress levels, a student’s immune system can also become more susceptible to common colds and other illnesses or infections. In severe cases, it can even lead to panic attacks.

Statistics show that about 12% of Canadians and 30% of Americans are affected by test anxiety, but it is important to note that these are just the recorded cases; not everyone experiencing test anxiety recognizes it for what it is.

Statistics show that about 12% of Canadians and 30% of Americans are affected by test anxiety,((Public Health Agency of Canada, “Anxiety Disorders,” A Report on Mental Illnesses in Canada (October 2002), http://bit.ly/2nx3Apf.)) but it is important to note that these are just the recorded cases; not everyone experiencing test anxiety recognizes it for what it is. Research suggests that test anxiety can decrease student performance by at least 10%,((Gregory J. Cizek and Samantha S. Burg, Addressing Test Anxiety in a High-Stakes Environment: Strategies for Classrooms and Schools (Chapel Hill: NC Corwin Press, 2006).)) which can mean the difference between getting a B and an A.

I decided to talk to my school counsellor about test anxiety and how I could raise awareness of the issue at my school. After our discussion, I decided to explore how common this condition is among my peers. One method I found through my research was the Nist and Diehl survey, which uses a questionnaire to determine whether a person has test anxiety. It consists of 10 questions that ask, on a Likert scale of 1 to 5 (1 being never and 5 being always), how often the student experiences symptoms. The numbers from each answer are then added together, and a score of 35 or higher indicates a possible case of text anxiety. Among the 100 peers I surveyed, 62% showed symptoms of test anxiety. These findings cut across all socio-economic groups, cultures and genders. This led me to wonder what exactly the root causes of test anxiety are.

Anyone who has ever spoken with high school students knows how busy their schedules are. The increase in standardized tests only adds to student workloads, and research suggests that the growing number of standardized tests over the years has increased student stress levels, which can be detrimental to their mental health.((Paul Heiser et al., Anxious for Success: High Anxiety in New York’s Schools (November 2015), http://bit.ly/2nebCz5.)) According to a study performed by the Council of Great City Schools, “The average student in America’s big-city public schools takes some 112 mandatory standardized tests between pre-kindergarten and the end of 12th grade – an average of about eight a year.” This accounts for 20 to 25 hours every school year.((Ray Hart et al., Student Testing in America’s Great City Schools: An Inventory and Preliminary Analysis (October 2015), http://bit.ly/1S4LyQZ.)) While less frequent in Canada (where students write between three and five standardized tests from Grades 3 to 12),((Arlo Kempf, The Pedagogy of Standardized Testing: The Radical Impacts of Educational Standardization in the US and Canada (Springer, 2016).)) standardized tests are a great source of stress and anxiety for students, and have remained a divisive practice.((Valerie Campbell, “What Is the Value of Standardized Testing?” The Facts on Education (Canadian Education Association and University of Prince Edward Island), February 2014, http://bit.ly/2nexquh.))

In addition to standardized tests, students also have unit tests for each chapter of each subject they learn. Although students cannot control the number of tests they have to take, they can develop effective study habits and test-taking skills to reduce their anxiety. By creating a study plan and following it, students can eliminate the “time crunch” pressure, which can lead or contribute to anxiety.

The mental health and well-being of students can benefit from evidence-based supports and practices. Research has found that techniques such as breathing exercises and yoga can help people manage test anxiety.((Azadeh Nemati, “The Effect of Pranayama on Test Anxiety and Test Performance,” International Journal of Yoga 6:1 (January–June 2013), http://bit.ly/2mM4auX)) Strong family support can also provide reassurance to anxious students. It’s a team effort – teachers, peers, counsellors, friends and family can all make unique and valuable contributions by providing positive reinforcement and teaching the skills necessary to manage anxiety.

The feeling of being overwhelmed is something we all have to deal with at some point in our lives. It may not be easy to manage anxiety, but in the end, the results can have a positive impact on our lives. Test anxiety is a common, yet manageable condition. Test anxiety can decrease student performance, but by being self-aware, accessing supports and applying proven techniques, students can reach their full potential.

 


Shweta Govilkar is in her junior year of high school and hopes to study psychology in university.

Download this article in PDF format.

Published on May 2, 2017




Participants Wanted for Survey on Mobile Work

Many employees in Canada are “on the move” for work. Mobile workers may engage in long daily commutes, extended absences from home lasting weeks, months and even years, and many people travel to, from and within their jobs. These employment patterns have an impact on workers, their families, employers and the communities in which they live.

To understand this reality and how it affects households and communities, and influences and impacts Canadian prosperity, the Vanier Institute of the Family is collaborating with 40 researchers from 17 disciplines and 22 universities across Canada and around the world as part of the On the Move Partnership.

As part of this research initiative, a team of researchers is conducting a study of leading HR policies and practices used to manage mobile workers and balance concerns regarding employee productivity, family and well-being.

The On the Move Partnership is currently seeking survey participants. Do you have responsibility for mobile employees in your organization who need to spend extended time away from home to do their jobs? If so, your participation is invited.

There are two ways to take part:

  1. A confidential telephone interview (which will take less than one hour to complete). Please contact Kara Arnold arnoldk@mun.ca for this option.
     
  2. An anonymous online survey taking approximately 45–60 minutes to complete.

On the Move will create a report and a free webinar on the survey findings. Participants will have access to these resources as benchmarks for participating organizations as well as a source of ideas about what policies and practices work for these employees and their organizations. Participants can also enter a draw for a free registration to an online HR Social Media seminar.

Please email Kara Arnold for more information: arnoldk@mun.ca.

To learn more about the On the Move Partnership, visit the project page, or read the following resources:

 


The proposal for this research has been reviewed by the Interdisciplinary Committee on Ethics in Human Research and found to be in compliance with Memorial University’s ethics policy. If you have ethical concerns about the research, such as the way you have been treated or your rights as a participant, you may contact the Chairperson of the ICEHR at icehr@mun.ca or by telephone at 709-864-2861.




Infographic: Women, Caregiving and Work in Canada

Caregiving is a fact of life and a common family experience in Canada. At some point in their lives, most family members have provided – or will provide – care to a family member or friend with a long-term health condition, disability or aging need. However, Canadians don’t share a single narrative or caregiving experience, as social, economic, cultural and environmental factors shape who is expected to provide care, what kind of care they provide and the consequences of managing caregiving in addition to paid work.

And while the gap between women and men has lessened over the past generation, caregivers have historically been disproportionately women, and this remains true today. Research also shows that on average, women in Canada devote more time to caregiving tasks than men and are more likely to experience negative consequences as a result of their caregiving.

Our new infographic Women, Caregiving and Work in Canada explores family caregiving and work in Canada with a focus on women.

Highlights include:

  • 30% of all women in Canada reported that they provided care in 2012.
  • Women aged 45 and older reported having spent an estimated 5.8 years providing care throughout their lives, compared with 3.4 years for men.
  • Women are significantly more likely than men to report having spent 20 hours or more per week providing care (17% and 11%, respectively).
  • An estimated 72% of women caregivers aged 45 to 65 in Canada are also employed.
  • Women reported experiencing a variety of employment impacts as a result of their caregiving responsibilities: 30% reported missing at least one full day of work; 6.4% retired early, quit or lost their paid job; and 4.7% turned down a job offer or promotion.
  • Estimates show that women caregivers in Canada lost an aggregated $221 million in wages annually between 2003 and 2008 due to absenteeism, reducing work hours or leaving employment entirely.
  • Among women caregivers who have access to flexible work arrangements, half (47%) feel they cannot utilize these options without it having a negative impact on their careers.

 

Download the Women, Caregiving and Work in Canada infographic from the Vanier Institute of the Family.

 

Learn more about women, family caregiving and work in Canada:

 


Published on March 28, 2017




Lived Experience: Understanding Families Affected by Incarceration

Farhat Rehman

Incarceration has an impact on thousands of families across Canada. When a person is sentenced to time in prison, their families are often profoundly affected; they are separated from a son, daughter, sibling, parent or other relative. Feelings of stigma, guilt and shame are common, and can be compounded when the sentenced family member is also living with a mental health condition – a reality for many incarcerated individuals and their families.

My family life has been profoundly affected by incarceration ever since my son was sentenced in 2001. When the chasm of the prison system had swallowed him up, the world appeared dark with no hope of seeing daylight. Our lives took a drastic turn on that ominous day. Our family’s lives and relationships were forever changed.

As a mother, I couldn’t help but wonder over and over again why my son had committed such a serious criminal act. Why did his mind work this way? What could have been done to prevent this catastrophe? Why, after years of treatment in the mental health system, had he still fallen through the cracks? What could I have done differently that would have prevented this crime from taking place and tearing apart two families? Since then, there have been daily reminders as I speak to him and visit him in prison. For us, his family, the impact of my son’s action have sunk in gradually over time. The nightmare of prison has played havoc with his mental health conditions with all the ups and downs of a roller coaster, and it’s become a constant source of worry for our family.
 

The nightmare of prison has played havoc with his mental health conditions with all the ups and downs of a roller coaster, and it’s become a constant source of worry for our family.

 

Incarceration affects family relationships, family traditions and family futures

As we have learned, in-person visits can be traumatic for the visitor. When visiting someone in prison, you have to first pass through layers of security such as the ion scanner (a drug-scanning device known for detecting false positives). Otherwise, you risk being turned away, which can seriously impact the inmate’s prison life.

There is no occasion that is celebrated as a family where I don’t feel my son’s absence. The festivities, the good food and laughter lack the genuine happiness that can come from family gatherings. This is never really talked about openly.

Family members will occasionally ask about my son and he may receive birthday cards from family and friends, but there is a kind of hesitation to discuss such a sad subject and ruin a festive atmosphere. The fact a family member has not been seen among you for almost 16 years registers low on the Richter scale of family life.

These days, as I contemplate the possibilities of the future, I wonder if this will be the time that my son will be able to start to turn his life around. Will he convince the authorities that he is deeply remorseful and resolved to never offend again? Will he be seen as worthy of being allowed to be paroled out of prison and into the community, where he can start the long process of healing and repairing the ravages of a lengthy period of incarceration? Will he be able to reintegrate himself into our family, one that misses him terribly but has adapted to life in his absence?

The love and light of support gets families through

While I contemplate these questions daily, I am grateful for the support of those around me. When my son – and my family – first began our journey with the justice system, I felt like I was travelling down an uncharted road. Despite being well connected to community, there was no real support I could turn to where others would understand what it was like to have a son in prison.
 

Despite being well connected to community, there was no real support I could turn to where others would understand what it was like to have a son in prison.

 
In November 2010, a community activist and expert connected to the Church Council on Justice and Corrections and a crisis worker at the John Howard Society (JHS) introduced me to ‬another mother with a son in prison. We all met for the first time at JHS in December 2010 – three mothers coming together with common experiences and goals.

From this shared experience, Mothers Offering Mutual Support (MOMS), a support group for women, was born. The first formal MOMS meeting occurred on December 15, 2010. Our meetings take place at the local JHS building, during the first Thursday of the month. JHS has generously donated this space to us so we can meet in a location with privacy.

We now total more than 45 members, all of whom feel immensely grateful to be able to come together and climb out of the black hole we fell into when our children were convicted of an offence resulting in their incarceration. Now we come together to support each other and find ways to help them in a meaningful and constructive way. Mothers whose sons have completed their sentence or are on parole continue to support and guide the new members who join the group.

A loving family on the outside can play an important role in advocating, financially supporting and providing loving contact to offset the indelible ravages of incarceration. Through MOMs, we are able to support each other as we support our incarcerated children.
 

A loving family on the outside can play an important role in advocating, financially supporting and providing loving contact to offset the indelible ravages of incarceration.

 
The harsh realities of incarceration are with us, but together we encourage each other to take one day at a time. We have been working to ensure the justice system facilitates rehabilitation and education, with a focus on physical and mental well-being and supporting our sons or daughters while they serve their sentences and plan for their futures. This has provided us with opportunities to engage in dialogue with government and community leaders about human rights. Policies and programs benefit from understanding our lived experiences and our perspective as mothers. We have been encouraged by increased public awareness of these issues.

As you can imagine, for some moms and family members, issues of stigma and safety keep us fearful of speaking out publicly, even though we are worried sick and lose sleep thinking about the condition of our children. We do not want to add to our shame and worry by being on the receiving end of insensitive or negative comments.

As mothers affected by incarceration, we meet regularly to share our experiences and our shock, pain and heartbreak. Working together gives us energy to focus on strategies to equip ourselves with knowledge and best practices to keep ourselves and our loved ones hopeful and healthy. We are determined to achieve humane and just treatment for our loved ones in prison as we work together to strengthen the ties that bind us in our struggle as families affected by incarceration.

 


Farhat Rehman is co-founder of Mothers Offering Mutual Support (MOMS), a support group for women with incarcerated family members.

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Published on March 14, 2017




A Snapshot of Family Caregiving and Work in Canada

At some point in our lives, there is a high likelihood that each of us will provide care to someone we know – and receive care ourselves. Family members are typically the first to step up to provide, manage and sometimes pay for this care.

Families are highly adaptable and most of the time people find ways to manage their multiple work and family responsibilities, obligations and commitments. However, juggling work and care can sometimes involve a great deal of time, energy and financial resources, and employers can play an important role in facilitating this care through accommodation, innovation and flexibility.

In A Snapshot of Family Caregiving and Work in Canada, we explore some of the family realities and trends that shape the “landscape of care” across the country. This resource highlights how our family, care and work responsibilities intersect, interact and have an impact on each other.

Highlights include:

  • 28% of Canadians (8.1M) report having provided care to a family member or friend with a long-term health condition, disability or aging need in the past year.
  • Three-quarters of family caregivers (6.1M) were employed at the time, accounting for 35% of ALL employed Canadians.
  • Most (83%) surveyed caregivers say their experience was positive, and 95% say they are effectively coping with their caregiving responsibilities.
  • 44% of employed caregivers report having missed an average 8–9 days of work in the past 12 months because of their care responsibilities.
  • More than one-third of young carers (36%) arrived to work late, left early or took time off due to their caregiving responsibilities.
  • Employers across Canada lose an estimated $5.5 billion annually in lost productivity due to caregiving-related absenteeism.
  • Research shows that caregiving provides a variety of benefits to caregivers, including a sense of personal growth, increased meaning and purpose, strengthened family relationships, increased empathy and skill development.

 

Reconciling care and work requires understanding, respect and recognition from employers that sometimes an employee’s family circumstances need focused attention. Research shows that family caregivers and their employers benefit from policies that are inclusive, flexible and responsive, and when employees have a clear understanding of the process for handling individual requests for accommodation and customizing work arrangements.

For nearly all Canadians, caregiving is inevitable at some point over the course of their lives. Care is not always predictable and does not always arise outside working hours. Open communication and creative approaches to harmonizing work and care in a flexible manner benefits employees, employers, the economy and society.

Download A Snapshot of Family Caregiving and Work in Canada from the Vanier Institute of the Family.

 

Learn more about family caregiving and work in Canada:

 


Published on February 21, 2017




Supporting the Health of Mothers and Their Babies in the Context of Incarceration

Dr. Ruth Elwood Martin and Brenda Tole

When a friend told Ruth Elwood Martin that there was a need for a part-time family physician to work in a women’s correctional centre, her immediate thought was that there was no way she could work in a prison clinic. She perceived that it was the lowest kind of medical job, only for those doctors who were unable to find any other type of work.

Ruth is not sure what drew her to start practising medicine in a prison, but she did. On that first day in 1994, she felt like she was visiting another planet, passing through those gates, experiencing another world and learning from the people inside it. Ruth saw more pathology and more tragic medical diagnoses than she had seen in a year in her regular family practice in Vancouver’s West Side.

In the clinic, women told her about traumatic events they endured as children, young teenagers and women. Ruth would put down her pen, bearing witness to their lives, and listen to medical and social histories she could not imagine enduring. That first day in her new position changed Ruth’s life forever and she knew that prison health would become her calling. Ruth has often reflected that if she had been dealt the same childhood cards as the women she met, she might be sitting in their chairs.

In 2003, Brenda Tole was assigned to oversee the remodelling of an older facility that had housed provincially incarcerated men and to open it as the “Alouette Correctional Centre for Women” (ACCW), a medium-security facility to house provincially sentenced women. If you are a parent with school-aged children, you will have noticed how the school principal greatly influences the overall ethos of a school. In a similar manner, the warden of a prison influences the ethos of the institution, which in turn influences the overall health of the inmates.

From the day it opened in 2004, Brenda shaped the tone and ethos of ACCW. She maintained that if you expect both staff and incarcerated individuals to treat each other with respect, they will rise to meet those expectations, at least most of the time. That’s how she planned and that’s how she ran ACCW, not on the basis that 1% of the population may breach those expectations.

Brenda knew that the more she gave people opportunities, the more they valued the opportunities and responded positively. The more she gave responsibility to the women for doing things themselves, and the more she talked with the staff about her plans, the better the situation would be for everyone.

During a meeting of key health care players planning for health care delivery at the new ACCW, Brenda met Sarah Payne, the director of Fir Square at BC Women’s Hospital, a maternity unit for substance-using mothers. Babies who remained with moms at Fir Square had positive health outcomes compared with the health of babies that were taken away from their moms at birth.((Ronald R. Abrahams et al., “Rooming-in Compared with Standard Care for Newborns of Mothers Using Methadone or Heroin,” Canadian Family Physician 53:10 (October 2007), http://bit.ly/2k4K29I.)) Sarah asked Brenda to consider the possibility that babies born to incarcerated mothers who came to the BC Women’s Hospital for their delivery might return with their mothers to ACCW, in order to foster breastfeeding, attachment and nurturing.

Separation through incarceration negatively affects the health of new mothers and their infants

With peer-reviewed academic literature growing on the subject, Brenda had good reason to consider this proposal. Evidence shows that one of the most compelling motivators for incarcerated women is pregnancy and their children. International correctional practices that promote contact between women and their children have shown benefits for both. Positive results have been seen in visits, email, tapes, telephone calls and letters. Children of incarcerated women are negatively impacted if the contact with their mother is limited or absent. Although it is accepted around the world that nursing infants and/or small children benefit from remaining with their incarcerated mothers, this was rarely seen in Canada at that time.

Many incarcerated women have dependent children. Worldwide, an estimated 6% of incarcerated women are pregnant while serving prison time.((Marian Knight and Emma Plugge, “The Outcomes of Pregnancy Among Imprisoned Women: A Systematic Review,” BJOG: An International Journal of Obstetrics and Gynaecology 112:11 (December 2005), doi.org/10.1111/j.1471-0528.2005.00749.x.)) An estimated 20,000 children each year are affected by the incarceration of their mothers in Canada,((Alison Cunningham and Linda Baker, Waiting for Mommy: Giving a Voice to the Hidden Victims of Imprisonment. London, ON: Centre for Children and Families in the Justice System, 2003.)) where women tend to be held in correctional centres that are large distances from their children and families due to the limited number of correctional facilities for women across the country.

The provision of mother–child units to women in prison who have given birth to their infants while incarcerated is considered normal practice in most countries in the world. Published reports of such units exist for 22 countries, including England, Wales, Australia, Brazil, Denmark, Finland, Germany, Greece, Italy, the Netherlands, New Zealand, Russia, Spain, Sweden, Switzerland, some US states, Kyrgyzstan, Ghana, Egypt, Mexico, India and Chile.((Helen Fair, “International Profile of Women’s Prisons,” World Prison Brief (February 7, 2008), http://bit.ly/2knx0BM.))((Kiran Bedi, It’s Always Possible: Transforming One of the Largest Prisons in the World. New Delhi: Stirling Paperbacks, 2006.))((Women’s Prison Association, “Mothers, Infants and Imprisonment: A National Look at Prison Nurseries and Community-Based Alternatives,” Institute on Women & Criminal Justice (May 2009), http://bit.ly/2hwPK0L.))

One of the reasons for keeping incarcerated mothers with their newborn babies is that it facilitates breastfeeding, which the World Health Organization reports has health benefits for the infant and new mother.((World Health Organization, “Infant and Young Child Feeding,” Fact Sheet (September 2016), http://bit.ly/1o6MEg8.)) According to international health experts, babies should be exclusively breastfed until they are six months old if possible, and then continue to be breastfed on demand until they are two years of age. Babies who are not breastfed may be at increased risk for diabetes, allergies and gastrointestinal and respiratory infections.((Health Canada, “Nutrition for Healthy Term Infants: Recommendations from Birth to Six Months,” A joint statement of Health Canada, Canadian Paediatric Society, Dietitians of Canada, and Breastfeeding Committee for Canada (2013), http://bit.ly/LTH03C.))

In addition to the well-known health and nutritional benefits, some research has shown that breastfeeding can contribute to psychosocial development((Grace S. Marquis, “Breastfeeding and Its Impact on Child Psychosocial and Emotional Development,” Encyclopedia on Early Childhood Development (March 2008), http://bit.ly/1cESBkC.)) – the associated physical contact, eye contact and the quality of feeding promote mother–child attachment. However, establishing and maintaining breastfeeding on demand is not possible unless mothers and babies can be housed together with 24-hour contact.

Typically, mothers who return to prison without their babies after giving birth are prescribed milk-binding pills and are often prescribed antidepressants. In this situation, many mothers experience profound grief and debilitating guilt, despair and hopelessness. Many resort to substance use as a coping strategy. 

Mother–child unit developed to support well-being of incarcerated mothers and their babies

In 2005, Brenda asked Ruth, “As the prison physician, what is your opinion about the idea of incarcerated women who deliver babies in hospital being able to return here with their babies?” Ruth felt it was the most sensible idea she had heard in years, and she then expanded her prison medical practice to perform new roles, such as newborn examinations, breastfeeding coaching and addressing medical questions about newborns.

Through collaboration and partnership with several other ministries and community agencies, a mother–child unit was developed at ACCW based on the best interests of the child. With the support of Corrections Branch Headquarters, the ACCW health care team, correctional staff (both managers and frontline staff) and other provincial ministry personnel, it was decided ACCW could facilitate the return of mothers and babies to ACCW when recommended by BC Women’s Hospital and agreed to by the Ministry of Children and Family Development (MCFD), who had final authority over the placement of the child.

The decisions to place the mother and child together at the correctional facility were made by an interdisciplinary team consisting of the key staff from BC Women’s Hospital, ACCW health care, ACCW administration and the MCFD. If the mother was Indigenous, the pertinent Indigenous communities were consulted, when applicable. The mother and her family were included in all stages of this process. The support and services that Fir Square offered the mother before and after the birth fostered the mother’s confidence in parenting and in participating in the planning of her future and that of her baby. All checks and balances were put in place to ensure that ACCW was a safe and positive environment for the mothers and babies, with the cooperation of the mothers, other incarcerated women and correctional staff.

Incarcerated women who gave birth and who were deemed by MCFD able and willing to provide appropriate parental care were allowed to keep their infants in their care while in prison. During the initiative’s duration (2005–2007), 13 babies were born to incarcerated mothers, nine of whom lived in prison with their mothers and stayed there until their mother’s release. Eight babies were breastfed for the duration of their mother’s prison stay. Fifteen months was the longest stay of any infant in prison. The babies’ health and development was monitored by the community public health nurses, ACCW health care providers and MCFD social workers.

Release planning for the majority of the mothers and babies included placement at a residential supportive residence for women with substance use histories of the Fraser Health Authority, which took mothers and their young infants. The residential placement staff aimed to facilitate the transition of these women into the community.

Being involved in the initiative with BC Women’s Hospital had a profound positive effect on the women directly involved, the correctional staff and other incarcerated women, and the ministries and community agencies who partnered with ACCW.

Mother–child unit facilitates maternal involvement

Initially, other agencies and ministries were surprised and cautious regarding the proposal of the newborn babies returning to the facility with their mothers. The team at ACCW and BC Women’s Hospital took the time and facilitated many discussions and held meetings for all stakeholders to contribute to the program’s success.

Initially, the rights of the infant to be with the mother for attachment, bonding and breastfeeding was overshadowed for some by the feeling that this “privilege” should not be afforded to incarcerated mothers. As the initiative continued, the attitudes of many began to shift from cautious and guarded to comfortable and supportive. Community agencies were willing to provide supportive services to the children and mothers within the correctional facility. The collaboration reduced the need for ACCW to develop programs and services specific to the incarcerated population.

The mothers involved expressed great joy and were grateful that they could continue to breastfeed and nurture their babies at the correctional facility. They participated in parenting classes provided by a community agency through visits by the public health nurses and the MCFD worker. They also participated in health examinations by the ACCW physician to ensure the safety and health of their babies. Several of the mothers were permitted to go out into the community on escorted passes, both before and after the birth of their babies, to participate in various programs offered by community agencies that welcomed their participation.

Other women who did not have the opportunity to be with their children had to deal with the reminder of the pain they suffered as a result of being away from their own children. Seeing the babies at ACCW triggered feelings of loss, but a general feeling of hope permeated the entire population and the atmosphere at the facility was more positive in many ways. Incarcerated women wrote about their experiences as part of a prison participatory health research project, and their writing was later published in a book titled Arresting Hope.((Ruth Elwood Martin, Mo Korchinski, Lyn Fels and Carl Leggo, eds., Arresting Hope: Women Taking Action in Prison Health Inside Out. Inanna Publications, 2014.))

Seeing other ministries and agencies support this initiative had an impact on many of the incarcerated women. Most had very little trust in government agencies due to previous negative interactions. Seeing the agencies working together to ensure the babies stay with their mothers gave them a different perspective from which to view these groups. Some voiced a new interest to work with agencies to initiate contact with their own children with whom they had lost contact, or to work to improve their own lives to make a better life for their children.

For many, seeing the mothers and babies thrive at the facility and be released into the community together continued to reinforce the feeling that this initiative was not only the child’s right but also the right thing to do for the child.

Mother–child unit upheld by BC Supreme Court

In 2008, Brenda retired from ACCW and the BC Corrections Branch Headquarters shut down the prison mother–child unit. Amanda Inglis and Patricia Block, whose babies were born after the unit had closed, became appellants in a five-year legal case that led to a BC Supreme Court hearing in May 2013. During the women’s compelling testimony, Patricia told the court that there were as many as five different people caring for her daughter while they were separated. She tried to continue to breastfeed her baby while in prison, she said, but had difficulties in doing so.

At one point, her daughter’s foster mother stopped using the breast milk that Patricia had pumped because she worried it “wasn’t good milk.” Patricia had to inform the MCFD, who then ordered the foster mother to provide the breast milk to her baby. Patricia said that pumping milk in her prison cell for her newborn baby, who was then staying with relatives, gave new meaning to the phrase “crying over spilt milk.”

In December 2013, Honourable Judge Carol Ross ruled in Inglis v. British Columbia (Minister of Public Safety) that the cancellation of the mother–child unit infringed the Charter right to security of the person (section 7) of the mothers and babies affected by the decision, and that the infringements were not in accord with the principles of fundamental justice. The ruling also held that the cancellation constituted discrimination and violated section 15(1) of the Charter, the right to equality of the members of the affected groups, namely provincially incarcerated mothers who wished to have their baby remain with them while they serve their sentence and the babies of those mothers.

The judge directed the government of British Columbia to administer the Correction Act Regulation in relation to this issue in a manner consistent with the requirements of sections 7 and 15(1), and she gave six months to provide an opportunity for the government to correct the unconstitutionality of the present situation and comply with the Court’s direction.((Inglis v. British Columbia (Minister of Public Safety), 2013 BCSC 2309 (SC), H.M.J. Ross, http://bit.ly/2jiUVk0.))

Guidelines developed to facilitate program adoption across Canada

The Collaborating Centre for Prison Health and Education (CCPHE) hosted a two-day working meeting in March 2014 at the University of British Columbia to generate best practice evidence-based guidelines to inform the implementation of mother–child units across Canada. Experts were invited to present during four panel discussions entitled “The Rights of the Child,” “The Correctional Context,” “Pathways and Programs” and “Evaluation.”

Thirty stakeholder organizations were invited to contribute to the writing of the guidelines by selecting delegate representative(s) to participate in the working meeting. Delegates included those from BC Corrections Branch, Correctional Service Canada, New Zealand Corrections and Women in2 Healing (formerly incarcerated mothers).

The CCPHE contracted Sarah Payne to write an initial guideline framework based on her analysis of the meeting proceedings. A “content analysis” method was used to ensure that all themes developing from the meeting data were captured in the emergent guidelines. As a final stage, international resources and research publications, which had been presented by experts as evidence during the working meeting, were reviewed.

The resulting Guidelines describe 16 guiding principles and best practices required for optimal child and maternal health inside a correctional facility, including the correctional context, pregnancy, birth, education, correctional and medical care, discharge planning and community partner engagement. Delegates from BC Corrections Branch and Correctional Service Canada, who attended the writing meeting, incorporated the Guidelines’ principles and best practices into their respective organizations’ policies and procedures.

Follow-up evaluations of the mother–child unit currently under way

The ACCW mother–child unit was established on the principle that babies should accompany their mothers back to the ACCW, which was supported by the 2013 BC Supreme Court ruling that deemed it unconstitutional to separate the two. Currently, the “new” BC provincial program and the federal program (as well as programs in the U.S.) are based on the principle that it is a privilege for the incarcerated mother rather than a right: incarcerated pregnant women have to submit an application and go through a difficult, stressful and protracted approval process.

Some infants now currently reside with their mothers in federal women’s correctional facilities across Canada. However, bringing babies to live with their mothers inside provincial correctional facilities has been slow, even though a refurbished mother–child unit opened in July 2014 at ACCW. More education and understanding about the cultural, epigenetic, legal and permanent health impacts of a decision to remove a baby at birth can help support maternal and infant health in prisons across Canada.

A 10-year follow-up evaluation of the ACCW mother–child unit that ran from 2005 to 2007 is currently under way. Through in-depth interviews with mothers whose infants lived at ACCW, this evaluation is exploring their experiences and the current health and social development of their children.

Each of the mothers interviewed to date have reported that the decision to have her baby live with her in prison transformed her life. Each woman attributed the quality and quantity of time that she spent with her baby in ACCW to making a positive long-term impact on the mother–child relationship, and each reported that she now has an exceptionally close relationship with her child. Each woman also spoke very affectionately about her child’s attributes, with kindness and a caring nature as foremost.

 


Dr. Ruth Elwood Martin is a Clinical Professor in UBC’s School of Population and Public Health and recipient of the 2015 Governor General’s Award in Commemoration of the Persons Case.

Brenda Tole is the former warden at the Alouette Correctional Centre for Women from the time it opened in 2004 until her retirement in 2008.

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Published on February 7, 2017




The Canadian Debate on Spanking and Violence Against Children

Kathy Lynn

Just as families have evolved across generations, so too have our ideas about parenting, children and the social norms regarding discipline. While there is always diversity in what people feel is appropriate, there has been a significant shift across generations away from authoritarian parenting styles toward a more compassionate view that treats children as rights-bearing individuals rather than property.

Despite this societal shift, the use of corporal punishment in the form of “spanking”((The term “spanking” is used in this article to include corporal punishment and the use of “corrective” physical force against children.)) is legally protected under section 43 of Canada’s Criminal Code, also known as the “spanking law.” Section 43 reads as follows:

Every schoolteacher, parent or person standing in the place of a parent is justified in using force by way of correction toward a pupil or child, as the case may be, who is under his care, if the force does not exceed what is reasonable under the circumstances. R.S.C., 1985, c. C-4

This defence first appeared in the Criminal Code in 1892 and has changed little since.((Laura Barnett, “The ‘Spanking’ Law: Section 43 of the Criminal Code,” Parliamentary Information and Research Service (June 20, 2008), http://bit.ly/2d3ZvWi.)) Discussions about what to do with section 43 have an interesting and active history stretching back to the 1970s and earlier, but it is still on the books today.

“Spanking” in the Courts

Section 43 has been challenged a number of times over the past 30 years. In 1998, the Canadian Foundation for Children, Youth and the Law started a rights-based legal action in the Ontario Superior Court to challenge the constitutionality of section 43 of the Criminal Code on the basis that it violates the Canadian Charter of Rights and Freedoms and the United Nations’ Convention on the Rights of the Child.

The challenge was dismissed by the Ontario Superior Court and the Ontario Court of Appeal. Despite the dismissal, the government argued that physical force should be discouraged as a normative technique of correction. The case then moved on to the Supreme Court of Canada, but, in its January 2004 decision, the Supreme Court held that section 43 did not infringe on the Charter. It did, however, set out a series of judicial limitations (which do not appear in the Criminal Code) on corporal punishment:

  • Only parents may use reasonable force solely for purposes of correction.
  • Teachers may use reasonable force only to “remove a child from a classroom or secure compliance with instructions, but not merely as corporal punishment.”
  • Corporal punishment cannot be administered to children under two or to teenagers.
  • The use of force on children of any age “incapable of learning from
    [it] because of disability or some other contextual factor” is not protected.
  • Discipline by the use of objects or blows or slaps to the head is unreasonable.
  • Degrading, inhuman or harmful conduct is not protected, including conduct that raises a reasonable prospect of harm.
  • Only minor corrective force of a transitory and trifling nature may be used.
  • The physical punishment must be “corrective, which rules out conduct stemming from the caregiver’s frustration, loss of temper or abusive personality.”
  • The gravity of the precipitating event is not relevant.
  • The question of what is “reasonable under the circumstances” requires an objective test and must be considered in context and in light of all the circumstances of the case.((“What’s the Law?” Corrine’s Quest, accessed September 27, 2016, http://bit.ly/2dwYIJ2.))

The current legal context has led to confusion and conflict due to contradictions between the definitions of assault outlined in criminal law and definitions of child abuse found in provincial and territorial law, as outlined by the Ontario Public Health Association:

“… a provincial or territorial child welfare authority may investigate a report of parental physical abuse of a child, conclude that she is at risk in her family and apprehend her. When this happens, police may lay a charge of assault. However, section 43 provides parents with a legal defence against such a charge. This has led to situations which seem to defy logic, in which the definition of “a child in need of protection” in provincial and territorial law leads to the child’s apprehension, but the protection afforded to parents under section 43 of the Criminal Code leads to their being acquitted of assault.”

There have been many legislative attempts to have section 43 repealed or amended, with 17 private member’s bills being tabled in Parliament since 1994, though none have succeeded. Senator Céline Hervieux-Payette has introduced numerous bills; however, to date, all have died at various stages of reading due to elections and prorogations of Parliament.((Coalition on Physical Punishment of Children and Youth, “Physical Punishment Update #16,” Joint Statement on Physical Punishment of Children and Youth (March 2016), accessed September 27, 2016, http://bit.ly/1WJKWEN.))

Pressure to repeal section 43 has also mounted from the international stage since Canada signed the UN Convention on the Rights of the Child. Article 2 of the Convention states that signatories “take all appropriate measures to ensure that the child is protected against all forms of discrimination or punishment on the basis of the status, activities, expressed opinions, or beliefs of the child’s parents, legal guardians, or family members.”((United Nations, “Convention on the Rights of the Child,” Treaty Series (November 20, 1989), http://bit.ly/1fGCcXV.))

In response to reports from Canada regarding the action it has taken to meet the requirements of the Convention, the United Nations Committee on the Rights of the Child recommended that physical punishment of children in schools and families be prohibited and that section 43 be removed from the Criminal Code. However, no action was taken and the law remains on the books. To date, 51 countries have banned the physical punishment of children in all settings.

Most recently, the Truth and Reconciliation Commission (TRC) recommended repealing section 43 as the sixth of its final report’s 94 calls to action. “The Commission believes that corporal punishment is a relic of a discredited past,” it reads, “and has no place in Canadian schools or homes.”((Truth and Reconciliation Commission, “Canada’s Residential Schools: The Legacy,” The Final Report of the Truth and Reconciliation Commission of Canada (December 2015).)) The federal government has since committed to accepting all calls to action outlined in the TRC report.

“…corporal punishment is a relic of a discredited past, and has no place in Canadian schools or homes.”

– Final Report of the Truth and Reconciliation Commission

 

 

“Spanking” research

A most compelling body of research has been developed around the question of physical punishment of children. In June 2016, Dr. Elizabeth Gershoff, Associate Professor at the University of Texas at Austin, and Andrew Grogan-Kaylor, Associate Professor of Social Work at the University of Michigan, published a literature review that includes a wide range of studies on corporal punishment of children. They found that the research has been consistent. Spanking is at best ineffective and at worst harmful to children.((Elizabeth Gershoff and Andrew Grogan-Kaylor, “Spanking and Child Outcomes: Old Controversies and New Meta-Analyses,” Journal of Family Psychology, 30:4 (June 2016), doi:10.1037/fam0000191.))

A series of meta-analyses have demonstrated that in addition to increases in aggressive behaviour in children, spanking has been associated with increases in mental health problems into adulthood, impaired parent–child relationships, delinquent behaviour and criminal behaviour in adulthood.((Elizabeth Gershoff, “Corporal Punishment by Parents and Associated Child Behaviors and Experiences: A Meta-Analytic and Theoretical Review,” Psychological Bulletin, 128:4 (July 2002), doi:10.1037//0033-2909.128.4.539.)) There is also research showing that a risk that initial “corrective” spanking can progress to child abuse.((Joan Durrant et al., “Punitive Violence Against Children in Canada,” Centre of Excellence for Child Welfare (March 31, 2006), http://bit.ly/2czf1mO.))

The research shows that hitting children is ineffective – instead of teaching children the reasons their behaviour needs to change, it simply causes the child pain and engenders fear. Studies have shown that children need to internalize reasons for behaving in appropriate ways.((Elizabeth Gershoff, “Spanking and Child Development: We Know Enough Now to Stop Hitting Our Children,” Child Development Perspectives 7:3 (July 10, 2013), doi:10.1111/cdep.12038.)) Spanking teaches them to behave in order to avoid physical punishment. When the threat of physical punishment is gone, children find no reason to behave appropriately. Spanking can lead to some children considering violence toward others as a problem-solver. A violent attitude can also work to reduce family cohesion.

The future of “spanking” in Canada

Evidence shows that children do not learn appropriate behaviour from being physically hurt. While children need to be accountable for their behaviour, modelling positive behaviours and teaching them to self-regulate, communicate their feelings and ask for help are more effective. Parents play an important role in socializing children, teaching how certain actions and behaviours are not acceptable and providing opportunities to develop the skills to function well in society.

For teaching children to grow and mature into responsible, capable and contributing adults, spanking is not the way. Violence against children should be against the law, not defined by it. We know there are more compassionate and effective ways to raise children to be capable young adults.

 

Corinne Robertshaw: A Committed Advocate

Corinne Robertshaw was a lawyer with the federal government in the 1970s. She became concerned about injuries and deaths of children caused by parents. She determined that section 43, which provides legal defence for assault against children, was a factor contributing to these injuries and deaths. She produced a study on child deaths caused by physical punishment (Discussion Paper on Child Protection In Canada, February 1981).

In 1990, she retired and dedicated the rest of her life to seeing the repeal of section 43. She created a national, multidisciplinary committee to mobilize Canadians interested in the issue and to continue to develop evidence and arguments in favour of repeal. She died in January 2013 and Corinne’s Quest: End Physical Punishment of Children was formed to continue her work and honour her legacy.

 


Kathy Lynn is a parenting speaker, author and chair of Corinne’s Quest.

This article was reviewed by Rina Arseneault, C.M., Associate Director of the Muriel McQueen Fergusson Centre for Family Violence Research (MMFC) at the University of New Brunswick.

Published on November 15, 2016