Cultural barriers, financial strain & systemic gaps: how international students cope with unplanned pregnancies

Kharo came to Canada on a study visa from Nigeria in September 2022.

She was admitted in a two-year program in a global marketing course at a college in Ontario.

After receiving an offer in February the same year, she was married in April of 2022.

Kharo, identified by only one name, found out she was pregnant just a few weeks before arriving in Canada.

She paid $36,000 for school fees, excluding housing, meals, and daily living expenses. But that included a private health insurance plan, which is compulsory for all international students enrolled in Ontario.

When Kharo’s spouse got to know about her pregnancy, he was skeptical about her decision to move abroad and study in Canada. It was decided that she would pursue her studies, and if there were any complications, she would return home.

After she started her studies, doctors suggested Kharo undergo a dating ultrasound at a college clinic to establish a due date.

She was informed that her student health insurance plan wouldn’t cover her pregnancy-related healthcare costs, based on her due date.

It was devastating news.

The private health insurance provider even tried to reject coverage for her ultrasound but she insisted they were responsible for the costs, as it was requested by the company.

A COVID-19 OHIP exemption policy, which offered healthcare assistance for uninsured individuals, was utilized when she scheduled an appointment with her obstetrician at the time.

But that didn’t go too far, as the doctor sent her a $400 bill for the preliminary consultation after a few months.

Kharo was frustrated with the insurance policy and costly pregnancy-related healthcare treatment.

She decided to have a home birth with the assistance of a midwife, opting for midwifery care instead of the high costs associated with hospitals, since midwifery services in Ontario are accessible to all individuals, regardless of their immigration status.

However, the plan did not proceed as intended when the midwife determined the baby was at risk of complications, making a home birth unsafe.

(Daryl Wilkerson Jr./Pexels)

At the hospital, the initial plan was to have the midwife assist with the delivery of the baby. But due to significant pain she required an epidural at a cost of $1,000 prior to administration.

She had no choice but to put it on her credit card, unsure how she would eventually pay it off.

Following the delivery, her newborn experienced breathing issues and required specialized treatment in the NICU for three days.

Fortunately, the midwives she collaborated with were able to secure OHIP coverage for her baby, which alleviated some of the immediate financial strain. Kharo was still confronted with a hospital bill of $6,000 for her own use of the hospital facilities, a debt that felt overwhelming as an international student struggling with limited financial means.

Two months following the birth of her child, she discovered that her college insurance had unexpectedly covered her hospital expenses. She suspected a previous email, in which she mentioned that a lawyer from a community legal clinic was requesting a copy of the policy that explained the college’s initial denial, may have impacted the decision to change course.

Kharo’s turbulent journey, shared by the Women's Legal Education and Action Fund, or LEAF, an advocacy group for gender equality, illustrated the challenges international students encounter in accessing essential healthcare. 

Many students, who get pregnant once here, sometimes in disturbing circumstances, do not have many of the options she had.

During a Brampton Council meeting on November 13, Councillor Navjit Kaur Brar brought forward a symbolic motion to bring attention to the challenges many women face during pregnancy, tied to November’s designation as adoption awareness month.

She advocated for greater social and financial support from provincial and federal governments to ease adoption-related barriers that in turn would make it easier for many women trying to make difficult choices in unique circumstances. 

"Every woman should have the right to have prenatal care, regardless of the financial barriers that they face," she emphasized.

Brampton Councillor Navjit Kaur Brar is advocating for better supports for women dealing with unplanned pregnancies and other related challenges.

(Alexis Wright/The Pointer)

Brar also advocated for international students, many of whom are not covered for prenatal care through educational institutions, calling on provincial and federal governments to provide better support for birth mothers in this vulnerable group.

She spoke of the inequality in financial support students and other women face.

Data she shared from the Mississauga-based JFJ Hope Centre shows 40 percent of the adoptions facilitated by the organization involved South Asian birth mothers, all of whom were international students. Notably, 55 percent of these mothers did not have access to OHIP, resulting in a lack of access to essential prenatal care, as university and college health insurance programs do not cover services related to pregnancy.

Many international students are weighed down by cultural stigma and uncertainty regarding Canada’s privacy rules, finding it difficult to seek assistance during their pregnancies amid anxiety about family and community members learning of their situation. Brar said this drives many to become reclusive, isolating to avoid any potential exposure to the community.

She read out her motion, describing that, "there is a culture of shame within many racialized communities, many of the birth mothers do not seek out aid or care due to this…international students who are birth mothers may be living in shared accommodations and may have to find alternate accommodations or may experience homelessness due to keeping the pregnancy a secret."

Councillor Brar said medical expenses can easily reach $30,000, with no financial assistance available from provincial or federal programs.

Even though international students make a substantial contribution to the Canadian economy, they frequently encounter systemic obstacles such as insufficient access to healthcare, housing instability and a shortage of support for essential services like prenatal care and adoption assistance.

As of 2022, the Government of Canada reported that long-term international students added $30.3 billion to Canada’s GDP and filled 353,850 jobs.

A study finding released in June last year, titled "When I came to Canada, I almost forgot myself: Where I am, who I am", by Stefanie Machado of Simon Fraser University and her team, detailed the experiences of young immigrant women aged 15-30, focusing on how immigration influenced their journeys related to pregnancy, motherhood and marriage.

Young immigrant women in British Columbia, based on the research, commonly encountered substantial difficulties concerning pregnancy, motherhood and marriage. Many do not have access to health insurance, which results in delays in obtaining essential prenatal care and contraception, with some only receiving medical assistance during delivery. Their financial insecurity, stemming from low-paying jobs, work limits imposed on international students and workplace discrimination, along with limited maternity benefits, leaves them at risk during pregnancy and the early stages of motherhood. Social isolation, caused by a lack of family support, language obstacles and cultural barriers, worsens their challenges, while societal expectations assign caregiving roles solely to them, often hindering their educational and career ambitions.

Gurpreet Malhotra, CEO of Peel’s Indus Community Services, told The Pointer that financial support from the United Way, along with collaborations with the Children’s Aid Society and the Sonar Foundation, aids young parents, including international students, by offering mentorship, baby supplies and assistance during challenging phases of their journey.

Gurpreet Malhotra, CEO of Peel-based Indus Community Services, has worked with many young women navigating unplanned pregnancies in unique circumstances.

(Muhammad Hamza/The Pointer)

He said many parents encounter difficulties, including societal stigma and insufficient knowledge about their student health insurance around medical services during pregnancy.

"In some cases…the insurance companies have said: that if they become pregnant while here, they would be covered. But the students don't know that, so they don't access prenatal care, and they don't access things like prenatal vitamins and other things that others would normally be able to access." 

Parents also receive poor information concerning immigration regulations related to childbirth in Canada.

"So, some have been misinformed that if you have a baby here, the baby stays here, and now, all of a sudden, you are the parent of a Canadian citizen; therefore, you have a right to stay here. It doesn't work that way."

Cultural stigma and financial challenges for newcomers including international students facing unplanned pregnancies also pose unique challenges, he said. A lack of access to insurance, family support, or resources to manage education, employment and parenting successfully, create significant anxiety for many young people in Peel. 

Because of the cultural dynamics often involved, which place even more pressure on young women struggling to meet parental and community expectations ingrained in centuries old traditions, these deep-seated influences can become obstacles to well-being. 

"The stigma creates barriers at every turn—students can’t access insurance, lose family support, and fear explaining their situation to employers or schools,” Malhotra said. “We need to be understanding, supportive, and there for them." 

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