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01.12.2012 | Research | Ausgabe 1/2012 Open Access

International Journal for Equity in Health 1/2012

Privatisation & marketisation of post-birth care: the hidden costs for new mothers

International Journal for Equity in Health > Ausgabe 1/2012
Cecilia Benoit, Camille Stengel, Rachel Phillips, Maria Zadoroznyj, Sarah Berry
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1475-9276-11-61) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare no competing interests concerning this paper.

Authors’ contributions

The first author planned the study, and oversaw the data collection. The first three authors performed the analysis. All authors contributed to the drafting of the initial manuscript, and read and approved the final version.


Retrenchment of government services has occurred across a wide range of sectors and regions. Care services, in particular, have been clawed away in the wake of fiscal policies of cost containment and neoliberal policies centred on individual responsibility and market autonomy. Such policies have included the deinstitutionalisation of care from hospitals and clinics, and early discharge from hospital, both of which are predicated on the notion that care can be provided informally within families and communities. In this paper we examine the post-birth "care crisis" that new mothers face in one region of Canada.


The data are drawn from a larger study of social determinants of pregnant and new mothers' health in Victoria, Canada. Mixed methods interviews were conducted among a purposive sample of women at three points in time. This paper reports data on sample characteristics, length of stay in hospital and health service gaps. This data is contextualised via a more in-depth analysis of qualitative responses from Wave 2 (4-6 weeks postpartum).


Out results show a significant portion of participants desired services that were not publically available to them during the post-birth period. Among those who reported a gap in care, the two most common barriers were: cost and unavailability of home care supports. Participants' open-ended responses revealed many positive features of the public health care system but also gaps in services, and economic barriers to receiving the care they wanted. The implications of these findings are discussed in relation to recent neoliberal reforms.

Discussion & conclusions

While Canada may be praised for its public provision of maternity care, mothers' reports of gaps in care during the early postpartum period and increasing use of private doulas is a worrying trend. To the extent that individual mothers or families rely on the market for care provision, issues of equity and quality of care are pivotal. This paper concludes with suggestions for further research on the impact of recent changes in post-birth care on new fathers and on inequities in pre and post-birth care in less-resourced regions of the world.
Authors’ original file for figure 1
Authors’ original file for figure 2
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