Evidence of meeting #28 for Human Resources, Skills and Social Development and the Status of Persons with Disabilities in the 45th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was experience.

A recording is available from Parliament.

On the agenda

Members speaking

Before the committee

Hamill  Communications Coordinator, As an Individual
Meunier  Professor, Université du Québec à Montréal, As an Individual
Venditti  Human Resources Professional, As an Individual
deMontigny  Full Professor, Université du Québec en Outaouais and Director, Fatherhood, Family and Society Research Group, As an Individual
Fockler  Registered Nurse, Pregnancy and Infant Loss Network, Sunnybrook Health Sciences Centre

Andréanne Larouche Bloc Shefford, QC

Thank you, Mr. Chair.

Thank you once again, Ms. Hamill, Ms. Venditti and Ms. Meunier, for coming to testify this morning to help us in our consideration leading up to the adoption of this bill. I hope it can be passed, receive royal assent and be implemented. Based on the emotional testimony we heard today and at the last committee meeting, it is clear that this bill must move forward.

Ms. Meunier, I would like us to complete this examination of the bill. Earlier, I was talking about extending it to adoptive and blended families. Should we also think about some categories of self-employed or precarious workers who may be excluded from the support provided for in this bill? Should we think about what we can do for people who may not be specifically included in the bill?

9:15 a.m.

Professor, Université du Québec à Montréal, As an Individual

Sophie Meunier

Yes, absolutely. We've seen this exclusion in the case of parents we've met. Parents told us that they couldn't take leave because they were self-employed. There was no leave, which was an additional challenge for them. I absolutely agree that parents in this situation should be taken into consideration.

Andréanne Larouche Bloc Shefford, QC

Ms. Meunier, from a public policy perspective, have you seen international best practices to support bereaved parents? Is that something you've had a chance to look at?

9:15 a.m.

Professor, Université du Québec à Montréal, As an Individual

Sophie Meunier

Yes. Actually, I would say that it varies from country to country. I think Australia does have some good measures in place. We're starting to see a little more leave for both parents, meaning not only the person who carried the child, but also the other bereaved parent, who is starting to be a little more taken into account.

A lot is being done in terms of leave, but as I was saying earlier, awareness-raising is also needed in the workplace. It's not much talked about it at work. However, perinatal deaths affect one in four or five pregnancies.

I'll give you an anecdote. When I launched my first research project and showed up for work the next morning, about five people emailed me and four people came to see me to tell me that it was really great to conduct research projects to better support parents after a perinatal death, because it had happened to them. People started telling me their stories. It is very clear that there is a significant need and a lack of support. Parents feel a bit isolated and don't talk about their situation. There's really an increased need for support for bereaved parents.

You asked me where the scope of the bill could be expanded. The research projects I've done don't just look at postpartum deaths, but also those that happen during pregnancy. We realized that, in terms of perinatal death, losing a child to pregnancy at 19 weeks of pregnancy causes as many symptoms of psychological distress and perinatal loss as losing a child to pregnancy at 21 weeks, at birth or in the first few days of life. Certainly, expanding the scope of the bill to this type of death would be a major step forward for us as well.

We were talking about expenses earlier. A bill like this may well involve expenses, but we also have to talk about the costs that will be incurred if we do nothing. In particular, I was talking about the trouble people may have functioning at work, the productivity problems and the difficulties arising from all the steps they have to take to get sick leave when no other leave is offered. All of that comes at a cost. If we act more preventively by offering leave, I think we can end up coming out ahead.

The Chair Liberal Bobby Morrissey

Thank you, Ms. Larouche.

I give a heartfelt thank you to the witnesses who appeared here this morning. You can see you had a meaningful impact on committee members. Thank you for your testimony.

With that, we'll conclude the first round, and I'll suspend for a few minutes while we transition to the second.

The Chair Liberal Bobby Morrissey

Thank you, committee members.

We will resume with the final panel. Since they're here in the room, I will not go through the notes.

I would like to welcome, for the second panel, Dr. Francine deMontigny, full professor at the Université du Québec en Outaouais and director of the fatherhood, family and society research group.

From the Sunnybrook Health Sciences Centre, we have Megan Fockler, registered nurse, Pregnancy and Infant Loss Network.

Each witness will have five minutes or less for an opening statement.

We'll begin with Dr. deMontigny.

Francine deMontigny Full Professor, Université du Québec en Outaouais and Director, Fatherhood, Family and Society Research Group, As an Individual

Good morning.

I'll speak in French, but I can answer questions in English, if they're not too complex. I'm a little nervous this morning.

Madam Chair and members of the Standing Committee on Human Resources, Skills and Social Development and the Status of Persons with Disabilities, thank you for inviting me to testify today. I previously appeared before this committee in 2018. Therefore, I'm very pleased to see that the project is ongoing.

I'm here as a researcher and trainer. For over 10 years, I held the Chaire de recherche du Canada sur la santé psychosociale des familles, which focused on perinatal bereavement. I am also a health research fellow at the Fonds de recherche du Québec, where our work has focused on perinatal bereavement for over 15 years. I will be speaking to you about work spread out over more than 30 years of research experience, involving more than 35 projects conducted to examine the experience of parents and stakeholders in perinatal bereavement.

I am also the mother of three daughters. My middle child died 36 years ago at 26 weeks of pregnancy. Had that not happened, my career might have taken a different turn and I might not have focused on perinatal bereavement. It must be said that back then, it was trivialized. Even today, we have trouble acknowledging that this has occurred.

To put perinatal death in context, one in four pregnancies ends in perinatal death, whether early, meaning in the first 20 weeks of pregnancy, or late, after 20 weeks of pregnancy. That's about 100,000 perinatal deaths per year.

The statistics take into account the 1,000 deaths that occur around the time of birth, but they neglect all the early deaths that occur at 12, 18 or 20 weeks, which parents experience as the loss of a person who is already a small baby.

A first episode of perinatal death also increases the risk of complications in the next pregnancy. A 25-year-old woman who experiences a miscarriage six weeks into her pregnancy is already more likely to experience a second miscarriage, stillbirth, premature birth or even infertility. These risks are amplified each time it happens. However, despite how prevalent it is, the phenomenon continues to be trivialized.

What our studies from the past 30 years have taught us is that men react to bereavement as strongly as women do, but their experience is often overlooked and they are relegated to a supporting role.

What about the other parent? We really have very little data on the experiences of co-mothers or adoptive fathers in a perinatal death.

What we know is that the symptoms of grief are just as significant for parents who experienced a perinatal death between 12 and 20 weeks of pregnancy as for those who experienced a later death.

Perinatal death and the resulting grief have harmful and lasting effects on the mental health of women and men. Up to five years or more after a death, they can experience depression, anxiety, post-traumatic stress, somatic symptoms and obsessive-compulsive disorders.

In our study of women who had a miscarriage in the first 20 weeks of pregnancy, one in five women in our sample had suicidal thoughts. That's not insignificant.

International studies show that one in four women sees a psychiatrist after a perinatal death. There is a cascading effect on the health care system.

What we also know is that symptoms of grief, depression and anxiety persist into the next pregnancy, and even after the birth of the child, particularly among men, who often react more strongly after the birth of a living child.

The mental health impacts on both parents are real in the short, medium and long terms.

These mental health conditions will also have an impact on children, both those in the family at the time of the death and those born afterward, because when children are exposed to depression and anxiety in their parents, they are also more likely to experience mental health issues, depression, anxiety and behavioural problems in turn.

Therefore, it is clear that perinatal bereavement has a ripple effect on the entire family.

Perinatal bereavement also has an impact on the physical health of parents, who may develop heart disorders, gastric disorders or inflammatory disorders.

The current lack of leave support therefore has consequences for the person, the relationship, the children and the workplace.

In terms of relationships, we know that when one of the parents returns to work prematurely, the spouses will have trouble supporting each other in their grief, which will lead to tension and distance within the couple.

The work done by Ms. Meunier, who gave a presentation earlier, tells us that returning to work prematurely has consequences, whether it's presenteeism, meaning when someone is at work but not really productive, difficulties related to returning to work or prolonged distress. If someone is unproductive in front of a computer, it's not that bad. However, if someone is unproductive while operating heavy machinery, that can have consequences for workplace safety, for them or for the people around them.

Parents also told us that they had lost their jobs because their employer felt that they had become unmotivated, that they were different, that they had changed. I wonder why.

In conclusion, not supporting parents when this happens and in the weeks and months that follow is costly for society. It's expensive. Perinatal bereavement has direct and indirect economic consequences that are still misunderstood.

Our studies have shown, as I mentioned earlier, that parents who experience perinatal death make repeated and increased use of health services in the ensuing months and during the next pregnancy. There are costs to the health care system that have not been catalogued.

At the same time, we know that there are also social and familial costs stemming from the psychological consequences on existing children, on family relationships and on extended family members. Grandparents write to tell me about the distress they are experiencing.

Mr. Chair, you are signalling that my turn is up, but I will take another second.

There are also costs associated with mental health problems in the workplace, which are not catalogued and are still misunderstood.

I therefore conclude by recommending that all parents who experience perinatal death be granted paid leave so that they can physically and emotionally recover from the shock, which is what Bill C‑222 proposes to do.

Thank you.

The Chair Liberal Bobby Morrissey

Thank you, Ms. deMontigny.

9:30 a.m.

Full Professor, Université du Québec en Outaouais and Director, Fatherhood, Family and Society Research Group, As an Individual

Francine deMontigny

I apologize for my speaking time. I didn't have anything in front of me to indicate it.

The Chair Liberal Bobby Morrissey

It's not a problem.

Ms. Fockler, you have five minutes, please.

Megan Fockler Registered Nurse, Pregnancy and Infant Loss Network, Sunnybrook Health Sciences Centre

Mr. Chair and members of the committee, thank you for the invitation to join you today in this very important conversation. I'm here today speaking in support of Evan's law.

My name is Megan Fockler and I work as the manager of the Pregnancy and Infant Loss—or PAIL—Network. I'm speaking today on behalf of Michelle LaFontaine, who is the director of PAIL Network. She was not able to be here today.

Prior to my work as the manager of PAIL Network, I worked as a registered nurse in obstetrics for 17 years, first as a labour and delivery nurse, and then as a nurse in high-risk obstetrics, supporting families through the experience of a high-risk pregnancy. In my nursing career, I have had the privilege of caring for families throughout their child-bearing years and the honour of walking alongside many as they face the most devastating outcome: the death of their infant. I've been in the room when their dreams for the future change in an instant. I've listened to them as they express the depth of their sadness. I've heard stories about the positive impact of compassion, as well as the negative impact of silence, stigma and bureaucracy on their grief journeys.

At PAIL Network, we provide education to health and service professionals focused on skilled and compassionate bereavement care. We have heard from hundreds of professionals that their biggest fear when caring for or working with families is making things worse through something they say, a resource they don't have to share or a discussion about a system barrier that they know the family must face.

Such barriers and bureaucracy impacted one of our PAIL Network volunteers, Kayla, who got a bill of over $4,000 at tax time for receiving benefits after her daughter Frankie died. My colleague Brandon faced barriers when he needed to navigate the system for EI sickness benefits after the death of his daughter Hannah, all while battling what he later learned was PTSD from the circumstances surrounding her death. Bureaucracy also impacted Carmen, another PAIL Network volunteer, when she needed to go in person to Service Canada to cancel her parental EI leave after her daughter Olivia died. Carmen said, “When you're in that kind of grief, dealing with administrative processes feels impossible... It's something no grieving parent should have to face.”

Evan's law is an opportunity to remove a barrier that we consistently hear is adding to the grief and burden of families. If passed, this bill would change a program process for the better. In addition, this bill would send a compassionate message to families that their loss, their baby and their well-being matter. Evan's law will allow people to focus on what matters around the time of their infant's death: honouring them, grieving within their family and community, and choosing for themselves when to return to work.

As the government begins this new program for families experiencing infant loss, I believe it will be very important to also think of the process for effective implementation and the funding required to develop the necessary resources and education surrounding policy changes and supports for families. PAIL Network has experience and expertise in these areas and is available to assist the government to scale up additional supports and resources. It would be very feasible to replicate the work of PAIL Network nationally, and there is a lot of appetite to do so.

The provision for funding would enhance the effectiveness of this bill and help to expand the training resources and tools needed to make sure families encounter compassionate responses from those they encounter along their grief journeys, and other supports to ensure they are not grieving alone. Compassion is a core value that I hold within my own professional practice, and it is so important for grieving families. Evan's law is compassion in action.

Thank you again for including me in this important conversation.

The Chair Liberal Bobby Morrissey

Thank you, Madame Fockler.

We'll begin the first round of six minutes with Ms. Falk.

9:35 a.m.

Conservative

Rosemarie Falk Conservative Battlefords—Lloydminster—Meadow Lake, SK

Thank you very much to both of you for being here, for the work you're doing and for sharing the knowledge and experience you have with this committee. It's very much appreciated.

Dr. deMontigny, you brought up some interesting statistics, like the fact that one in four pregnancies ends in a miscarriage. Something we've definitely experienced in the previous hour of testimony is that grief affects everybody differently and comes in waves. This is not talked about. There's very much a stigma around this. I know this even from talking to friends of mine or family members who have lost babies. “Am I permitted to talk about the baby who didn't make it?” There's a weird stigma.

What do we need to do as a society and a culture to help destigmatize this so that once people work through their own emotional process, we can have these conversations about the loss of a child?

9:35 a.m.

Full Professor, Université du Québec en Outaouais and Director, Fatherhood, Family and Society Research Group, As an Individual

Francine deMontigny

We've been working on that for the past two years by producing documentaries and infographics—one-pagers—for the population to make known what parents experience after a miscarriage, what they experience when they're navigating the health system and what they're experiencing when they're returning to work with Dr. Meunier. We were funded to produce the documents, but there was no money to make a campaign in society, and I think that's what we need.

There are awareness campaigns for suicide and mental health, for example.

We have campaigns for drunk driving—don't drink and drive—or for when somebody is told about cancer and how it hits the family. You see those pictures and they really strike you.

We need to do that nationally to make it known that for parents who experience a miscarriage or, later in a pregnancy, a death, it's a real baby, even though it's six weeks old. I've seen embryos that were nine weeks old, and you can see everything with the baby. You can see the eyes. You can see the shape of the head.

For the parents, that child is already one year old, it's already in school and they already have plans. As soon as they know they're expecting, they're already seeing themselves as parents. It's all those dreams they have to grieve.

9:40 a.m.

Conservative

Rosemarie Falk Conservative Battlefords—Lloydminster—Meadow Lake, SK

You brought up the good point, too, that it's not just the mother. It's everybody. It's everybody who knows and everybody who would have been part of that life.

How about you, Ms. Fockler? Do you have anything to add about destigmatization?

9:40 a.m.

Registered Nurse, Pregnancy and Infant Loss Network, Sunnybrook Health Sciences Centre

Megan Fockler

I agree. I think awareness raising is so important.

We know there's stigma. This is what families tell us all the time. It happens when they receive care at the hospital after the fact and in their own lives. I agree with the development of resources and the awareness campaign.

At PAIL Network, we do some advocacy on pregnancy and infant loss in awareness month in October. We have a walk for families. A lot of this is to help families feel like they're not alone, but it's also to raise awareness of the issue, to make it a more common thing to speak about.

Resources for people to know what to say in terms of compassionate communication—I heard earlier about grief literacy—is so important, because most people don't mean to cause harm. I know professionals and family members...but there are a lot of misperceptions about pregnancy and infant loss that add to the harm that can be caused by something somebody says.

Rosemarie Falk Conservative Battlefords—Lloydminster—Meadow Lake, SK

Just looking at that stat of 25%, that's pretty high—

9:40 a.m.

Full Professor, Université du Québec en Outaouais and Director, Fatherhood, Family and Society Research Group, As an Individual

Francine deMontigny

When you're 40, it's one out of two, and it goes up.

9:40 a.m.

Conservative

Rosemarie Falk Conservative Battlefords—Lloydminster—Meadow Lake, SK

Sure, and it affects everybody in terms of how they deal with that and how they process that information.

I was also alarmed with the stat of one in five having suicidal thoughts. That is—

9:40 a.m.

Full Professor, Université du Québec en Outaouais and Director, Fatherhood, Family and Society Research Group, As an Individual

Francine deMontigny

Actually, we've known in our practice women who have committed suicide. They go back home and there's no support and no structure. If there is, it's very unequal in different parts of the provinces and in different provinces. In one province, you might have support—

9:40 a.m.

Conservative

Rosemarie Falk Conservative Battlefords—Lloydminster—Meadow Lake, SK

Even if you're rural or remote versus urban, that all matters in the access to services.

9:40 a.m.

Full Professor, Université du Québec en Outaouais and Director, Fatherhood, Family and Society Research Group, As an Individual

Francine deMontigny

Exactly. Your husband may be back at work, and it looks like everything is fine with him. You're all alone at home ruminating about your loss, and you're getting support that's not adequate for what you need. We've known women who have committed suicide.

9:40 a.m.

Conservative

Rosemarie Falk Conservative Battlefords—Lloydminster—Meadow Lake, SK

Thank you for the work that both of you are doing. It's important.

The Chair Liberal Bobby Morrissey

Thank you.

Ms. Desrochers, you have the floor for six minutes.

Caroline Desrochers Liberal Trois-Rivières, QC

Thank you, Mr. Chair.

I want to start by thanking the witnesses who are here to share their experience, expertise and knowledge. We've heard some very difficult testimony on this bill, which is extremely important.

I want to reiterate our commitment to making this bill move quickly. All members on this committee are prioritizing this bill because we know it's important for grieving parents. There's a commitment in budget 2025 to fund benefits for grieving parents. This illustrates that we are serious about moving this forward. We really need to move this bill out of committee and back to the House so it can move to the next step.

This is a very personal issue for me. In 2017, my best friend's son, who was nine years old and was also my son's best friend, died from a tragic soccer accident. Both of my friends just checked out. I had to step in and be the person to talk to the employers, to do the administrative issues and to even do the funeral arrangements, because they had no family nearby. I also lived through two miscarriages, so I know very well how grief is not linear.

I have continued to support and accompany my friend since 2017. Everything you mentioned, Ms. Fockler, about when you returned to work is true—how people were tiptoeing around you and how some people were always afraid that you were going to break out and cry at any moment. There are people who wish you would move on, because it's been long enough and by now you should have had all the time to grieve. People don't know how to handle grief.

Your points about advocacy and education around it are really important. This is something we should be working on.

In the previous panel, it was mentioned that grief is not a linear process. I'd like both of you to tell me whether we should consider a more flexible approach for parents.

It is possible that someone, after a 12-month leave or after a few weeks, whichever, has grieved and gone back to work. They may feel completely fine and able to continue, or they may even have support. However, we know that grief is not a linear process. We know that, within a year, there will be a tougher time, sometimes without really knowing why.

Would there be a benefit to having more flexibility, so that the benefits given for bereavement are not necessarily linear?

That's my first question, and it's for both of you.