(MIS)Treated

What's it like to navigate fertility care as it becomes increasingly profit-driven in Ontario?
Infertility is considered a medical condition by the World Health Organization and in Canada, it's defined by age. A study from 2023 shows that a fifth of men believe that fertility is a "woman's problem," but the science says otherwise. Approximately one third of infertility is attributed to male factors, another third is attributed to female factors, and in one third of couples, there is no cause identified. This is known as unexplained infertility.
One of the key medical interventions for infertility is called in-vitro fertilization – or IVF. IVF has become a big business. In 2023, it was estimated at $50 billion and is projected to double in the next decade.
Today, host and producer Nam Kiwanuka is joined by journalist Caitlin Walsh-Miller and Irene Darrell-Austin, a Toronto-resident with lived experience navigating fertility care. They talk about how infertility impacts families, the growing disparity of who can access treatments and why this industry needs to be regulated.

Links:
The High Price of Hope https://torontolife.com/deep-dives/inside-torontos-white-hot-fertility-market/
Private equity piles into Canada's fertility clinics https://financialpost.com/feature/private-equity-piles-into-canada-fertility-clinics
Disturbing errors at Ontario fertility clinics destroy couples’ baby dreams years after province abandoned oversight plans https://www.thestar.com/news/investigations/disturbing-errors-at-ontario-fertility-clinics-destroy-couples-baby-dreams-years-after-province-abandoned-oversight/article_502ba774-1f20-4fb0-b2e3-4fb7780e3e82.html#tncms-source=login
Fertility is not just a 'women’s problem' but a fifth of men think it is, a new study finds https://www.euronews.com/health/2023/06/10/fertility-is-not-just-a-womens-problem-yet-a-fifth-of-men-think-it-is-study-finds
Male Infertility is a Women’s Health Issue—Research and Clinical Evaluation of Male Infertility Is Needed https://pmc.ncbi.nlm.nih.gov/articles/PMC7226946/
Yes, men have a biological clock too. But it’s not just age that affects male fertility https://theconversation.com/yes-men-have-a-biological-clock-too-but-its-not-just-age-that-affects-male-fertility-268298
The female scientist who changed human fertility forever https://www.bbc.com/future/article/20200103-the-female-scientist-who-changed-human-fertility-forever
Where Is the First ‘Test-Tube Baby’ Now? All About Louise Joy Brown, the First Child Ever Born via IVF https://people.com/where-is-louise-joy-brown-the-first-ivf-baby-now-8748006
IVF: The women who helped make it happen https://pmc.ncbi.nlm.nih.gov/articles/PMC6352853/
The Vatican’s Secret Role in the Science of IVF https://www.vanityfair.com/style/story/pope-secret-history-ivf?src=longreads
How IVF has led to a record number of single moms in their 40s https://www.npr.org/2026/01/12/nx-s1-5647761/ivf-fertility-motherhood-40s-cost-donor-decision
Ontario Connecting More Families to Fertility Supports https://news.ontario.ca/en/release/1007375/ontario-connecting-more-families-to-fertility-supports
Celebs IVF: All the celebrities who had IVF, from Kourtney Kardashian to Jennifer Aniston https://www.cosmopolitan.com/uk/body/g39990713/celebs-ivf/

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In this country, midwives "were once a cornerstone of every Indigenous community." What happened?
Before the 20th century, midwifery was essential for communities throughout Europe, Africa, Asia, and America. With the growth of western medicine in the late 1800s to early 1900s, midwives were instead accused of being unsanitary and unscientific. Midwifery became known as "the Midwife problem," and the practice was phased out and operated in legal "grey zones."
In 1994, after decades of midwives pushing back, Ontario became the first province in Canada to recognize and legalize midwives. In 2024, PEI became the final province in Canada to officially recognize midwifery. If the history of midwives is this complicated in the Global North, what is it like to practice as a midwife in places experiencing civil unrest or conflict?
A new documentary follows five midwives who are doing that work. On today's episode, host and producer Nam Kiwanuka speaks to two midwives, Ximena Rojas Garcia and Jay MacGillivray, as well as Nance Ackerman, the director of "The Delivery Line: Midwives on the Frontlines." Together, they speak about the challenges of the work that these midwives do, but also about the joy of catching a baby.
Links:
Midwifery: A Woman's Labour, A Woman's Choice, 1994 CanLIIDocs 506 https://www.canlii.org/en/commentary/doc/1994CanLIIDocs506#!fragment//BQCwhgziBcwMYgK4DsDWszIQewE4BUBTADwBdoByCgSgBpltTCIBFRQ3AT0otokLC4EbDtyp8BQkAGU8pAELcASgFEAMioBqAQQByAYRW1SYAEbRS2ONWpA
British Columbia to let midwives prescribe abortion pill and other drugs https://www.thestar.com/news/canada/british-columbia/british-columbia-to-let-midwives-prescribe-abortion-pill-and-other-drugs/article_f4b5639a-847f-5038-98a1-b82fb4208b00.html#tncms-source=login
Indigenous communities across Canada have always had midwives https://indigenousmidwifery.ca/history-strategic-plan/
A Brief History of Midwifery in America
https://www.ohsu.edu/womens-health/brief-history-midwifery-america
THE MIDWIFE PROBLEM IN THE UNITED STATES
https://jamanetwork.com/journals/jama/article-abstract/236051
Why Are We Asking Doctors If Women Should Have Midwives?
https://pathwaystofamilywellness.org/holistic-healthcare/why-are-we-asking-doctors-if-women-should-have-midwives.html
Childbirth evacuation among rural and remote Indigenous communities in Canada: A scoping review
https://www.sciencedirect.com/science/article/abs/pii/S187151922100038X
25 years on: What midwifery in Canada has achieved and what it still needs https://theconversation.com/25-years-on-what-midwifery-in-canada-has-achieved-and-what-it-still-needs-120210
The Destruction of Canadian Midwifery during the 20th Century
https://birthinternational.com/the-re-emergence-of-canadian-midwifery/?srsltid=AfmBOoq9ax0eNorpdo1FISNUjB2sOB7TlOFK1Mo79rbISeZ9DLcxZhHN
After decades-long push, P.E.I. now offers midwifery to oversee pregnancies https://www.cbc.ca/news/canada/prince-edward-island/pei-midwifery-services-offered-1.7102229
Georgia bans many midwives from practicing. Now, several are suing the state https://www.nbcnews.com/health/womens-health/midwives-sue-challenge-state-restrictions-rcna264951
Facing rural realities and mistrust in hospitals, these women turned to home births
https://www.cbc.ca/radio/thecurrent/freebirthing-rural-maternal-medicine-9.7172199

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This episode is about forced and coerced sterilization of Indigenous women and girls in Canada. Please listen with care.
In 2025, Senator Yvonne Boyer, Ontario's first Indigenous senator, proposed a bill to criminalize forced and coerced sterilization. If passed, Bill S-228 will amend the Criminal Code to ensure that forced sterilization would be included in the definition of aggravated assault, punishable by up to 14 years in prison.
The bill follows Canada's Truth and Reconciliation Commission - the TRC. The TRC was meant to bring a "fair and lasting" resolution to the legacy of Indian residential schools, and by extension, Canadian colonialism. One of the Calls to Action from the TRC was for Canada to hold a national inquiry into the crisis of missing and murdered Indigenous women and girls. That Inquiry dealt with a wide range of concerns, including forced and coerced sterilizations.
This Red Dress Day, host and producer Nam Kiwanuka features Harmony Redsky from the Survivors Circle for Reproductive Justice. Harmony reveals how one survivor was sterilized as recently as 2024. The episode discusses the history of forced and coerced sterilization, the organization's survivor-led initiatives, and the current push for legislative change to criminalize these violations.
Special thanks to Pam Palmeter for production support.
Got a question or comment? Email us at: [email protected]
If you, or someone you know, is struggling with mental health, visit any of the following resources for support: Canada.ca/mental-health Kids Help Phone Call 1-800-668-6868 (toll-free) or text CONNECT to 686868.
Research links:
Survivors Circle for Reproductive Justice
https://www.reproductivejusticesurvivors.ca/
Indian Residential Schools Settlement Agreement
https://www.rcaanc-cirnac.gc.ca/eng/1100100015576/1571581687074
UN Special Rapporteurs Highlight Forced Sterilization of Indigenous Women in Canada
https://cglj.org/2019/07/18/un-special-rapporteurs-highlight-forced-sterilization-of-indigenous-women-in-canada/
Canada indigenous women were coerced into sterilisations, lawsuit says
https://www.theguardian.com/world/2017/oct/27/canada-indigenous-women-sterilisation-lawsuit
National Inquiry into Missing and Murdered Indigenous Women and Girls
https://www.rcaanc-cirnac.gc.ca/eng/1448633299414/1534526479029
Truth and Reconciliation Commission of Canada: Calls to Action
https://nctr.ca/about/truth-and-reconciliation-commission-of-canada-calls-to-action/
Hundreds gather to celebrate Murray Sinclair's legacy with round dance in Winnipeg
https://www.cbc.ca/news/canada/manitoba/murray-sinclair-round-dance-9.7059423
Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
https://documents.un.org/doc/undoc/gen/g16/000/97/pdf/g1600097.pdf?OpenElement
A legacy of colonialism: Senate Bill S-228 aims to criminalize the forced sterilization of women
https://www.ipolitics.ca/2025/08/07/a-legacy-of-colonialism-senate-bill-s-228-aims-to-criminalize-the-forced-sterilization-of-women/
Rather than a ‘chilling effect’, Bill S-228 provides protection from forced sterilization
https://healthydebate.ca/2026/04/topic/bill-s228-protection-forced-sterilization/
A federal bill aimed at protecting women could actually cause harm
https://healthydebate.ca/2026/03/topic/bill-s228-sterilization-womens-health/
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Only 3% of studies in neuroscience examine a female-only population, even though women make up 50% of the population. When it comes to neuroscience, research on women's brain health is greatly lacking.
Host and producer Nam Kiwanuka speaks with two scientists who are leading the research, not only on women's brain health but how hormonal changes impact women's brain health. Nam asks the experts about the latest findings, the gaps in research in this field, and the challenges that neuroscientists face when trying to get their work funded in the first place. Is Canada falling behind in women's brain health research? What opportunities are there in this research space?
In collaboration with MaRS Impact Health and recorded in front of a live audience at a conference putting women's health at the forefront, Nam interviews Dr. Liisa Galea from CAMH, The Galea Lab and Dr. Natasha Rajah from the Brain Health Equity in Aging and Memory (BHEAM) Lab at Toronto Metropolitan University.
Links:
The Lab of Behavioral Neuroendocrinology: https://www.galealab.com/
The Brain Health Equity in Aging & Memory (BHEAM) lab: https://www.bheamlab.ca/
Mind the Gap: Hormonal Contraceptives and Brain Health
https://womenshealthresearchcluster.com/professional-development/conferences/mind-the-gap/
Estradiol-based Menopausal Hormone Therapy is associated with improved episodic and prospective memory scores in the Canadian Longitudinal Study of Aging
https://www.medrxiv.org/content/10.1101/2025.01.13.25320471v1
Biological sex & menopause effects on vascular health and rsFMRI connectivity in middle-aged adults
https://www.bheamlab.ca/downloads/AAIC_abstract_Kearley_2025.pdf
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In the U.S., Black women are more than three times as likely to die during childbirth as white women. In the U.K., Black women are more than twice as likely to die in childbirth, and babies born to Black mothers are at an increased risk of stillbirth. Here in Canada, stats to better understand health outcomes for Black mothers aren't even available. While there are provinces in Canada that collect race-based data, historically, this country hasn't tracked health outcomes by race, which means the picture for what Black maternal health looks like across the country is unclear. However, if statistics from other jurisdictions are any indication, birthing and pregnancy are a greater risk to Black mothers, no matter where they live or what their socioeconomic background is. On this episode, we speak with Jennifer Dockery and Jenelle Ambrose Dash about the work that the Black Maternal Health Collective is doing, including Toronto's Black Maternal Health Week taking place April 11-17th. We also talk about accountability, the concerns of collecting race-based data in Canada, and what action looks like.
Got a question or comment? Email us at: [email protected]
If you, or someone you know, is struggling with mental health, visit any of the following resources for support: Canada.ca/mental-health Kids Help Phone Call 1-800-668-6868 (toll-free) or text CONNECT to 686868.
Research links:
The weathering hypothesis and the health of African-American women and infants: evidence and speculations
https://pubmed.ncbi.nlm.nih.gov/1467758/
Weathering” and Age Patterns of Allostatic Load Scores Among Blacks and Whites in the United States
https://pmc.ncbi.nlm.nih.gov/articles/PMC1470581/
Black Women Excluded from Critical Studies Due to ‘Weathering’
https://medicine.yale.edu/news-article/black-women-excluded-from-critical-studies-due-to-weathering/
Childbirth Is Deadlier for Black Families Even When They’re Rich, Expansive Study Finds
https://www.nytimes.com/interactive/2023/02/12/upshot/child-maternal-mortality-rich-poor.html
Black midwife's death highlights racial gap in maternal mortality
https://www.pbs.org/newshour/show/black-midwifes-death-highlights-racial-gap-in-maternal-mortality
"Colorblind Care" Is Costing Lives. Meet The Woman Who Started Toronto’s First Black Maternal Health Week To Change That
https://www.essence.com/news/toronto-first-black-maternal-health-week/
Racial variations of adverse perinatal outcomes: A population-based retrospective cohort study in Ontario, Canada
https://pmc.ncbi.nlm.nih.gov/articles/PMC9246499/
Black Maternal Morbidity and Mortality
https://www.bornontario.ca/initiatives-resources/health-equity-and-indigenous-health/black-maternal-morbidity-and-mortality/
Beyonce opens up about pregnancy complications with twins
https://abcnews.com/GMA/Culture/beyonce-opens-pregnancy-complications-twins/story?id=62480855
Serena Williams: What my life-threatening experience taught me about giving birth
https://www.cnn.com/2018/02/20/opinions/protect-mother-pregnancy-williams-opinion
Systemic racism affects maternity care for black women in England, say MPs
https://www.theguardian.com/society/2025/sep/17/systemic-racism-affects-maternity-care-for-black-women-in-england-say-mps
https://www.pbs.org/newshour/health/u-s-maternal-deaths-more-than-doubled-over-20-years-heres-who-fared-the-worst
https://www.npr.org/2024/05/28/nx-s1-4977627/rachel-somerstein-invisible-labor-c-section
https://sph.umich.edu/pursuit/2020posts/state-of-maternal-mortality-the-inequitable-burden-on-black-mothers.html
https://www.sciencedirect.com/science/article/pii/S2667193X22002253
https://www.communitysolutions.com/resources/medical-bias-weathering-deadly-impact-black-mothers
https://nationalpost.com/news/maternal-death-injury-in-canada
https://www.cbc.ca/documentaries/i-made-a-documentary-about-the-black-maternal-health-crisis-then-i-experienced-it-1.7101607
https://www.cdc.gov/womens-health/features/maternal-mortality.html?CDC_AAref_Val=https://www.cdc.gov/healthequity/features/maternal-mortality/index.html
https://www.mckinsey.com/institute-for-economic-mobility/our-insights/closing-the-black-maternal-health-gap-healthier-lives-stronger-economies
https://www.milwaukeeindependent.com/newswire/black-maternal-mortality-rate-reaches-3-5-times-white-women-racial-gap-childbirth-widens/
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