Maternal Child Health
Aboriginal women have traditionally had the highest respect within their communities for their gift from the Creator to be life givers. In keeping with this gift, most of us have celebrated rites of passage such as the beginning of menstruation as a significant life event, with ceremony and teachings. This celebrated the transition from childhood to womanhood, and was seen a part of a spiritual journey that honoured the maintaining of health and well-being of each woman, her family and her children, many of whose faces we could not yet see. This is a practice that continues today in many communities and families.
The Challenge
The continuation and maintenance of reproductive health for Aboriginal women in today’s environment is a particularly serious issue due to a birth rate 1.5 times higher than mainstream Canadian women. There are also concerns about increased rates (2 to 2.5 times higher) of infant mortality, through pre-natal, stillborn or newborn deaths. Traditional understandings of pregnancy and childbirth as normal life events contrast with the prevalent western medical view of maternity care throughout the 20th century, as a condition that needed to be managed, like an illness requiring treatment. Together with the legacy of colonialism, these views have marginalized Aboriginal women and created social and economic conditions leading to severe disadvantage in many fronts. A gap has widened between individual and community preventive and healthy practices, creating barriers in obtaining western medical care when appropriate, and inaccessibility to culturally relevant, culturally safe health care for Aboriginal women and their infants. Physical barriers have emerged, preventing regular access to health care providers, as well as growing crisis in lack of health care providers for many northern and isolated communities. In urban centers, there is a growing need for Aboriginal health care providers, and for health care that is culturally relevant to the needs of the Aboriginal woman. Concerns are on-going regarding the medical evacuation of Aboriginal women north of 60 to urban centers in the south at 28-32 weeks gestation, where children are born in southern hospitals, in unfamiliar surroundings and separated from their families for up to six weeks after delivery.
The Program
In response to the current situation faced by Aboriginal women, many of whom must leave familiar surroundings and loved ones in order to bring their children into the world, NWAC has updated and revised a booklet “Giving Birth Away from Home”, originally developed by the North-western Ontario Women’s Health Information Network and Red Lake Women’s Information Group in 1990. This booklet, “Journey for Two”, has now been completed and will be distributed nationally through a variety of venues, and is intended to be used as a guide for expectant mothers in helping them plan for their delivery. This booklet contains valuable information to the expectant mother such as what to bring with you, how to prepare a birth plan, discussion spiritual and cultural needs with hospital staff, tips on community supports while away, and provides resource materials, contacts and information. NWAC recognizes that midwifery is an integral part of reproductive health for Aboriginal women and is currently engaged in addressing the issue of identifying opportunities for safe birthing options for Aboriginal women, including the promotion of midwifery, expanding current health policy to offer midwifery as an essential health service through informed choice and the encouragement of more Aboriginal midwives and birth attendants. In response to growing concerns about maternal child health and Aboriginal peoples, Aboriginal leaders and First Ministers announced in 2004 that there would be new investments in programs to improve the health status of Aboriginal people. Through this commitment, the Maternal Child Health Program was established by Health Canada in an effort to address issues concerning Aboriginal women and maternity care.
The Opportunity
The ultimate goal of the MCH is to improve the health outcomes for expectant Aboriginal women, their families and their infants through a variety of approaches including providing home visits by nurses and family visitors who are experienced mothers in the community, during pregnancy, post-partum and early childhood. In addition, it is intended that Aboriginal children will be provided with a good start by linking children and families with special needs to various community services such as Aboriginal Head Start, the Canada Prenatal Nutrition Program, and Early Childhood Development programs. Within this framework, NWAC seeks to work with federal, provincial and territorial agencies, together with partner organizations in exploring opportunities to return safe birthing options to Aboriginal communities.