Midwifery

The Creator has gifted women with the unique ability to bring forth new life. For ten lunar months, the unborn child, cradled and protected, hears the heartbeat of its mother. As the child emerges from the protection of the womb into this physical world, traditionally, in many Aboriginal cultures the child would hear the beat of the drum, which signifies the heartbeat of Mother Earth. The first words that the child would hear would be those words spoken from a grandmother or the midwife who greets the child in their native tongue. Hearing those words gave the child the basis of the connection of who she is and where we come from as a people.

The midwife, in Aboriginal cultures was much more than a woman who delivered babies. She was well respected within the community and was often seen as a “wise woman”, who gave guidance in all aspects of women’s health, from puberty to menopause. Looking retrospectively, 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.

The Challenge

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, health care in the context of cultural safety for Aboriginal women, their infants and families.

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. NWAC is concerned about the medical evacuation of Aboriginal women north of 60 to urban centers in the south at 28-32 weeks gestation, often with no social supports, where children are born in southern hospitals, in unfamiliar surroundings and separated from their families for up to six weeks after delivery. It has been suggested that the breakdown in the fabric of the childbearing experience and the interruptions in familial bonding caused from birthing away from home have contributed to the increasing number of Aboriginal children in care.

The Program

As part of the investment in programs to improve the health status of Aboriginal people, the Maternal Child Health (MCH) program was developed and is delivered by First Nations and Inuit Health Branch (Health Canada). The goal of the MCH program is to improve the health outcomes of pregnant First Nations women and families with infants, and young children.

The MCH program provides services such as visiting nurses during pregnancy and after delivery, as well as providing community support such as visits and follow up with experienced mothers from within the community. The MCH program is also committed to exploring opportunities to return safe birthing options to communities including the promotion of midwifery. NWAC will be exploring these options and working with partners such as the Society of Obstetrician-Gynecologists of Canada (SOGC); Canadian Association of Midwives (CAM) and affiliates; Schools and Training Centers for Midwifery and government policy makers to promote midwifery and bring birthing closer to home. NWAC intends to explore successful Aboriginal models including the Birth Center at Six Nations and the Inuulitsivik maternity center in Puvirnituq.

The Opportunity

Promoting the expansion of current health policy to offer midwifery as an essential health service through informed choice for Aboriginal women is part of the agenda of the NWAC Health Unit. Through work with essential partners and government policy makers, NWAC is working on promoting the encouragement of more women to become Aboriginal midwives and birth attendants to answer the call for safe, culturally appropriate birthing options for Aboriginal women.

Links

• MCH
• HIV and Women
• ECD
• FAS/E
• Diabetes
• CPNP