Reproductive Justice Library: Government Document & Policy

This paper incorporates statements from some First Nations and Inuit midwives, and non-Aboriginal midwives who were interviewed by NAHO for this project. Métis content was provided by the Métis Centre of NAHO. We thank all of these women for sharing their stories and their insightful input into this paper. In particular, we would like to thank Darlene Birch, Ellen Blais, Katsi Cook, Carol Couchie, Sharyne Fraser, Meaghan Moon, Christine Roy, and the midwives of the Inuulitsivik Health Centre in Purvinituq, Nunavik (Northern Québec).

The Maternity Experiences Survey (MES) is a national survey of Canadian women’s experiences, perceptions, knowledge and practices before conception and during pregnancy, birth and the early months of parenthood. This report presents findings on all major topics covered by the MES, grouped in three chapters covering pregnancy, labour and birth, and postpartum. In addition to national results, provincial and territorial level analyses are reported. Findings by maternal age, maternal education, parity (i.e., primiparous or multiparous), type of birth (i.e., vaginal or cesarean) and household income level (i.e., at or below vs. above the low income cut-off) are also presented.

“When planning began in the 1980s for a new regional health centre in Povungnituk, local women's organizations and health care planners from the south began to assess the overall medical needs of the population and to look for better solutions to the issue of birthing and the participation of Inuit in the process. The concerns of local women mirrored an evolving philosophy in some circles that health services in Aboriginal communities should reflect values associated with their cultures and should empower local people to take control of the services in their communities. From this grassroots movement was born the Innuulisivik Maternity Centre, where the vast majority of Inuit women living in Hudson Bay communities now give birth with the help of Inuit midwives and midwives in training. This is a unique arrangement in Canada and presents an example that could be adopted or adapted by other Aboriginal communities in the country. This document represents a synthesis of a great deal of information collected about the Maternity Centre and about the cultural construction of pregnancy and birth. The information is presented in a way that highlights the questions and concerns of the community members who participated in the research. Most of the information was collected while the author was in Povungnituk under the auspices of the Royal Commission on Aboriginal Peoples, although some complementary information comes from previous research conducted with funding from different granting agencies and organizations"--Intro., p. 2-3.

This report is the third in a series of Giving Birth in Canada reports. It explores the costs associated with delivering maternity and infant care in Canada, including provincial, national and international comparisons, where available.

The Inuulitsivik Health Centre in Puvirnituk, Quebec, created in 1986 by the efforts of a local women’s association and a supportive physician, is but one example involving Inuit and non- Aboriginal midwives collaborating with other health professionals to deliver their children in their communities. Traditional midwifery passed from one generation to another is regarded as an important conveyor of cultural knowledge and identity, and as a source of esteem among Aboriginal women (Paulette, 1995). Current debate about appropriate legislation, educational requirements, models of training, registration, licensing and questions concerning safety issues and financial costs must include Inuit, Métis and First Nations women who have a vested interest in any outcome or decision. In addition to honouring the wisdom of Elders who have passed on their knowledge and skills to the next generation, readers will be sensitized to past and present midwifery and Aboriginal midwifery in Canada, with a focus on the future. (from Introduction)

This short paper was commissioned by the First Nations Centre, National Aboriginal Health Organization to focus exclusively on First Nations issues in midwifery, to provide a more in-depth yet inspiring background for consideration by people considering midwifery as a career, or for development of midwifery programs in or near First Nations communities. Dr. Farah Shroff was contracted to write this paper because of her extensive experience as a developer and instructor in midwifery and medical education, as the author of a book on midwifery, as a strong ally for the sovereignty of First Nations people, as a strong advocate of primary care and marginalized peoples, and as a holistic health practitioner.

Research paper submitted to the Royal Commission on Aboriginal Peoples