Born (almost) free: how midwives save millions

JOHN THOMPSON

Nowyah Williams from Rankin Inlet could be the mother of modern midwifery in Nunavut.

As such, she has a lot to celebrate.

Since she started working in Rankin Inlet’s birthing centre in 1993, some 451 babies have been delivered by midwives and their helpers at the facility, which is now part of the community’s health centre.

Each baby delivered at the birthing centre saves the government about $10,000 by avoiding costly medical travel, Nunavut’s health minister, Leona Aglukkaq, estimated while cheering on the progress of midwifery in a March 16 minister’s statement.

The centre had 42 births last year, up by one-third over 2005.

In conjunction with Nunavut Arctic College and the University College of the North, Rankin Inlet has also hosted a maternal care worker and midwife training program.

Last year the program produced two first-year graduates, who are qualified to work as maternity care workers: Diane Tiktak and Rachel Jones.

When these students complete their second year of study, they will receive a diploma in midwifery. A third year of study follows, when the students intern under the supervision of a registered midwife.

The second intake of students started their studies in Rankin Inlet in September. And plans are in the works to offer the program in Iqaluit by this fall, and in Cambridge Bay by 2008-9.

As well, recently the Midwives Association of Nunavut became a registered society, and elected a new board of directors in February this year. The association’s new president is Natsiq Kangok of Iqaluit.

The Government of Nunavut plans to introduce new legislation sometime this year that would permit this association to register midwives in the territory, and offer appropriate recognition to traditional Inuit midwives. Presently, territorial law doesn’t recognize midwives as a profession.

At a gathering of midwives from Nunavut, Nunavik and Nunatsiavut last week in Iqaluit, Williams was honoured, with her colleague Joyce England, for her hard work.

“I knew right away that sending out Inuit to have babies was not right,” she said, recalling when she was first hired to work as a nurse’s aid.

“Back then the government didn’t understand how strong I was,” she joked. “They didn’t know what kind of goals I had, so they hired me.”

“They’re stuck with me now.”

For a long time, doctors and health bureaucrats believed sending Inuit women south for childbirth was the best practice.

But attitudes have since changed, those who attended the meeting pointed out.

Dawn Walker of Health Canada says there’s “oodles of science” that says it’s not good for aboriginal women, or babies, to be medevaced away from the home community.

And keeping births in communities is more closely aligned with Inuit values. One participant pointed out you only need to hear the proud voices of elders who describe where they were born to understand this: they always describe a specific location, and the surroundings, such as a nearby river. Few describe a hospital bed.

“Childbirth is not an illness. It’s part of the natural process,” said Pauktutiit President Martha Greig.

“They felt they were just a statistic when they were giving birth in a hospital,” she said, referring to Inuit women sent south for birth.

Williams is familiar with stories of Inuit mothers left their community for so long, their other children didn’t recognize them when they returned.

“I’m joking now, but I’ve cried for my people,” she said.

Another obstacle was fear of legal liability, and inadequate insurance, which at different times have barred Inuit from Rankin Inlet’s birthing centre.

Two registered midwives are still required to be present in Rankin Inlet’s birthing centre for a traditional Inuit midwife assist.

But at least now, “It’s not just my voice any longer,” Williams said.