Nunavut has an interest in midwifery, but training lags behind
“Training Inuit into these positions is critical”
A wall hanging decorates the hallway outside the birthing room at the Kivalliq Health Centre in Rankin Inlet, where midwives deliver over 50 babies every year. (Photo by Sarah Rogers)
Nunavut’s Department of Health says it’s actively recruiting new midwives to fill seven vacant positions across the territory, as part of its effort to make midwifery more accessible to Nunavut families.
There are 10 midwife positions across Nunavut, based in Cambridge Bay, Iqaluit and Rankin Inlet.
But earlier this year, two Inuit midwives in Rankin Inlet left their positions at the community’s maternity centre, leading to the suspension of local prenatal and birthing services for expectant mothers in the Kivalliq region.
Although neither of the midwives spoke publicly about their reasons for their departures, a former colleague said the women faced discrimination and an unrealistic workload.
The National Aboriginal Council of Midwives says midwives and birthing centres in Nunavut need better support and funding if they’re to remain sustainable.
Last year, the GN vowed to provide increased support to build up midwifery in the territory, in response to a recommendation in the final report of the National Inquiry into Missing and Murdered Indigenous Women and Girls.
The Department of Health told Nunatsiaq News in a Sept. 4 email that it’s “committed to increase the number of maternity care workers and midwives in Nunavut.”
Nunavut Arctic College offered a midwifery program between 2006 and 2014 that graduated four students over that period.
Courses leading to a Maternity Care Worker certificate were offered in Cambridge Bay and Rankin Inlet as the first year of a three-year diploma in midwifery, which could then be counted towards a degree.
Fiona Buchan-Corey, dean of health programs at the NAC, said the program folded due to a lack of interest from qualified applicants as well as an end to funding through the Territorial Health Investment Fund, a three-year investment to help northern regions implement local health care services.
“It was a really expensive program to deliver,” she said. “It would entail sending interns to [southern hospitals] to complete their required 50 births.”
But Buchan-Corey said there is indeed still interest; she receives between five and 10 applications each year from students interested in studying midwifery at the NAC.
She said it’s unclear whether those applicants then end up enrolling in southern midwifery programs.
Buchan-Corey said the college hasn’t had any recent conversations with the GN on revitalizing the program.
And for its part, the Department of Health said it hasn’t received any requests from Nunavummiut for training support in midwifery.
“Although there isn’t a training program in Nunavut, there are several midwifery training programs in Canada in which [the Department of Health] would support students in their placements,” the department said in a Sept. 4 email.
“Nunavummiut have access to various financial supports for post-secondary education.”
And base funding for the delivery of midwifery services has not been cut, the department noted.
The GN estimates that midwives have delivered about a third of the births in Cambridge Bay and Rankin Inlet in recent years.
“Obviously, training Inuit into these positions is critical,” Buchan-Corey said. “As someone who’s had to give birth outside the territory in the past, my preference would have been to have my children in the community.
“As a post-secondary institution, you want to help people acquire those skills. The ongoing challenges are always securing instructors who have the appropriate skills to mentor those people,” she said.
“And if it could be Inuit who have those skills to train those skills, that would be amazing.”
There are still some traditionally trained Inuit midwives in Nunavut, but the Health bureaucracy has no interest in them and the GN has made it illegal for them to do what they used to do.
That’s called progress.
You should talk to your MLA and start a petition to have midwives not be regulated. Seen a few births? Good enough. Don’t read? Who cares. No formal education required. No concerns about massive liability here.
.
I’m sure 99.9% of Nunavummuit aren’t going to roll the dice with their lives and their babies with unaccredited (aka traditionally trained) midwives.
.
Anyone can go to university and get accredited. If people actually wanted to do it, NAC would offer it.
Isn’t it strange that the dean of NAC health programs “said it’s unclear whether those applicants then end up enrolling in southern midwifery programs.” doesn’t at least try to keep track of people who want to go to the program, but can’t because they folded it?
It doesn’t take much to send a follow up email, or a 1-2 page questionnaire to anyone they have to turn away. They could send it 6 months to a year after, get an idea of how many potential students they have turned away and compare how many dedicated applicants and useful people they would have trained. With that info, they can then go to the GN with hard numbers saying “because you don’t fund that program anymore, we’ve had to reject XX people, and YY have had to leave the territory to learn a profession urgently needed across the territory”.
But inter-organization communication and long-term planning has been an issue in the territory since 1999, so while unfortunate it’s not really surprising.
Left the college a few years ago. We definitely tried to get this sort of information, but former students don’t respond, don’t keep phone numbers and emails up-to-date with alumni tracing staff. Very very challenging to do without a response from alumni.
“Nunavut Arctic College offered a midwifery program between 2006 and 2014 that graduated four students over that period.”
At some point we have to ask ourselves what is a reasonable return on investment? Is a program that is very costly to run, but produces so little result, really worth it?
ROE, ridiculous amount of funds are spent on flying southern based practitioners (this includes nurses, Docs, specialist, x-ray just to name few) back and forth from their southern homes to Nunavut and back and forth and back forth as many times as they please. They could come for as little as a few days at a time or a few weeks if they feel “adventurous” all at the expense of the GN. Their flights, accommodations, high pay, over time, per-diems, extra training they require surpasses the amount of money that would be spent to train very capable local people by millions. Local practitioners could provide culturally appropriate care and they would stay in Nunavut. The program has only been run a couple of times and was brand new, which was part of the reason for the high cost in the beginning I’m sure. Any program being offered for the first time is costly as it is being developed. But once a program over comes some hiccups it could run smoother and not be as expensive as it would become established. And having successful graduates shows that it may not be such a foreign concept after all. We do appreciate all the great practitioners that come up and take care of our health but maybe we should look at training our own to work along side these practitioners. Imagine having Inuit nurses, midwives, x-ray/ultrasound techs and even doctors all trained on their land like GN promised! WOW!!!
So what you are saying is, this massive expensive that offers very little (arguably, no) return is okay because there are other massive expenses that offer minimal return? That’s really not very compelling.
There’s an interesting and subtle bigotry against southern professionals that runs through your commentary. Can you see it?
.
Unfortunately, it’s extremely common to hear this kind of thing in Nunavut. I bring it up because it has clearly distorted your perceptions between what are legitimate, and necessary uses of funds (granted very expensive and not optimally inefficient ones) versus spending that has offered no discernable benefit at all. Another way to put this, what you are offering us here is a false comparison. Spending on doctors and nurses is essential. It can’t just be stopped because you perceive that these people view their “excursions” into the north as an “adventure”. These people actually offer something of high value to the people they serve.
.
We can talk all day about an ideal were Inuit staff all health centers and every imaginable position in the territory, okay. The point I’m making is that despite years of spending, in this case an 8 year program that yielded 4 graduates (how many of those are still working? Did the two who recently resigned come from this cohort?), there is practically no beneficial result to report. Simply put, spending millions on training programs is not getting us anywhere. Why is that? This is a serious question and until it confronted and addressed, I don’t know what you think is really going to change.
.
My 2 cents this is an issue at least partially attributable cycles of dysfunction in modern Inuit culture; dependence on government, a lack of value placed on education and progress, a visceral rejection of outsiders and an unwillingness to model successes because of it.