Nunavut’s health minister vows increased support for midwifery

“We have this momentum which is just getting started”

Instructor Elizabeth Hadlari uses a model of a woman’s body as a teaching tool during a 2011 session with students in a Nunavut Arctic College maternity care worker program in Cambridge Bay. That program, and a similar one in Rankin Inlet, produced a handful of midwives for the two communities. (Photo by Jane George)

By Jane George

The recently released final report from the National Inquiry into Missing and Murdered Indigenous Women and Girls includes a recommendation for improved midwifery services for Inuit by Inuit.

As things stand, only half the midwife positions in Nunavut are staffed.

Of the 10 indeterminate registered midwife positions in Nunavut, only five are filled, Health Minister George Hickes said last week in the territorial legislature.

As well, there are no midwives at all in the Baffin region, the most populous of the territory’s three regions.

But Hickes still insisted, during a later interview focusing on midwifery in Nunavut, that there’s a momentum to build up midwifery in the territory. He said the MMIWG report’s recommendation will provide an additional incentive.

Hickes pointed to a pilot project in Cambridge Bay, which sees the three midwives based at the Kitikmeot Health Centre visiting the outlying communities in that region to work with expectant mothers.

This has already produced positive results on birth weights and breastfeeding, he said.

But ramping up midwifery has been a challenge due to the lack of patient boarding homes. That’s key to bringing pregnant women from, say, Kugaaruk to deliver in Cambridge Bay, or from Naujaat to deliver in Rankin Inlet.

Hickes said that his department is now looking at the feasibility of boarding homes in Cambridge Bay and Rankin Inlet with the federal government.

“At some point it has to happen,” he said.

Especially in Rankin Inlet, the presence of a boarding home will alleviate pressure on patient services in Winnipeg, he said.

As for Iqaluit, there are no midwives at all, although the services of birth support coaches, or doulas, are available.

There is no easy answer as to why there no midwives in Iqaluit, Hickes said.

But he said there is a proposal for a birthing centre in Arviat, where roughly 70 babies are born every year.

“We have this momentum which is just getting started,” Hickes said.

But more than 10 years ago, there was a more visible effort by Inuit women to bring back midwifery to the territory. This led to the 2008 Nunavut Midwifery Act.

Nunavut Arctic College also developed a “laddered” program to develop midwives.

The course flowed out of Nunavut’s maternal and newborn health strategy for 2009-14 in which Tagak Curley, who was then health minister, promised that “we seek to bring birth back to our communities.”

Courses for a Maternity Care Worker certificate were offered in Cambridge Bay and Rankin Inlet as the first year towards a three-year diploma in midwifery, which in turn could eventually be part of a degree in that field.

The maternity care workers partnered with registered midwives and other care providers to assist in community wellness programs, providing a range of prenatal and postnatal resources and family support.

The plan was to see midwifery graduates meet standards set by the Canadian Midwifery Regulatory Committee and provide care that is “culturally appropriate for and acceptable to the residents of Nunavut.”

The midwifery courses have not been repeated and, in the two communities with midwives, there is still no obligation for women with low-risk pregnancies to deliver there with midwives.

Hickes said it’s unlikely that this would be mandatory in the near future.

Midwives deliver about a third of the births in Cambridge Bay and Rankin Inlet, he said.

The Health Department couldn’t immediately say how much it costs every year to bring expectant mothers and their escorts to deliver outside the territory because most of these costs are covered by the Non-Insured Health Benefits Program for Inuit.

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(5) Comments:

  1. Posted by Safety on

    If you have to leave your home anyway at 36 weeks and wait to deliver in another community, might as well go to one that has a hospital and doctors, so that they can deal with complications. If the midwife was located in the person’s home community, it might be worth the increased risk to deliver there, but if you have to leave home anyway, it just makes no sense to not have the added safety of obstetricians and operating rooms being immediately available.

    • Posted by Hospital Thinking on

      Yes, I too go eat a hotdog in a hospital just in case I choke and the safety net of doctors are there to assist me.

      • Posted by Logic on

        If you choke on a hot dog in your community, anyone can do the heimlich maneuver on you. If any number of urgent life-threatening complications suddenly arise during labour or delivery, you need to be in a hospital for immediate surgery or blood transfusions. People forget that women and babies used to die in childbirth. Usually everything goes well, but when it doesn’t, bad things happen very fast and can result in death or permanent disability of the mother or the baby. It’s fine if people want to take those risks, but I hope they are being informed of them, especially if they need to leave home and go somewhere else to have the baby anyway.

      • Posted by Israel MacArthur on

        While I’ve never had a baby, I’m confident that the risks associated with eating a hotdog are somewhat less than having a baby. Unless they are those yellow no-name hotdogs, don’t even want to think about them.

  2. Posted by Dumb and Dumber on

    There are traditional midwives in the Baffin region.
    The health care establishment refuses to recognize them and the Justice department makes it illegal for them to practice, just like drum dancing used to be illegal.
    Colonialism is alive and well in Nunavut.

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