Aboriginal Midwifery As a Career Choice

Midwives Association of BC - Aboriginal Committee October 16 2013

What is our purpose?

1) Demonstrating solidarity and support with traditional midwives as we work towards a definition of Aboriginal Midwifery that is not inclusive to enrolment with our college prior to 1998 and increasing access to Aboriginal midwifery services for Aboriginal communities.

2) Connect with communities and encourage women to enter the maternity care field

What is a Midwife?

§  a respected healthcare profession

§  specialist in pregnancy, birth and postpartum

§  $70 000 - $120 000 / year

Traditional meanings for word ‘midwife’

�  Cree – ‘the one who delivers’

�  Objibwe – ‘the one who cuts the cord’

�  Inuktitut – ‘the one who waits for the birth’ & ‘the helper’

�  Coast Salish – ‘to watch, to care’

�  Chilcotin – ‘women’s helper’

�  Nuu-chah-nulth – ‘one who can do everything”

� Midwives have been ‘catching’ babies for thousands of years in most cultures

�  In BC since January 1998 = official & paid by healthcare system (like nurses & doctors)

Difference between Registered Midwife & Doctors?

�  Choices - home or hospital birth

- options re tests/visits

�  Personalized care – long visits 45min-1hour each - smaller teams

�  Newborn care - Home visits for first 1- 2wks after birth

Stats on Midwives vs Doctors

Registered Midwives Doctors

C-section Rates 18.4% 31%

Planning VBAC 93% 41.6%

Successful VBAC 82% 80%

Drugs in Labour 12.2% 31.3%

Continuous Monitoring 51.4% 79.5%

The Job of an Aboriginal Midwife

�  http://www.isuma.tv/en/national-aboriginal-council-of-midwives/aboriginal-midwives

Woman power

�  There are currently 220 practicing midwives registered in B.C.

�  Only 4 Aboriginal self-identifying midwives are registered or studying in B.C.

Midwifery Practices in BC

How did we get here?

�  The negative impact of years of acculturation and assimilation have led to the decline of traditional midwifery practice in many parts of the country

(a)  broad societal shift of power and authority

(b)   traditional Aboriginal midwife role challenged and expertise ignored

(c)   traditional life now complicated by medical assessment and risk intervention

What does all this add up to?

� Women are being forced to leave their communities to birth in larger centers away from family, support systems, traditional birthing practices....

Research says:

�  Strong cultural and physical ties to place of birth

�  Culturally appropriate care

�  Mental & physical health of women separated from families/communities

�  Health impacts/care of families left behind

�  Loss of belief in birth as normal part of lifecycle, including community based midwifery skills

Courtesy of Dr Jude Kornelson, Co-director Centre For Rural Health Research

Courtesy of Dr Jude Kornelson, Co-director Centre For Rural Health Research

FIRST NATIONS HEALTH AUTHORITY Action 21- the Transformative Change Accord

‘A maternity access project will be implemented to improve maternal health services for aboriginal women and bring birth 'closer to home and back into the hands of women’

Tripartite Aboriginal doula initiative

to improve birth experiences and outcomes for Aboriginal women

to re-introduce traditional Aboriginal support practices into the childbirth experience

to improve maternity care systems and access within geographic areas

to increase the number of Aboriginal women with formal doula training

What’s the difference between a doula & a midwife?

DOULA MIDWIFE

•  Emotional & physical support before, during & after birth

•  Life experience & or week long training

•  Traditionally granny, aunty, mother or sister

•  Clinical care provider responsible for health of mom & baby before during & after birth

•  3-4 years training + life experience

•  Traditionally granny, aunty, mother or sister

Tripartite Aboriginal Doula Initiative

�  http://www.youtube.com/watch?v=IZzR1BSHVkg&feature=youtu.be

Aboriginal Doula

My name is... 

Blending traditional and modern teachings

We know that traditional pregnancy and childbirth took place within a closely knit nexus linking the midwife to the birthing women, to the infant, to the husband/ partner, to the family, to the extended family and ultimately to the entire community.

Aboriginal Midwifery

�  Traditional Aboriginal midwifery practices including the use and administration of traditional herbs and medicines and other cultural and spiritual practices.

�  Contemporary aboriginal midwifery practices which are based on, or originate in, traditional Aboriginal midwifery practices, or

�  A combination of traditional and contemporary Aboriginal midwifery practices

Registered Midwifery Training

�  In BC – University of British Columbia – 4 year degree program in Faculty of Medicine = BMW

�  Ontario-McMaster, Ryerson and Laurentian = BMW

�  Quebec: Université du Québec à Trois-Rivières

�  Manitoba: University College of the North kanaci otinowawosowin Bachelor of Midwifery (KOB) Program

�  Alberta: Mount Royal College = BMW

Métis Student Midwife

My name is..

Educational Pathways

�  http://www.isuma.tv/en/national-aboriginal-council-of-midwives/aboriginal-midwifery-education

Learning from successes... Courtesy of Lauren Redman, SM

Continued….

Continued….

Continued….

Continued….

More Aboriginal midwifery programmes

Nunavik Community Education Program:

- offered through maternity programmes in health

- centres on the Hudson Bay coast in Quebec

- graduated 9 Inuit midwives who are currently eligible for full registration in Quebec

- currently 7 students in Puvirnituq, Inukjuak and Salluit

New mothers in the birthing room at the Kitikmeot Birth Centre in Cambridge Bay, Nunavut. (Photo by Bill Braden, courtesy of Nunavut HSS)

More Aboriginal midwifery programmes

�  Nunavut Midwifery Education Program

-  offered through Nunavut Arctic College

-  Currently based in Cambridge Bay, Nunavut (rotating locations)

-  has graduated two registered midwives, two maternity care workers & currently has five students

Setting up practice

�  Hi my name is…

Questions?

Our Contacts

�  We welcome questions/comments/discussion/ideas through email.

�  Marijke de Zwager- marijkebabycatcher@gmail.com

�  Misty Wasyluk- misty.wasyluk@gmail.com

�  Lauren Redman- l_redman@hotmail.com

�  Deb Peters- d_peters013@hotmail.com

�  Shannon Greenwood- momsnbabe@gmail.com