Traditional childbirth practices were intrinsic to the Inuit way of life and crucial to maintaining the social fabric of Inuit communities.
The bonds within the family and community were thus reinforced and intensified much beyond the birth event, extending to a child’s education and place in the community. Children had a special bond with the person who delivered them, especially if it was a grandparent.
Children were taught to show appreciation and respect to the person who helped bring them into the world. For example, it was customary to present one’s midwife with the child’s first piece of sewing or the first animal hunted. This expression of gratitude would maintain and reinforce the relationship throughout the child’s life. Changing circumstances, however, allowed fewer opportunities for Inuit women to practice midwifery. Inuit were ‘encouraged’ to move into communities by the federal government in the 1950s through the provision of family benefits and health services.
Initially, the government stationed midwife nurses from England in Inuit communities. These nurses would attend home births only upon invitation and collaborated with Inuit midwives. Later on, women were invited to give birth at the nursing station with Inuit midwives to assist in the birthing process. But eventually, their presence was no longer welcomed. Home births and Inuit midwifery were actively discouraged and in some cases, Inuit midwives were threatened with legal action if they practiced within a private home.
In addition, medical authorities began evacuating women considered high risk to hospitals. This evolved into the present practice whereby almost all Inuit women give birth in hospitals far away from home. In Nunavik, taking birth out of the community is also seen as symbolic of disrespect, neglect and a colonialist approach to health care in indigenous communities. Pauktuutit has been active in lobbying with Inuit women for community-based childbirth. It has also started the task of documenting traditional midwifery practices to help salvage the vast knowledge of elders before it disappears.
The organization has been entrusted with a historically significant body of knowledge about traditional Inuit practices related to pregnancy, childbirth, and midwifery through a research project undertaken in 1992/93. This body of knowledge includes traditional Inuit knowledge related to prenatal care and nutrition gathered from 75 open-ended interviews with traditional midwives across the Arctic. The return to midwifery is gaining momentum across Canada and in the North as an alternative to medical intervention. With increases in demand, and its demonstrated cost-effectiveness, acceptance and regulation, midwifery is occurring on a province-by-province basis.
Inuit midwives are being trained and more women are insisting upon the option of giving birth in their own community. While Inuit women appreciate the value of modern medicine and the presence of doctors and nurses in case of complications, giving birth in southern hospitals adds to the sense of loneliness, shyness and stress associated with these institutions. The distance of hospitals from most Inuit communities and language barriers also increase women’s sense of isolation, loneliness and separation.
All of these factors, as well as the worry of leaving young children, sometimes infants, and families for extended periods of time, create a less than healthy environment in which to give birth. Building on the “Promoting, Supporting and Strengthening Inuit Midwifery” meeting held from March 13 – 15, 2007, in Iqaluit, Nunavut, Pauktuutit hosted the initial meeting of an Arctic Midwifery Working Group (AMWG). On March 11-12, 2008, the working group met in Ottawa and developed an action plan for the next two years. The working group recommended that Pauktuutit continue to take the lead for this group until all steps of the national action plan are complete.
In the 2008-2009 the working group was unable to hold a full face to face meeting due to a number of unforeseen circumstances and in 2009/10 and in 2010/11 no funding was available to support this process. The members of the working group want to move the Inuit midwifery agenda forward and would like to implement components of the draft National Inuit Midwifery Action Plan that was developed in 2008. Birthing closer to home remains a priority in Inuit communities.