Mi'kmaw women lead effort to bring midwifery to Indigenous parents

With few Mi'kmaw communities able to access midwives, the Nova Scotia Native Women's Association has been holding public meetings in First Nations across the province to gauge interest in expanding midwifery services.

Midwifery is currently only available to those living in the catchment area of St. Martha's Hospital in Antigonish, the IWK in Halifax, and Fishermen's Memorial and South Shore Regional hospitals in Lunenburg County.

That leaves many First Nations, including its largest communities in Cape Breton, with no access.

"What Indigenous communities are realizing across the country is that we can't wait for the current system to move forward on their own accord," said Alisha Julien Reid, lead consultant on the project.

"It's always the people who ask and demand change first. And so we are moving forward with Tajikeimk to make these dreams happen."

Julien Reid is a midwife from Millbrook First Nation, though she is not currently practicing. Suzanne Brooks, the wellness advisor for the association, is also from Millbrook. They have been leading the community meetings.

The meetings are a part of a partnership between the association, the National Aboriginal Council of Midwives, and Tajikeimk, the Mi'kmaw health authority. They're also looking at ways to decolonize birth and incorporate Mi'kmaw ceremony back into birthing practices.

Restoring the ceremony of birth

Julien Reid said the meetings have been informative when it comes to better understanding past cultural practices surrounding birth, as well as what families want now.

"Midwifery has always been a part of community and ceremonies have always been a part of those births," she said.

"Indigenous midwifery specifically can service women in a culturally safe way, as well as implement or restore and revitalize the ceremonies that we once had."

Some examples of ceremony include delayed cord clamping, having Mi'kmaw songs sung during birth, and having the parents of the baby be the first ones to speak to the child.

They've also heard from parents who would have liked to have access to a midwife when giving birth and toseveral women who are interested in becoming midwives and doulas.

Brooks believes having midwives more accessible to Mi'kmaw people could provide wider benefits. She contrasted it to the now-cancelled practice of "birth alerts," where hospitalstaff would notifysocial services if there were perceived issues at home, which sometimes led to authorities seizing a newborn.

In 2019, the National Inquiry into Missing and Murdered Indigenous Women and Girlsstated that birth alerts are "racist and discriminatory" and called on governments to immediately ban the practice, which Nova Scotia did in 2021.

"We would like to see more preventative care for our mothers. The birth alerts were a very dangerous and not safe practice," she said.

"If we were to restore midwifery, it would help with the high risk case so that we can start looking at how to help mom before baby arrives."

'Build community around her'

Brooks believes the continuity of care provided by a midwife from prenatal to six weeks postpartumbuilds trust and helps connect vulnerable women and infants to resources.

"A midwife would be able to create a connection and a bond and build community around her."

Regulated midwifery care was introduced in the province in 2009. In 2011 an external review recommended expanding services province-wide. In a statement, the Department of Health and Wellness said it has no immediate plans for expansions.

Although still in the early stages of the project, the information gathered by Julien Reid and Brooks will be used to work toward several goals and to apply for various funding sources.

The first goal is having midwives available under the Mi'kmaw health authority. The second is to create an Indigenous-led midwifery training program. They plan to approach several universities to discuss the matter.

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