National Inuit Midwifery Framework - Reclaiming Indigenous Birth

Improving Access to Sexual and Reproductive Health Service Across Inuit Nunangat

In March, 2023, Pauktuutit Inuit Women of Canada hosted a virtual National Inuit Midwifery Forum. In partnership with the National Council of Indigenous Midwives and with support from our project and Indigenous Services Canada, Pauktuutit’s first step toward creating necessary systemic change was to convene around the topic.

The goal of the Forum was to better understand the challenges faced by Inuit, the role of Inuit midwives, the importance of access to culturally informed midwifery services to health and wellness, and the need for a rights-based framework to facilitate the return and reintegration of Inuit midwifery across Inuit Nunangat.

Throughout the Forum, participants heard from Inuit mothers, fathers, grandparents, and Elders regarding how childbirth evacuation policies have affected them, their families, and their communities. They also learned of hopes and dreams for a future with more social supports for expectant Inuit and their families, closer-to-home access to the high-quality, culturally safe care to which Inuit are entitled, and environments that are safer, more welcoming, and better-suited to Inuit and Inuit families when they must leave their communities for care.

Read the summary or full report of proceedings and findings from the Forum. This gathering formed the basis of our ongoing framework to improve access to sexual and reproductive health services for Inuit families and communities.

Report Summary

Full Report

Research Findings from the Forum

Throughout the National Inuit Midwifery Forum, participants learned how mandatory childbirth evacuation policies have significant negative consequences.

They prevent culturally meaningful birthing experiences, traditional ceremonies and rights of passage.
They separate women and gender diverse Inuit from their support networks for weeks or months during one of the most vulnerable times in their lives.
They require Inuit to travel long distances by air, even when other pregnant women are advised against doing so.
They interfere with bonding between parents, infants and siblings.
They exacerbate poverty and stress within homes by reducing household income and requiring lengthy supports to assist with childcare and other roles and tasks typically attended to by those sent away for care.
They perpetuate intergenerational trauma by placing children left behind at risk of food insecurity and physical and/or sexual abuse.
They expose Inuit to culturally unsafe health care, anti-Indigenous racist practices, and violence, that negatively impact mental health and wellbeing, increase risk for postpartum depression, and foster distrust of the health care system.
They can lead to tragic outcomes. In 2021, Silatik Qavvik, a 35-year-old wife and mother of five, died from COVID-19 in Winnipeg after she traveled from Sanikiluaq, Nunavut for childbirth.
They deny Inuit the right to give birth and to be born in their homeland.
They undermine Inuit culture and lead to the loss of traditional Inuit knowledge, language and practices related to sexuality, reproduction, childbirth, and midwifery.
They disregard key international Human Rights instruments and national guidance tools including the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP - Articles 24.1 and 24.2); the Truth and Reconciliation Commission of Canada (TRC – Calls to Action 22, 23); and the National Inquiry into Missing and Murdered Indigenous Women and Girls (Right to Culture, Right to Health).
They divert a staggering amount of health care funding away from creating and sustaining adequate and appropriate reproductive health and neonatal care infrastructure, as well as health human resourcing and education within Inuit Nunangat.
They result in ineffective communication between Inuit and their health care providers, endangering mothers and infants, impacting the quality of care, and reducing capacity to knowingly provide informed consent to medical treatments including forced and coerced sterilization.
They are not evidence-based, do not consider cultural, emotional, and financial risks to neonates, mothers, families, and communities, and have not led to improvements in maternal health outcomes and infant mortality rates.

The National Inuit Midwifery Forum reaffirmed Pauktuutit’s commitment to bringing birth back to Inuit communities, revitalizing Inuit culture, language and traditional Inuit birth practices, and reclaiming Inuit sovereignty over reproductive health and birthing.

Access to midwifery is recognized as a primary health and cultural right, and efforts should be met with clear legislative and funding commitments. This aligns with the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP), which protects Inuit rights to maintain and transmit their culture and to be protected from assimilation. In March 2023, Pauktuutit partnered with the National Council of Indigenous Midwives to host a virtual gathering funded by Indigenous Services Canada. A report of the proceedings and outcomes of the National Inuit Midwifery Forum is now available.

The forum was sponsored by Indigenous Services Canada and our CIHR Project: Assessing Economic Costs of Obstetric Evacuation and Social Cultural Benefits of Indigenous Midwifery.