U of A program lets Nunavit women give birth in their homes
By Jodie Sinnema, Edmonton Journal Dec. 18, 2009
Natsiq Kango caught her first baby in 1976 as she was flying from Resolute to Iqaluit.
A woman on the jet went into premature labour. When the flight attendant asked for help, since she didn't speak Inuktitut and had no birthing skills, Kango stepped forward.
Equipped only with a pair of dull scissors, string, paper towel and some blankets, Kango helped the woman -- a midwife who guided Kango between contractions and heavy pushing -- deliver a healthy baby boy.
Today, 53-year-old Kango is a traditional midwife herself. Although she isn't registered with the midwifery college, she learned her skills from her mother-in-law, sister-in-law and other northern elders and is now sharing her knowledge through Nunavut's first midwifery training program.
The aim of the program is to train midwives locally so more Nunavut mothers can give birth in their home communities.
Beverley O'Brien, a nursing professor at the University of Alberta who helped develop the midwife program, said 60 per cent of Nunavut women have to travel more than 100 kilometres to give birth. Women at higher risk of complications often travel to Winnipeg or Ottawa.
In Canada, two per cent of expectant moms have to travel more than 100 kilometres to give birth, O'Brien said.
"It has been incredibly difficult when you take a woman away from her family and leave the kids with whoever," O'Brien said. "There would be family breakups," Kango said. "There would be child abuse and neglect. It's part of the tragedy that happens that started when the medical system took over medicine."
Before colonization, Kango said there were no doctors or nurses in Nunavut, so men and women stepped forward to be midwives.
But in the 1960s and '70s, when western medicine arrived full force, mothers had to leave their homes, husbands and children six to seven months before their delivery to give birth in distant hospitals.
"With this kind of method of hospitals to send the mother out without husband or parents to attend, it was hard for the mother," Kango said. With increased stressed, they would smoke more, lose their appetite and lose interest in looking after themselves. Oftentimes, health professionals couldn't speak any Inuit languages, leaving the women isolated in pain.
Even now, Kango said women must leave home for hospital two weeks before their due date because airlines won't allow them to come aboard later for fear of early labour. Kango said women with low-risk pregnancies will be able to stay at home as more local midwives get their diplomas from Nunavut Arctic College, with some going on to get long-distance degrees from Laurentian University in Sudbury, Ont.
"A healthy community has to be one where women can give birth," said O'Brien, who has been travelling to Nunavut for three years to speak with traditional midwives, most in their 80s. They share stories of feeding the best cut of meats to expectant mothers and delivering babies in ice houses, or tents made of furs. That history is informing the new midwifery program.
"The more confident we get (in the training program), the more willing women are to stay in their community and be confident the midwives will look after them," O'Brien said.
Part of the program emphasizes cultural competency and respect for traditions. O'Brien said non-Inuit midwives or nurses used to encourage Inuit women to scream or moan their way through painful labour.
"Apparently, it's very shameful to make a lot of noise and be heard, so by encouraging women to behave in a way that doesn't sit well with their community and also the kind of behaviour that would embarrass them after the fact, is not right," O'Brien said. "We need to know how people like to do things when we go into health. The traditional midwives have become a resource for us."
The new midwives will be able to use that knowledge, and their native language to explain the birthing process, post-natal depression, good diets and the best sleeping positions for babies.
"It's a beautiful feeling watching and speaking and helping the delivery of a baby," Kango said. "It's a fantastic feeling knowing that a new form of body will be coming into the world to celebrate the family."
