‘Pijitsirniq’ is an Inuit societal value that means serving and providing for family and community…a broader take on the adage, ‘it takes a village to raise a child.’ Pregnant women – and their babies – benefit from the care of family, community and elders. Healthy moms give birth to healthy babies – and the Nunavut is dedicated to ensuring the health of both.
Inuit people across the territory – community members, political leaders, health care providers, researchers and parents – have all advocated for the return of community-based birthing as an option for expecting mothers and their families. The Maternal and Newborn Health Care Strategy is a five-year plan put into place in 2009 to addresses child mortality rates. Its goals include increasing the availability of in-territory care, the number of Nunavummiut who deliver maternal and newborn care, accessibility of culturally-relevant care at all stages of pregnancy, and use of family planning and support for parenting skills.
The strategy confronts the reality of birth in Nunavut: that birth has been medicalized, removed from communities and moved into hospitals over the past decades. The strategy has put into place concrete ways to reverse this trend, including the launch of regional birthing centres in Rankin Inlet and Cambridge Bay and a greater focus on recruiting, training and employing Inuit midwives and maternal care workers throughout the territory. Nunavut has also introduced new legislation to support midwifery throughout the territory with the 2008 Midwifery Profession Act.
The Nunavut Arctic College’s Maternity Care Worker and Midwifery program is now training Inuit women in Iqaluit and Rankin Inlet and will soon be expanding to Cambridge Bay. Inuit midwives are able to provide culturally relevant care to pregnant mothers in their native language. As of 2009, three Inuit midwives had graduated from the school and are now practicing throughout the territory, providing care to women in communities outside Iqaluit.
Inuit midwives is a step towards incorporating Inuit Qaujimajatuqangit (IQ), or ‘traditional knowledge’, in all aspects of program and service delivery. IQ is traditional knowledge that is passed on from generation to generation – and includes a range of skills from making a parka to midwifery practices. In birthing situations, it means that the celebration that traditionally follows a birth can be held. Elders are able to continue these traditions, which include an initial blessing that explains the baby’s namesake and their expectations.
The Rankin Inlet Birthing Centre first started operating in 1992 and services the surrounding region, providing low-risk pregnant women with a birthing option close to home. Since its inception, it has seen over 500 births, allowing more mothers to stay in Nunavut to deliver their babies. An audit of the centre’s practices from its inception up to 2004 found an increase in the adequacy of prenatal care, no neonatal deaths, a low incidence of prenatal complications, and a significant reduction in the number of mothers and newborns who required transfer to other communities for care – from 25% to 10%. This birthing centre also operates a satellite clinic in Arviat – the community with the territory’s highest birth rate.
Another birthing centre has opened this year in Cambridge Bay. Since early 2010, Cambridge Bay has seen three births. Eventually, women from the Kitikmeot region will be able to deliver their babies in Cambridge Bay.
Nunavummiut have a lot to be proud of culturally, socially, economically, politically. In the 11 years Nunavut has been its own territory, there has been a lot of progress – progress that will continue with time. The territory is working to improve health indicators, but these changes take time and won’t happen overnight. Instead of highlighting statistics that portray Nunavut negatively, the rest of Canada, researchers and the media would do well to recognize the positive things that are happening here, contextualize statistics within Nunavut and celebrate the successes throughout the territory.