Image
Summary
Caption: Neepeeshowan Midwives in Attawapiskat First Nation is staffed by (from L-R): Tesla Koostachin-Nakogee, Fetal Alcohol Syndrome Disorder (FASD) worker and aspiring midwife; Christine Roy Sage-Femme, Registered Midwife, and Jennifer Tookate, office administrator and assistant at births.
By Xavier Kataquapit
Windspeaker.com Contributor
Traditional midwifery is alive and well in Attawapiskat, albeit with some growing pains and struggles.
As a result of a critical meeting on March 19, organized by Christine Roy, Sage-Femme, registered midwife (SF MW), Neepeeshowan Midwives in Moose Factory have seen restrictions lifted and a new acceptance and support for midwifery emerge for the people on the James Bay coast. The meeting was held at the Weeneebayko General Hospital in Moose Factory.
The meeting was called by Roy, who has been instrumental in working with the leadership, Elders and members of Attawapiskat First Nation in putting in place an Indigenous midwifery practice.
The meeting addressed the decision by the Weeneebayko Area Health Authority (WAHA) to have no more planned births in Attawapiskat: WAHA had limited the midwives’ scope of practice to only attending emergencies in the community.
“It was wonderful to see so many people come together to find a solution to a decision that was derailing our midwifery practice in Attawapiskat. We were all grateful and honoured that Elder Dorothy Wynne was on hand to share her vast experience in lobbying for a return to Indigenous midwifery for First Nations,” said Roy.
Elder Wynne, of Moosonee, Ont., who has been on the WAHA Board of Directors for years, a board member of Ontario Native Women’s Association, and a 2015 recipient of the Ontario Medal for Good Citizenship, has long been an advocate for a return to Indigenous midwifery for remote communities. She reminded everyone that the traditional practice of midwifery had been part of indigenous culture for thousands of years.
“The people have spoken and their voices have been heard. For thousands of years Cree midwives, as they are known in Cree, ‘Kakishkapeshegit’, have been caring for Cree women in a traditional role that is part of the culture. It is important that we all understand that,” said Roy.
The meeting was attended in person by Roy; Elder Dorothy Wynne; Elder Elizabeth Tookate, Attawapiskat First Nations Council; Chief Ignace Gull of Attawapiskat; Wayne Turner, CEO, Attawapiskat First Nation; Rebecca Friday, deputy grand chief Mushkegowuk Council; Emily Eby, RM Neepeeshowan Midwives; Rollande Hookimaw, Attawapiskat First Nation, WAHA board of directors; Gordon Green MD, chief of staff, WAHA; Cherie Nicholson MD, WAHA; and Ellen Blais, director Indigenous Midwifery, Association of Ontario Midwives.
The meeting was also attended via conference call by André Lalonde MD, former executive vice president Society of Obstetricians and Gynaecologists of Canada (SOGC), consultant in Women’s Health; Elizabeth Brandeis RM, president, Association of Ontario Midwives; Joanna Noble RN CRM, Healthcare Risk Management Supervisor, Healthcare Insurance Reciprocal of Canada (HIROC); Douglas Bell MD, associate executive director, Canadian Medical Protective Association (CMPA); Kelly Dobbin RM, registrar, College of Midwives of Ontario; Crystal Culp RN, director Professional Practice WAHA; and Lesley Paulette, RM in Fort Smythe, Northwest Territories.
“As a result of this meeting and based on the input of our Elders, leadership and health experts, a solution was reached to allow the midwifery practice in Attawapiskat to continue,” said Roy.
First Nation Elders, community members and advocates have been lobbying for Indigenous midwifery on the James Bay coast since the early 1980s when the government of Ontario and provincial advocates began discussing the regulation of midwifery practices in the province.
During the consultation process that led to the creation of the Midwifery Act, which was established in 1994, Indigenous advocates, including those from the James Bay coast, successfully lobbied for an exemption of Aboriginal midwives in the Act.
This exemption identified Aboriginal midwifery as appropriately the responsibility of Aboriginal communities. Over the course of two decades, several initiatives were established to bring midwifery back to First Nations. Since then, Indigenous health advocates for building local midwifery practices have been supported by other organizations.
In 2011, Roy was hired by WAHA to conduct consultations and create a proposal for midwifery services with the eventual goal of establishing midwifery practices to communities on the James Bay coast within the health organization’s catchment area.
“There is numerous research that shows that medical relocation for birth has negative effects, especially for Indigenous women from remote communities. Allowing women to give birth in their home land is not only healthier for families, but it also gives the community the chance to celebrate the birth of their children in their home First Nation. This also allows an opportunity for local young women to see midwifery as a career choice for themselves,” said Roy.
The consultations for midwifery practices for First Nations in the James Bay area met with support from regional and local First Nation political leaders, as well as letters of endorsements from community representatives, Elders and women. Support for this initiative was also provided by the WAHA Chief of Staff, regional health organizations, SOGC, Association of Ontario Midwives and the College of Midwives of Ontario.
The proposal for midwifery practices was adopted by the WAHA board of health and in 2012 the Ontario Ministry of Health and Long-Term Care approved funding for Neepeeshowan Midwives, a new remote midwifery practice on the James Bay coast. Roy then led the building of the practice in Moose Factory for three months to build a foundation for services in Attawapiskat.
In December 2012, Neepeeshowan Midwives began their practice in Attawapiskat. Since then, they have assisted in 39 births in the community and they have supported 255 women during their pregnancies.
Their progress was stalled in 2015 when WAHA informed Neepeeshowan Midwives that the local hospital was unable to assist midwives with planned deliveries in the community. Midwives continued to provide ongoing education to nurses regarding labour, birth and basic emergencies.
The original concern from WAHA was that there was no access to an operating room if surgery were needed and no blood products if blood products were needed.
“Our midwifery practice follows through from prenatal to postnatal. We monitor and we are expert in providing early identification for any need of consultation and transfer. We are also insured by the Health Insurance Reciprocal of Canada (HIROC) which provides full support for midwives working in remote communities,” said Roy.
Midwives are trained to manage obstetrical emergencies in all settings and undergo regular recertification in neonatal resuscitation and managing emergency skills.
In the fall of 2017, Roy gathered support from Attawapiskat chief and council, as well as from local members through petitions, to reaffirm their support of choice of birth place and maintain low-risk planned births for the community. Regional support was also provided by Mushkegowuk Council Grand Chief Jonathan Solomon to support planned community birth in Attawapiskat. This led to the meeting on March 19 to discuss planned birth in Attawapiskat Hospital for low-risk women.
Neepeeshowan Midwives is staffed by Roy, Jennifer Tookate, office administrator and assistant at births and Tesla Koostachin-Nakogee, Fetal Alcohol Syndrome Disorder (FASD) worker and aspiring midwife.
Roy, originally from Sherbrooke, Que., is a long-time advocate for First Nation health services and specifically for Indigenous midwifery on the James Bay coast. She is married to Lawrence Rose, a First Nation member of Attawapiskat. Roy has known and lived with family and friends in the community for more than three decades. A registered nurse and registered midwife, she has been involved in midwifery since the early 1980s.