Birthing returns to indigenous communities

Aboriginal midwife Dorothy Green at her home at Tyendinaga Mohawk Territory Wednesday. The role of indigenous midwives is not limited to birth and pregnancy. They also look after breastfeeding, nutrition and parenting skills. As well as being traditional practitioners and primary healthcare providers, they are also healers and mentors of ceremonies.

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The Ontario Midwifery Program has agreed to fund indigenous midwives to bring birth back to their communities.

In Ontario, prior to January 2015, the only funding for midwives to practise on reserves was allocated through the Aboriginal Healing and Wellness Strategy that received funds from several provincial Ministries, including the Ministry of Health and Long-Term Care (MOHLTC). This funding is provided directly to the aboriginal midwives through the Six Nations Birthing Centre. These funds flow through the band council.

This historical decision came after a lot of hard work at the Association of Ontario Midwives to submit a funding proposal to the Ministry of Health and Long-Term Care in March of 2014, after a gap in funding was identified. This gap was realized after a number of Indigenous midwives who had received training were not able to access funding in their own communities.

This will allow the graduates of the Aboriginal Midwifery Training Program at Six Nations, and possibly other educational institutions, to start practising and to establish birthing clinics and centres within indigenous communities.

Prior to the funding approval in January, Indigenous midwives, as primary health care providers, were not able to access funding to practise in their communities. Physicians and nurses have been funded for many years through an agreement with Health Canada. In some cases, nurses have some training to deliver prenatal care according to Ellen Blais, policy analyst for Aboriginal midwifery at the Association of Ontario Midwives.

“This prenatal care generally ends at approximately 36 weeks of pregnancy. At 36 weeks, they evacuate women alone out of their community to the nearest hospitals, Sometimes, it’s thousands of kilometres away,” explained Blais.

“This agreement to fund indigenous midwives is making me overjoyed. This is historical,” Blais added.

Before funding was allocated, many women on reserves, rural and urban indigenous communities found themselves alone, away from their families and partners in urban major centres. This was because of limited to no access to indigenous midwifery care and birthing clinics in their local community. 

“In our cultural beliefs, we pick our mothers and we pick our fathers, and we choose to come in through that doorway. As an Onkwehonwe midwife, it’s our role and responsibility to protect that sacred space,” explained Tyendinaga midwife Dorothy Green.

“We look after the whole life cycle. It’s not just during that transition from child to woman, to a birthing mother. For us women are the centre of the family. They are the ones who give direction and provide that care and love and nurturing,” Green said.

The role of indigenous midwives is not limited to birth and pregnancy. They also look after breastfeeding, nutrition and parenting skills. As well as being traditional practitioners and primary healthcare providers, they are also healers and mentors of ceremonies. 

For Green, her role is to protect that doorway of life and death, birthing people through the doorway of death, and birthing babies through the doorway of life. They bring back spiritual, emotional, mental and physical wellness into their community, enabling the creation of sacred, powerful healing spaces.

Green dropped a 22-year-old government career to pursue her passion at the Aboriginal Midwifery Training Program at Six Nations carrying her ancestral traditions of women healers forward.

Right after graduation in 2011, Green took on a six-month contract at the Six Nations Birthing Centre. Upon her return to Tyendinaga, Green has been advocating for culturally appropriate healthcare and indigenous practice while running her own clinic with a birthing team since May 2012. She is able to practice midwifery under the 1991 Ontario Midwifery Act exemption that recognizes the practice of aboriginal midwives.

“Birth is a spiritual event, it’s not a medical event,” Green explained. “We sing to the mother so she’s hearing songs in her language. We sing to the baby so they can hear their first language,” Blais said.

Women learn to trust that their bodies know what to do during birth. Midwives are there to guide and support.

Apart from a small number of Indigenous midwives working at Six Nations, there are four other Indigenous midwives known to the National Aboriginal Council of Midwives wanting to work under the exemption in the Midwifery Act.

With the new decision to fund, Indigenous midwives will have access to the same funding mechanism as registered Ontario midwives.

For Green, it’s a choice not to register.

“The hospital is not our jurisdiction... So, we continue to  maintain Rotinonhsonnih Culture, the way the Creator intended. We chose not to put our beliefs down and pick up the other,” Green explained.

The training program model at Six Nations incorporates both the traditional and western ways. It’s a concurrent program where students get hands-on practice with clients from day one, with one month off a year.

“As an Onkwehonwe midwife, I am trained by my own people and learn both western and traditional ways in providing care to Indigenous women, families and communities in low risk pregnancies; and provide supportive care for high-risk pregnancies working in peace and friendship with the specialists and hospital staff,” Green added.

The decision to fund Indigenous midwives and Six Nations midwifery program graduates by the provincial government comes at a critical point in Green’s career. She is and has been ready to establish a birthing centre in Tyendinaga Mohawk Territory for years. She has done numerous proposals based on research and feasibility studies with the help of a business consultant funded by the Tyendinaga Mohawks of the Bay of Quinte band office.

“Being funded is a huge milestone for us, for all the time that we’ve been advocating and speaking out about bringing birth back into our communities,” Green said.

“It gives us hope, so will just see what the expectations are, what is it that they are outlining and what are they willing to do,” Green explained.

For indigenous midwives, bringing birth back is a healing process for them and their community.

“We were stolen from knowing who we are. Knowing our culture. Knowing our tradition. Knowing our ceremonies. That was supposed to be wiped out of our memory, but it’s not,” Blais said.

"Through the care of Traditional mid-wives, we are going to have generations of people who are growing up stronger, and supported knowing who they are. They are going to know their culture. They are going to be able to carry their traditional bundles. Poorer health outcomes, and the tendency to rely on mind changing substances to numb the pain of intergenerational trauma created by colonization will not exist. Midwives have the capacity to heal our future generations and defend our communities from harm by providing safe maternal and newborn care that has culture at the heart. Blais said.

“To me, it’s connected directly with re-claiming our identity and strength and resiliency,” Blais concluded.

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