Good news and bad news for aboriginal midwives

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Quebec's national assembly is about to legalize midwifery but the PQ government's bill would make Nunavik's birthing centres illegal.

By Jane George

The good news contained in a draft law before Quebec's National Assembly is that Quebec finally intends to legalize midwifery.

The bad news is that if this bill passes in its present form, traditional aboriginal midwifery becomes illegal in Quebec.

This means that Inuit midwives in Nunavik will be delivering babies against the law, and the region's maternity units will be viewed as illegal.

On May 11, Quebec's Justice Minister Linda Goupil presented a bill that sets up a new professional body for Quebec midwives.

When it becomes law, only fully accredited members of Quebec's new "Order of Midwives" will have the exclusive right to practice in the province. Their duties will include "surveillance, evaluation, pregnancy, birth and the first six weeks of the post-natal period." They will also be able to prescribe certain medications.

But this draft law makes no exemption for native midwives who may lack the kind of university-level diplomas this new order will require, although Ontario did recognize such a distinction when it legalized midwifery in 1994.

According to a 1995 Pauktuutit study on traditional Inuit midwifery, "midwifery was not viewed as a 'profession' in the [southern] sense that knowledge and expertise reside only in particular individuals who have received specialized education and training. Rather, knowledge was shared among all those who had need of it."

Extensive training

Nunavik's community midwives and those in training always receive extensive hands-on instruction from Qallunaat midwives trained in the south of Canada or in Europe.

Their course of study also includes written texts, case histories and problem-solving. The completion of training is based on the students' competency as midwives.

But this training, given outside of a recognized educational institution, will become illegal if the bill before the Quebec National Assembly passes. The bill's passage will also be a setback for the Puvirnituq's Inuulitsivik Health Centre.

Due to pressure from the community, the centre acquired its maternity unit when it was built in the mid 1980s. Another maternity unit, also staffed by midwives, started up in Inukjuak at its new community health clinic more than a year ago.

Since that time midwives have helped mothers from the Hudson Bay coast deliver more than 700 babies.

Yet until five years ago, these midwives brought babies into the world "illegally."

They operated in a legal limbo because midwifery was completely banned in Quebec. Quebec then finally legitimized Inuulitsivik's midwives by turning its maternity unit into a "pilot project," one of several projects in different regions whose success Quebec's health department was to evaluate.

Nunavik's regional health board and municipalities have watched this lengthy legalization process with growing concern.

In February the municipal council of Inukjuak passed a resolution asking for a special status or exemption for First Nations and Inuit community midwives, noting the important role they have played in their communities, "historically and continually."

This resolution says that Inukjuak is "committed to protect, defend and enhance traditional and community customs, values, beliefs and a way of life and to honour and use the knowledge of our heritage to instill the foundation to strength in our future."

Quebec City ignoring native midwives

This resolution was forwarded to Quebec's health and social services department.

But apparently officials in Quebec City only recently realized that there was concern over the status of native midwives.

At the same time midwives in Puvirnituq and Inukjuak and native groups are saying that they were taken off guard by the bill's tabling at the National Assembly before they had a chance to fully voice their concerns. They're upset about the short amount of time left to mount any response.

Michelle Audette, the president of Quebec's Native Women's Association, said that her organization and native health groups met with provincial health department officials in early May, but they appeared to be more interested in the medical aspects of midwifery than midwives' traditional role in native communities.

Luce de Bellefeuille, a spokesperson for Quebec's health department, said that this meeting with native health groups was, in fact, the "first time" that anyone had ever raised concern about the status of native midwives.

She said that another meeting is planned for early June, but wouldn't speculate on what changes in the law this last-minute consultation with native groups could result in if any.

"Through the pilot projects, consultation has been going on for nine years," Bellefeuille said. "But there's still an opening to see what their preoccupations are."

The bill is expected to be adopted before the National Assembly adjourns in mid-June.

This article first appeared in the May 28th edition of Nunatsiaq News.
Nunatsiaq News
Box 8 Iqaluit NT XOA OHO Canada

The Helper, a video produced by Pauktuutit, the Inuit Women's Association of Canada, focusses on traditional midwifery as a healthy alternative in isolated or rural communities. The video is in Inuktitut. English subtitled version available. Available from:

The Inuit Women's Association of Canada
192 Bank Street
Ottawa ON K2P 1W8 Canada
Tel: (613) 238-3977
Fax: (613) 238-1787