Midwifery in Canada - Nunavut

Report submitted September 2007

Midwives Association to hold conference
The Midwives Association of Nunavut is now a registered society. Midwives who practice in Nunavut no longer need to join the NWT Midwives Association. The association has formed a board with members from across Nunavut; Regilee Ootova from Pond Inlet is serving as the interim president and Natsiq Kangoo of Iqaluit as the vice president. The purpose of the Midwives Association of Nunavut is to support and promote the reintroduction of Inuit traditional midwifery as well as support the registered midwives practicing in Nunavut. The association will support the Department of Health and Social Services and Nunavut Arctic College in their work to develop programs and training for midwives. A gathering is planned for February 2007 in Iqaluit, where traditional midwives from across Nunavut will be honoured.

Maternity Care Worker/Midwifery Program
Congratulations to the first-ever grads of the one-year-long maternity care worker certificate program: Diane Tiktak and Rachel Jones. The second intake of five students began their studies in September at the Kivalliq Campus in Rankin Inlet. Two students are from Arviat and three from Rankin Inlet. After 8 weeks in Rankin Inlet, the Arviat students went home for practicum and further education. This was done to facilitate family life, accommodation for the students, and program involvement for the community. A clinical instructor went with the students to assist with the practicum. Meanwhile, the curriculum for the second year is being tested and the practicum will take place in Rankin Inlet and Iqaluit. A successful completion of the second year will grant a diploma in midwifery. This will be followed by an internship year. The University College of the North (UCN) works with Nunavut Arctic College on the midwifery program. UCN’s involvement will ensure that the final part of the program, access to baccalaureate equivalent courses for midwives, will be available. The MCW/M Program is designed to strengthen the skills and increase the number of Inuit staff in the field of Maternal and Child Health. Elders were involved in developing the curriculum. At two separate meetings, Elders from across Nunavut defined what the cultural components in the program should be.

As well, video interviews were conducted with traditional midwives to record their knowledge. This knowledge was integrated into each course and will also be available as a stand alone manual. We are looking forward to including Pauktuutit’s extensive collection of traditional birthing knowledge into future coursework. Our goal is to ensure that all registered midwives – that is, all midwives who meet professional standards – have a working knowledge of and respect for traditional Inuit practices around childbirth.

Legislation
The Government of Nunavut plans to have legislation in place by mid-2007 which will provide the legal framework that is needed to direct the practice of registered midwives in the territory. A Working Group is reviewing existing legislation from other jurisdictions and determining what changes are needed to respond to the unique needs of Nunavut. A legislative drafter will prepare the actual legislation, which will be brought to the Legislative Assembly as a Bill.

Background
The effort to formally train and recognize midwives in Nunavut began more than a decade ago. In 1993 the Rankin Inlet Low Risk Birthing Project started after lobbying by women from the then Keewatin Region. A three year project was funded by the former Keewatin Regional Health Board and a Federal Government NHRDP Grant. The project granted low risk pregnant women the choice to give birth at the birthing centre in Rankin Inlet with midwives from the south. A maternity care worker was also hired with the intent to assist the midwives and to participate in a future training program for Inuit midwives. In 1996 the Project was incorporated into the health care system as a new program and became known as the Rankin Inlet Birthing Centre which is still operating, now part of the new health centre in Rankin Inlet. Since 1996 there has been an ongoing difficulty to recruit and retain midwives, delaying the opportunity for expansion and program development. In March of 2005 there was renewed activity to fulfill the recommendations from the project and stable staffing was in place which made it possible to move forward again. A Midwifery Implementation Committee has also been formed to examine and plan the expansion of midwifery services in Nunavut.