CAM (represented by Tonia Occhionero and Nathalie Pambrun) and NACM (represented by Carol Couchie, Ellen Blais and Alisha Nicole Apale) met with senior staff to advance our government relations work.
We met with policy directors from the offices of the Status of Women Canada, Indigenous Services Canada and Health Canada.
Nathalie Pambrun is a Franco‑Manitoban Métis midwife who has practiced in urban, rural and remote communities across Canada and internationally. Bridging environmental and reproductive justice movements at the community level, she embraces a human rights approach that effectively respects the coming generations. She is committed to midwifery care that is accessible, equitable, and culturally safe.
Nathalie has also been a member of the Core Leadership of the National Aboriginal Council of Midwives since its inception, and has served a two‑year term as the organization’s Co‑Chair from 2011 to 2012.
I graduated from the Midwifery Education Program at Ryerson University in 2013, and I recently completed my M.A. in Gender, Feminist and Women’s Studies at York University. My research focus was on Indigenous midwifery and decolonizing health care.
Currently, I work at Seventh Generation Midwives Toronto, I am also a contract lecturer and the Aboriginal Student Coordinator at the Ryerson MEP. I am committed to the strengthening and growth of Indigenous Midwifery and have a particular interest in midwifery education, both community and university based.
It has been a pleasure to work with Melissa Brown as the Co‑Chair of NACM over the last two years, and I say anushiik for all her contributions to NACM.
There are so many opportunities for NACM coming up, I appreciate this role and the attendant responsibilities. I will do my best to serve the community well during my time as Co‑Chair.
“We were able to visit more communities than had been originally envisioned by the project and made some good connections in those communities. We appreciate the hard work of Community Programs Lead, Evelyn George, who did an excellent job of positioning NACM as the voice of Indigenous midwifery in Canada.”
— Melissa Brown, Co‑Chair
Few Indigenous families in Canada have access to culturally safe midwifery care near their home communities. Transforming the experience of birth is central to intergenerational healing for Indigenous families. The project was designed to address the lack of access to Indigenous midwives.
Throughout the one-year project, 12 Indigenous midwives and Indigenous student midwives visited a total of 10 communities to deliver health education workshops, advocacy meetings or both. Another 12 Indigenous midwives and other health professionals developed and delivered 8 webinars on topics that were attended by a total of 95 persons. Fifteen midwives participated in a pilot mentorship program.
The project also enabled NACM to host a feast for 83 local and visiting Indigenous midwives during the ICM Congress in June 2017, and allowed us to meet with the federal ministries of Health and Indigenous Services, national Aboriginal Organizations, educational organizations and provincial and territorial midwifery associations.
Bringing Birth Home was funded by Save the Children Canada (SCC) and represented the second year of an ongoing partnership between SCC and NACM.
This framework will serve as a national occupational standard to support further development of critical human resources, educational resources and career planning tools. The Core Competencies Project is being undertaken in partnership with Save the Children Canada (SCC) and is funded with support from Johnson & Johnson.
In July 2018 NACM started a consultation process with Indigenous midwives to identify key competencies for the development of a National Indigenous Midwifery Competency Framework. Following this, NACM conducted a national Indigenous midwifery occupational survey. Through this survey, NACM aims to understand the size and profile of the Indigenous midwifery sector, expected attrition and anticipated changes in the employment patterns in order to meet the needs of the Indigenous community.
Following the survey, a group of NACM members from across the country came together in Toronto for a core competencies workshop. Indigenous midwives present at the workshop represented different geographic regions, registered and exemption midwives, First Nations, Inuit and Metis midwives, and different levels of experience. Facilitated by the Competencies Group, the midwives spent two days mapping out the unique roles of Indigenous midwives and the aspects of care that we provide. Together the midwives developed a set of core competencies for Indigenous midwifery in Canada. The next step of this project will be to have these core competencies reviewed by the wider NACM membership, with the end goal of a set of core competencies of Indigenous midwives developed and validated by Indigenous midwives.
Finally, NACM is undertaking a public engagement strategy with government, midwifery associations, and midwifery education programs and stakeholders in Canada. The work on this project will continue until June 2019. NACM member Cheryllee Bourgeois is working as the Project Lead to support the development of the Framework and NACM member Evelyn George is working as the Partnership Development Coordinator to support the public engagement strategy, supported by the NACM SCC committee.
The participants were selected for their potential to have a lasting impact on the lives of girls and women. The Women Deliver website reports that, as a group, they have already driven tangible progress on a wide range of issues, including sexual and reproductive health and rights, LGBTQ+ rights, peace and security,waterand sanitation, gender-based violence, education, maternal health, and political participation. The Young Leaders Program provides youth advocates with opportunities to build and strengthen their advocacy capacity and skills. Those opportunities include: the Women Deliver’s Young Leaders Program Digital University, Speakers Bureau, small grants, sponsorship to the Women Deliver 2019 Conference, and more.
When asked for her thoughts on her acceptance, Emily said,
“I am very excited to have been selected for the Women Deliver youth leadership program. It is a large international organization full of many talented, brilliant young people working to further women’s health, well-being, and equity. I feel totally honoured and humbled to have been selected to be a part of their cohort, and look forward to meeting these amazing folks, both virtually and in person at the Women Deliver conference in Vancouver in 2019. I think the program will be of huge benefit to my skills as an Indigenous midwife and women’s health advocate. We haven’t started any formal work yet, but I am looking forward to seeing what the program has in store in the near future.”
As the student Core Leader in 2017, Emily applied herself diligently to pursuing NACM’s vision of integrating an Indigenous midwife into every indigenous community in Canada. She has shown herself to be a considerate and reliable leader, as motivated to learn about leadership as she is to learn her profession. Congratulations, Emily!
Going to Attawapiskat was truly life‑changing in that it confirmed my desire to practice midwifery in rural/remote northern Ontario. And when I say north, I mean, north of North Bay! While I was there, I worked within the Attawapiskat Health Centre where Neepeeshowan Midwives is housed. I built inter-professional relationships with other health care providers, attended training sessions, held prenatal classes with a community member who became a friend of mine, and enjoyed walks by the Attawapiskat river with the founding midwife’s dog. Not to mention, the cute seals who made an appearance more than once.
If you live in Canada, you probably saw a lot of media coverage on Attawapiskat in recent years. Although some of it is true, we must remember that the media can really misrepresent Indigenous communities. It is true that communities are still healing from colonization, the wrath of residential schooling and consequent effects, but there is such beauty in how resilient we are. One of the ways in which Indigenous communities are taking back their traditional practices is in the craft and strength of Indigenous midwives.
As a Cree person, my true healing began with midwifery and there was something so incredibly powerful in being on the land and gaining more experience in a remote context while growing part of a future generation inside of me. When I traveled to Attawapiskat, I was in my second trimester of pregnancy. As I sat on the plane, I was reminded of the reality that childbearing people in remote communities must face when they get pregnant. While midwives support choice of birthplace, confinement and flying outside of the community is still an issue, considering people must leave behind family and other children.
When I graduate, I hope to join and support midwives who are working hard to provide culturally appropriate care for Indigenous families, especially in remote northern communities. I strongly encourage other students to consider a remote community placement on their journey to becoming a midwife. Even though I did not attend any births, working in Attawapiskat only solidified my desire to work in Cree communities, and allowed me to practice clinical skills and understand a remote midwife’s scope of practice. In obstetrical emergencies, they are it!
Some day, I hope to see more midwives working in Cree communities and continuing to support all of the work that Christine Roy started many moons ago. I also hope to see and contribute to a Cree community-based Midwifery Education Program that would allow community members to become midwives without leaving the James Bay.
I had been looking forward to my third year in the Midwifery Education Program because of the potential opportunity to fly to my family’s ancestral lands and support my People as a student midwife. Now I look forward to graduating, life‑long learning, and solidifying clinical skills, which will make me a better health care provider to my People in remote northern Ontario.
This young woman labored through the night and into the day, well supported by her partner and family. When she finally arrived at the pushing stage, however, her energy had reached a very low point. We tried various positions, techniques, and encouragement to help her push the baby out into the world. Her pain was intense and she was starting to give up.
With my fellow midwife, we strategized about what else we could do to help the birth along. We knew that if things did not continue to advance, the woman would need to be moved to hospital. Sensing the gravity of the situation, this woman’s sister picked up her hand drum and went into the adjoining room and began to drum and sing, asking for help from Creator to bring this baby forth. The energy in the room began to change and the labouring mother was visibly revived. In fact, we were all revived and renewed.
The woman’s determination and strength was restored and she began to push with new energy. Our efforts to coach and guide her flowed along with this new energy. The song from the other room ended, and I immediately went to ask for another.
“It’s working! Keep singing! Your song is helping to bring this baby!”
Not long after, the baby was born to the sound of the drum and his auntie’s song exactly as his parents had wanted things to be — surrounded by the love of family and community and in his own home. It was an incredible experience for us all.
