Giving Birth Alone Should Not Happen: Our Indigenous Women Need Choices

Image 1: Community Strength Credit Simone McLeod

Reflecting on my experience working with indigenous persons in remote northern Ontario and Manitoba, the one thing which has always stuck out to me as discriminatory is the treatment of pregnant woman. This is not to say the nurses and physicians working on reserve are being negative in their treatment of this specific sub-population. Rather the rules, which these women must follow along with the limited choices, they are presented with during their pregnancy through to the birth of their child. As a woman living on a remote fly in reserve in Ontario when you become pregnant your options for where to deliver your baby as well as which provider type you would like, are very limited. You do not have the option for a home birth or even a birth in your community. There is one exception in Ontario, the Attawapiskat reserve on James Bay as this community has a midwife present. The choice, for a pregnant woman, to give birth somewhere she is comfortable, with her family around her to sing their new child into the world, is not afforded to remote indigenous women. There are approx. 40 000 women in Canada annually who have to travel from remote areas to have their babies

Another matter these women have to deal with is the period referred to as confinement. This is the period of time where a women is considered possibly to deliver her baby. It occurs anywhere from week 36 and up in their pregnancy. They must leave their home, children, and support people to go to the place where they will deliver their baby and wait. They are provided with accommodation in a hostel, hotel or rooming house. From what I have been told by the patients I worked with they often felt unsafe and very alone. Until 2018, there were times that the women’s partners were not granted a flight to be with them during delivery. There were some circumstances, which did allow a partner or escort to be approved, these were, pregnant minors, women with high-risk pregnancies, women who required translators or for patients deemed mentally incapacitated. Thus, these women, were expected to spend their confinement period as well as their labour and initial postpartum period alone and isolated from their community. They would then have to fly with a 3-4-day old infant back to the reserve managing all the bags and baby gear. In image 2 below is an example of the planes that are flown to remote northern reserves, I took this photo on one of my many assignments over the years. . There are no ramps to get you on or off so the newly postpartum mother with babe in arms must traverse the steep stairs to both enter and exit the plane. As someone who has given birth twice, well supported and in the place of my choosing, I cannot imagine how scared and alone these women feel due of these rules.

Image2: Taken Myself in Sandy Lake Ontario

There have been a few positive changes since 2018 regarding this however in my experience it can still be a struggle to get a partner approved by the non-insured transfer company. There was a great article in the Toronto Star in 2017 that highlighted these concerns and brought attention to this situation. This provides hope that the future for indigenous women whom live on remote reserves will, one day hopefully, be provided with more options. Pushing towards having indigenous midwives present on every reserve will ensure that the women there are provided with the choices and care that they deserve when they become pregnant. By sharing these stories we create increased public awareness of the situation and opens the door for discussion and education. I will continue to share and advocate for the necessary changes so that in the future.