Maria Rose Sikyea is a young Dené artist living in Yukon with her adorable three-year-old. When I spoke to her in November, she was expecting a second child, whom she hoped would be delivered with the assistance of a midwife. But like many others in her situation, Sikyea faced a considerable roadblock: Yukon is the only Canadian jurisdiction that does not offer access to government-provided and funded midwifery.
In theory, this roadblock shouldn’t exist. Midwifery is a centuries-old profession relied upon internationally in traditional and hospital assisted births. But despite a five-year effort to get midwife services regulated and funded in Yukon, midwifery has been impossible to implement. Though I am relatively new to this struggle, I already feel like those grannies at protests holding up signs reading, “I Can’t Believe I’m Still Protesting This Sh*t.”
For the birth of her first child, Sikyea moved from her home in Northwest Territories to British Columbia. The province and the territory both have regulated and funded midwifery, making it accessible to her without causing financial stress. She chose a home birth, as the medical model isn’t her preference, and because it resembled the traditional births she was told of, coming from a generation and lineage of traditional midwives.
| The midwifery profession |
| Midwives must have formal educational training and be accredited through a midwifery program. The midwife supports the birthing person through the prenatal, pregnancy and postnatal stages of birth. They are able to deliver the newborn in more traditional settings, such as a person’s home or at a Birth Centre. In Canada, midwifery programs are obtainable at the University of British Columbia, Ryerson University, McMaster University, Laurentian University, l’Université du Québec à Trois Rivières, University of Manitoba and Mount Royal University. |
Now living in Yukon, Sikyea had the option of hiring the services of a practising midwife for her second child, but with a catch: she would have to pay thousands of dollars out of pocket. Also, with only one practising midwife in the whole territory there was no guarantee this option would be available to her when she needed it.
Sikyea told me birthing in the hospital was not an option she really wanted to consider. “I want to retain my power, as an Indigenous woman,” she said. A power she refers to as being taken away through colonization and the medicalization of births.
As explained in the book Born Into My Grandmother’s Hands: Honouring First Nations’ Birth Knowledge and Practice in North Yukon (The Firelight Group, 2019), until very recently, births in Yukon took place based on traditional knowledge and practice: “At the turn of the 20th century, there was a push to medicalise and modernise childbearing practices across Canada. Childbirth in a hospital setting, and under the authority of physicians, grew steadily. By the 1940s, midwifery was ‘no longer an option for the vast majority of Canadian women.’”
“I would give birth in a wall tent, surrounded by women and community on my traditional territory, if I could,” said Sikyea.
What gives, Yukon?
Geography is the easiest excuse for the lack of access to midwifery in Yukon. North of 60 is a world of mystery and wonder to many, including Canadians. Yet the Northwest Territories regulated midwifery in 2005, and Nunavut in 2011. This is clearly not a “North” thing.
At the same time, getting midwifery covered was hardly simple in the rest of Canada. Ontario only regulated the practice in 1994, Alberta in 1994 (with—major eyeroll—public funding not available until 2009), Quebec in 1999, British Columbia in 1998, Manitoba in 2000, Saskatchewan in 2008, Nova Scotia in 2009, and finally, New Brunswick and Newfoundland and Labrador in 2016.
How can midwifery services still be treated as a luxury in Yukon and not a fundamental right? How can we have better access to weed than midwifery care?
In 2015, then–Yukon NDP health critic Lois Moorcroft brought the issue to the Legislative Assembly. “Why is this government still failing to uphold women’s reproductive choice by not providing regulated and funded midwifery care?”, she asked.
In 2016, a newly elected Liberal government promised in its throne speech that Yukoners would have access to regulated, funded and implemented midwifery. A public consultation was performed in 2018. The results reiterated what most Yukoners and birthing people already knew: midwifery services are awaited with much anticipation in the territory.
The Community Midwifery Association of Yukon (CMAY) is one of the groups leading the charge for regulated midwifery in the territory. Its members were delighted to see their efforts finally come to fruition, when at a 2018 annual meeting the territorial ministers of health and community services reaffirmed the government’s promise and timeline for action. The room was filled with sighs of relief and excitement. Queen’s We Are The Champions was probably the only thing missing from the scene, as people hugged (in a pre-COVID world) and congratulated each other for the years of effort and advocacy.
It was a truly beautiful moment, one that I am still honoured to have witnessed. Briefly, my skepticism of government promises was alleviated. Briefly, the Yukon government caught me slippin’. In October 2019, CMAY was told, yet again, that regulated midwifery would have to wait.
Midwifery and COVID-19
The pandemic forced an alternative approach to child birth on Yukoners. Rules implemented last March required birthing people to attend checkups and ultrasounds on their own. For birthing, only one support person was permitted in hospital. If you had intended to give birth with the presence of one person all along, be it your partner, friend or doula, you’d be fine.
But if birthing in your culture is meant to happen surrounded by community, mothers, aunties, elders, doulas, etc., the pandemic put an end to your established and comfortable birth plan. Many Yukoners saw, once again, how necessary midwifery services are. The option of birthing at home, surrounded by a support network, especially at a time of uncertainty, was requested by many.
Birthing people living outside of Whitehorse have known what this dislocation feels like for some time. Four weeks prior to their due date, they are forced to relocate to the city. Sometimes they take partners, younger children and other family members with them. Many must stay in a hotel during that time, as there are very few alternative accommodations. Whitehorse is facing a housing-crunch; it is nearly impossible to find housing on a short-term basis.
At the book launch of Born Into My Grandmother’s Hands, I was left stunned and reflective by how Bonnee Bingham, Vuntut Gwitchin citizen from Old Crow, described the impact of this birthing process. The last trimester of pregnancy is an important part of welcoming the new baby for its family and community, a time of celebration and joy, she said. The four-week pre-natal and one-week post-natal stay requirements in Whitehorse deprive both family and community of this important rite.
Deaths are treated differently and are much more visible, said Bingham. The person dying is either surrounded by family or community, or medivaced out to Whitehorse or Vancouver. “How do you think seeing death and missing out on the joys of childbirth affects a community?”, Bingham asked.
“I acknowledge that I live, breathe and play on the traditional territories of (Insert Yukon First Nation).” The words are now spoken by government officials at every press conference, before every public event. What do these words mean, when traditional practices, such as access to midwifery, are made impossible to so many?
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Sikyea told me she wanted to give birth in the most traditional way possible. She attempted to get funding for private midwifery care through Jordan’s Principle, but this federal money is only available to her postpartum. She ended up paying out of pocket for bringing in additional support, and in exchange, teaching traditional work.
It was not enough to access the level of care she needed for birthing. Sikyea resorted to setting up a GoFundMe page to seek financial help from the community and from strangers, which she said she found very stressful. Her strength, tenacity and courage are admirable, to say the least. It shouldn’t have been needed in a country that prides itself on its publicly funded and accessible health care services.
With elections in the territory this coming November, the current government has made another promise: Yukon will have regulated, funded and implemented midwifery services by the fall. I’ll believe it when I see it.
Paige Galette is a Haitian activist, feminist and nationally based community organizer and educator. She currently lives and works in the traditional territory of the Kwanlin Dün First Nation and Ta’an Kwäch’än Council (Whitehorse, Yukon) where she sits on the board of the Community Midwifery Association of Yukon (CMAY). Paige sits on the steering committee of the CCPA National Office.