Loss of expanded midwifery services 'a major blow' to N.W.T. midwife community, say advocates | CBC News (2024)

Carla Ulrich · CBC News

· Posted: Jun 05, 2024 4:00 AM EDT | Last Updated: June 5

The recent territorial government'sproposalto cut midwifery services in Yellowknife has raised serious concerns among some people outside the capital.

Although the territory said midwife programs in the South Slave would not be affected, birth workers in Fort Smith, N.W.T. disagree.

Lesley Paulette is an Indigenous midwife from Forth Smith who played a major role in expanding midwifery in the territory. She's been a midwife since the early 1990s and helped develop the first midwifery program in the N.W.T., which started in Fort Smith.

Paulette said positions in Yellowknife were filled intermittently, despite claims from the government that they remained vacant. She said that systemic barriers and delays in implementing the programcaused frustration among midwives, leading them to leave.

"There wasn't robust support to recruit and staff these positions quickly," Paulette said.

She said that midwives were excited to work in theprogram but faced challenges that made it impossible to implement full-scope midwifery practice.

"Midwives have faced numerous challenges working within a system that doesn't fully support their practice," she said. "This has led to high turnover rates and a reputation that the N.W.T. is not a supportive place for midwives."

Paulette said the proposed cuts are disheartening for midwives across the territory, who were just beginning to see positive shifts and support for their work. The sudden announcement of the cuts has dashed these hopes, leaving many feeling frustrated.

"This is a major blow to the midwifery community," she said.

Paulette also disagrees that the cuts will safeguard smaller communities. She said when the expanded territorial program was introduced, Fort Smith and Hay River received additional staffing positions. Fort Smith increased its midwifery positions to three, while Hay River added two more.

Health Minister Lesa Semmler said that supporting services in those communities is also a reason to cut the Yellowknife program and refocus their support to communities that don't have other birthing options.

"The argument that Yellowknife is taking away resources from the smaller communities is just not true," Paulette said. "Cutting the positions in Yellowknife is not going to create new positions in Hay River in Fort Smith. Those positions have already been secured."

Paulette saidthe reduction of the Yellowknife program will have broader implications for the territory.

"Fort Smith and Hay River midwives will lose the benefit of being supported by and co-ordinated with other midwifery teams in the territory," she said.

"Operating in isolation weakens the profession. The strength of midwifery care lies in its network and the shared expertise across communities."

Paulette also said right now is the time to come together to strengthen the program instead of cutting it.

"Countries with robust midwifery services have better perinatal outcomes," she said.

"Investing in midwifery saves lives, improves health outcomes, and reduces costs. Our leaders must recognize these benefits and commit to supporting and expanding the midwifery program."

'Midwifery provides a care that nurses and doctors can't provide'

Farrah Freund is the co-ordinatorofOur Babies, Our Future, a drop-in program for families. The Fort Smith native has birthed six children in the community with the help ofmidwives and now works with moms and babies through their prenatal and postpartum journeys.

Freundsees midwifery as more than just a medical service and knows first hand how important a local midwifery program is.

"Midwifery provides care that hospitals, nurses, and doctors often cannot," she said. "Midwives offer one-on-one care, continuously checking on mothers and babies, offering guidance beyond clinical needs."

"It comes naturally to just be there and take care of another fellow mother," she said.

She also saidmidwifery is important inpreserving and reclaiming Indigenous traditions. The program's potential closure comes at a time when Indigenous communities are striving to reclaim traditional practices, including midwifery.

"That's what we've been designed to do. And when I say we, I say that in respect to my ancestors, who were also midwives on the land," she said.

"That's how they brought many babies forth and helped other women do the same."

An invaluable experience

Freund recalls being a brand new mother in 2008. She was struggling to breastfeed her new baby who was not latching properly. Paulette was her midwife and knew how strongly shefelt about the bond breastfeeding would create with her son.

"I was an exhausted first time mom," she said. "Lesley was so compassionate with me"

Freund said Paulette came to her house for two weeks to help her with breastfeeding, and to offer support, even during the night time.

I remember that one night I just couldn't do it anymore," Freund said "She lived 20 minutes away from town, in Fort Fitzgerald. She got in her car in the winter, and drove to town just to come help me and make sure I felt supported."

Freund also recalled Paulette sleeping outside her hospital room after she gave birth.

"I felt supported and taken care of. There's absolutely no way anyone would do that other than a midwife," she said. "That's how amazing having a midwife is,"

"Losing the midwifery program would be a huge loss for the community."

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