N.W.T. birth workers crowdsource support, call for midwifery expansion

After a labour shortage forced three months of baby deliveries to Edmonton, birth workers are crowdsourcing child care, birth services and funds for roughly 120 Northwest Territories and Nunavut residents who planned to give birth in Yellowknife.

The Northern Birthwork Collective's Sabrina Flack and Degha Scott say the current situation could have been avoided through support for expanded midwifery and birth services. They also note that people in the N.W.T. and Nunavut have faced the prospect of giving birth away from their home and support system for generations.

"This is really traumatic for a lot of families.... [It's] a burden to have to leave your community to come to Yellowknife. Having to go to Edmonton is just that extra burden."

The group's fundraiser prioritizes Indigenous families "who are disproportionately affected" with the prospect of giving birth away from their homes, communities and partners, said Flack. 

"Many people will be going alone and will be quite isolated in Edmonton for anywhere between three to six weeks, depending on how their pregnancy goes," she said. 

'Not a shock'

"Staff at this hospital have been ... demanding for a better work environment and it's not a shock that they are short staffed and not able to provide services," said Flack.

"There have been years of advocacy for midwifery to be a priority in the North [which] would take a huge amount of pressure off of our medical system."

The N.W.T. government will provide $50 a day plus $18 for meals for each individual and their escort. Even if some individuals qualify for a stay at the Larga boarding home, which offers food and lodging to travelling patients from the N.W.T. and Nunavut, the out-of-pocket expenses for unplanned costs such as child care will increase the burden on families, said Flack and Scott.

Northern birth workers created a Facebook group to connect people travelling south with childcare, meal and errand support in Edmonton and even people who can donate milk for children who must be left behind in the N.W.T.

The group also connects people to birth workers who live down south, are familiar with Edmonton's hospital system and can provide prenatal visits and "emotional support during a really, really challenging time," said Flack.

'Frustrating and infuriating'

Simply travelling to Yellowknife leads to increased costs for families in the N.W.T. and Nunavut who cannot give birth in their communities, said Scott, who's also with the collective.

The collective has been trying to build up birth work and midwifery in the North for exactly this reason.

"It's pretty frustrating and infuriating that this is happening and only coming to light now because it's affecting more than just the Indigenous population. This has been affecting Northern communities for generations, for hundreds of years since the 1800s since our birthing practices have been colonized."

Heather Heinrichs, president of the Midwives Association of the Northwest Territories, said a fully staffed midwifery program would have lifted some of the labour pressures off nurses on the birthing floor. 

"Every person that has a midwife attending them in labour reduces the amount of care that nurses are required to provide," said Heinrichs.

Midwives meet prenatal needs, order screening tests, lab work and ultrasounds, prescribe medications, attend to people during labour and provide stitches, she said. They can give low-risk pregnant people the opportunity to birth in their N.W.T. communities.

Midwives needed in Yellowknife

The N.W.T. has one midwife on the postpartum floor, but no clinical care by midwives in Yellowknife. Two of the four positions funded by the health authority in March were not posted until last week. Two additional positions, in Hay River and Fort Smith, are filled.

The midwives association sees the failure to post the two Yellowknife positions earlier as a "misstep" in mitigating the staffing shortage, she said.

"It is conceivable that there could have been midwives in Yellowknife who could have contributed to people being able to stay in the community to give birth," said Heinrichs. 

Both Hay River and Fort Smith will continue their birth services, but anticipate surges because of people who will elect to give birth in the N.W.T. rather than leave the territory, she said.

Based on her experiences working as a midwife in Hay River, Heinrichs said adding in travel days to postpartum recovery can cause "setbacks," and the trip may not be just one, but two days of travel. 

Bringing people out of their communities for birth is "effectively separating families," she said.

"Hopefully this might spur a conversation about how important it is to be able to birth in your community [and] to build a strong team of midwives who can support training other midwives, especially people who are from communities that would like to restore their birthing services," she said.