Midwifery program with core aboriginal mandate halted

A midwifery program designed to bring more midwives to Manitoba has been halted, leaving prospective students in the lurch and losing a core component of its original mandate – to train aboriginal midwives.

“As a student that graduated I just want to know, who is that program accountable to,” said Melissa Brown.

Brown is one of only eight graduates the University College of the North program has had in the past eight years. Another woman is just weeks away from completing the program.

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Of the eight, only two are First Nations.

Brown gave the valedictorian speech last month to UCN's first class of graduates from the aboriginal midwifery program. An Ojibwa-Navajo woman, she was especially interested in the program’s one-of-a-kind approach, a blended curriculum of aboriginal and western teachings.

Brown's class was the last one of its kind. UCN told prospective students in the spring that they were no longer offering the program for fall 2014.

UCN is now working with the University of Manitoba on a joint delivery strategy and an overhaul of the program. The two schools aren’t expected to accept new students until 2015, meaning there will be no new graduates for at least three years.

In a province with 49 practising midwives, that leaves many expecting mothers without the services they want.

Brown, who starts work at Winnipeg's Mount Carmel Clinic next week, said whenever someone hears that she’s a midwife they ask her how to get one.

“I’ve heard a lot of women compare it to winning the lottery,” she said.

It has an even bigger impact for Manitoba’s northern First Nations, which were promised the most from this program.

The UCN midwifery program began with a $1.6 million federal grant from the aboriginal envelope of the Primary Health Care Transition Fund.

According to a Health Canada fact sheet about the program, “after graduating from a four-year baccalaureate program in midwifery with a specialty in aboriginal midwifery, these midwives will enable women to give birth closer to home and receive culturally appropriate care, reducing the stress, risks and costs associated with routine evacuation for birth.”

Darlene Birch works in the Kinosao Sipi Midwifery Clinic in Norway House and is the only midwife in the province working in a First Nations community. The clinic was established in the community as part of the UCN program.

It’s not just the way you do things as far as catching a baby. It’s the understanding of the connection that the women and the families have to their traditions and to their land and to their cultural practices.- Darlene Birch, Kinosao Sipi Midwifery Clinic

Birch helped build the program’s original curriculum -- a massive effort that involved researching programs around the world and holding community consultations here in Canada.

“I think that the uniqueness and the true value of the program was how it was in response to communities and to traditional midwives that were still alive,” she said, adding that most of the those women have since passed away.

When asked what traditional aboriginal midwifery is all about she explained that “it’s not just what you do, it’s not just the way you do things as far as catching a baby. It’s the understanding of the connection that the women and the families have to their traditions and to their land and to their cultural practices.”

Program grinds to a halt

Millions of dollars have been spent to support the program. In 2009, the province boosted funding levels to more than $800,000 a year, a figure UCN said has remained steady over the years.

But first-year students have only been admitted to the program twice in eight years. Of the first class, which started in 2006, only one student was able to graduate.  

Christine Queskekapow is a Cree woman from Norway House. She was part of that original intake -- a group of all aboriginal students studying in The Pas and her home community. When the women were about to enter their fourth year of studies, UCN suddenly announced the program would move south to Winnipeg.

“We didn’t even get an invite from somebody saying 'do you want to apply to this program?' We weren’t even given the choice,” she said.

Many people involved with the program have said the move to Winnipeg was the beginning of the end for the distinctly aboriginal program - originally called kanaci otinawawasowin Bachelor of Midwifery, which translates to "sacred midwifery" in Cree.

Melissa Brown started in the second, and last intake to UCN midwifery in 2010. She said during her first weeks at the Winnipeg campus, there were no signs of the aboriginal curriculum and none of the core staff were aboriginal.

Determined to integrate tradition into the program, Brown took matters into her own hands.

“I would bring the students to ceremonies - so we would have sharing circles, pipe ceremonies, sweat lodge ceremonies,” she said.

“Some of the students received their spirit names, two of them are sundancers. These are non-aboriginal women who really connected with the cultural aspect of the program.”

What’s the future?

Brown questioned the commitment of the province and the universities to keeping the program focused on its original mandate to train aboriginal midwives to work in the north.

When asked if the new program delivered by UCN and University of Manitoba can still be characterized as an aboriginal midwifery school, the minister of education and advanced learning, James Allum, said, “Well, the program will serve aboriginal Manitobans, it will serve northern Manitobans, in fact all of Manitoba. Distinguishing it on that basis forgets that the objective is to make sure there are more midwives and more aboriginal midwives.”

Allum acknowledged there is a high demand for midwives throughout the province and said the new partnership between UCN and the University of Manitoba will make the program stronger than ever.

In hindsight, there could have been some issues that maybe were done differently but, I’m not going to point any fingers or anything like that.- UCN spokesperson Jim Scott

UCN spokesperson Jim Scott admits the midwifery program has had its challenges.

“In hindsight, there could have been some issues that maybe were done differently but, I’m not going to point any fingers or anything like that,” he said. “So I’m just focused on what we’re going to be doing about the midwifery program in the future.”

Darlene Birch said she hopes the committee working on the new program acknowledges how the midwifery school came about and that she can inspire them to preserve the original curriculum as much as possible. She said it should also give priority to training aboriginal midwives to reflect the fact that there are higher birth rates for aboriginal women than the general population.

Allum said this concern is being taken seriously, and that the new program will not lose “the very important aboriginal context that was at the heart of the program when it was first designed.”