Why Indigenous women are bringing 'the first ceremony' — birth — back to their communities

Unreserved50:00Bringing birth back into Indigenous communities

Ellen Blais was taken from her mother when she was a few hours old. As a Sixties Scoop survivor, Blais didn't grow up knowing her community, her culture or who she was. 

"I was adopted into a non-Indigenous home and there was racism," Blais told Unreserved host Rosanna Deerchild. "I'm now able to say that out loud. There was a lot of racism in that home."

As an adult considering her career path, Blais thought about what she could do to prevent her own experience from repeating itself in other children's lives. 

"I thought, 'Someone needs to stand at the bedsides of our women and stop these apprehensions from happening. Because it's not OK,'" she said. "It's not OK that I grew up for so many decades of my life not knowing who I am, not understanding my identity and my culture. 

"And so I decided to become a midwife."

Blais graduated from university with a midwifery degree in 2006, established a practice called Seventh Generation Midwives Toronto and then worked for a child welfare agency as a high-risk prenatal midwife. That job cemented the importance of what she was doing, she says.

"I worked with 500 moms and 500 babies over those years," Blais said. "And it took me a while to actually say, 'You know what? Every woman I'm working with is my birth mother, who I never knew. And every baby that I'm supporting this woman to bring into the world, and not be taken from her, is me.'

"It was an incredible realization that … this is who my mom really was," she continued. "I never knew her, but this is who she is. And she loved me."

Midwives were 'cast to the side'

Today Blais is the director of Indigenous midwifery with the Association of Ontario Midwives, where she works to expand midwifery services to Indigenous communities across the province.

Midwifery began to be recognized and regulated by Canadian health-care systems in the early '90s, but it's a practice that has much deeper roots around the world.

In North America, Indigenous midwives and doulas practised their traditions and helped bring Indigenous babies into the world long before the creation of government health-care systems. They were mothers, aunties, sisters and grandmothers who had birthing skills — and knowledge of traditional birthing ceremonies — that they passed down over generations.

But after European contact, colonization and the Indian Act, Indigenous midwives were "cast to the side," Blais said. Birthing was taken out of communities and homes and put in hospitals, she added.

So when Indigenous women went into labour, they would often be sent outside their community to give birth, sometimes hundreds or thousands of kilometres away.

They often still are.

"We call it birth evacuation," Blais said.

It happens, she says, because "there's no longer the knowledge base in the community" to provide fulsome prenatal, birthing and postpartum care.

But travelling outside of their community can be dangerous for pregnant Indigenous women, she said.

"Anti-Indigenous racism [is] rampant in the health-care system," Blais said. Midwives would be intervening in "those horrific colonial processes," like child apprehension, she said, which asserts that "taking children away from their parents is the right thing to do."

"And it's not. We know that."

In other cases, people have died waiting for care or not received the right kind of care, Blais said. And there remains the spectre of decades of forced or coerced sterilization.

"We believe if we had midwives there, that wouldn't happen," Blais said.

Birth in a remote Quebec community

Traditional birthing practices were part of the Cree community of Chisasibi, in northern Quebec, for generations. But like in many remote communities, they were replaced by birthing in institutional settings.

Denise Perusse is from Chisasibi, which sits about 1,500 kilometres north of Montreal. She says she had a difficult experience when she went into labour for the first time in 1995. Her contractions became irregular and hospital staff warned her she might have to be medically evacuated.

"I was scared to be alone," Perusse recalls. "I would have been sent down south with maybe one escort; I don't even know back then. So just knowing that I wouldn't have the support of the important people in my life was scary."

Her mother recommended bringing in a woman who had helped others during difficult childbirths. "And I said, 'Yes. Anything, anything — I don't want to leave.'"

The woman, a traditional Cree midwife named Sarah Ratt, came into the room to check on Perusse. The midwife was able to locate the baby's heartbeat just by looking at Perusse's belly, got her to walk around and helped the labour progress.

Then, Ratt told Perusse a story about how she gave birth in the bush, with only her own two young children in tow. She chopped wood, warmed up the home and got everything ready, all on her own. "So it was kind of like, I think, her way of saying, 'If I can do it in the bush, you can do it here.'"

Perusse gave birth to her daughter, Luna, without needing to be sent away. She later learned that Ratt died in a car accident a few months after Luna was born; her daughter was the last baby Ratt helped deliver.

"I felt so blessed to have had that opportunity for that help from this woman," Perusse said.

In 2017, midwifery services returned to the Eeyou Istchee territory, along with a temporary birthing home in Chisasibi, where Perusse served in an administrative role. She hopes to become a midwife one day.

Birthing is 'sacred'

A lot has changed for Indigenous midwives since Blais graduated from midwifery school in 2006.

There are now 35 Indigenous midwives in Ontario, according to the Association of Ontario Midwives (AOM). Those are among the roughly 120 Indigenous midwives, midwife elders and student midwives across Canada, the National Aboriginal Council of Midwives says.

To further boost those numbers, the AOM helped establish provincial funding for Indigneous midwifery education programs in several First Nations communities. An exemption clause in Ontario's Midwifery Act helps facilitate these teachings; it allows Indigenous people who want to practise as midwives in their communities to do so without getting a four-year midwifery degree from a university or registering with the College of Midwives of Ontario.

Samantha Spencer is one of the midwives in training through Kenhtè:ke Midwives in Tyendinaga, near Kingston, Ont.

While not all Indigenous midwives incorporate cultural teachings into their practice, Spencer says culture and ceremony will be an important aspect of her journey.

"Part of my healing and my community's healing — and healing as a people — is bringing back our cultural practices and incorporating that into our learning," Spencer said.

"I don't think I'll ever stop learning ceremony," she added. "All of those things that I have learned I hope to incorporate [into my midwifery practice] and I hope to give to the generations to come."

When Madison White was first pregnant, she had the support of family members and a midwife. But she said she saw friends who were pregnant at the same time not receiving supportive care from doctors — so she decided to become a doula and has been doing this work since 2017.

A doula provides emotional support, education and sometimes spiritual care to a pregnant person, in tandem with medical care from a doctor or midwife.

"I became an advocate for … the ancestral ceremonies of birthing," said White, who is from Akwesasne. "Allowing your body to do what it needs to do, versus [a doctor saying], 'OK, get up on the bed. I'm clocking out in two hours. We gotta get this baby out.'"

How a baby comes into the world matters, she said.

"When we look at our names, our Indian names, they set the stage of how our birth went, how the pregnancy went, what the factors were of the day of you coming into the world," she said. "And it's also who you will grow to be … so that's why birthing is so sacred and important to us and the new life that's coming in … it's the first ceremony."

Tagwanibisan Armitage-Smith is a birth educator and doula-in-training with the Aunties on the Road doula collective in Ottawa. Her home community is Kitigan Zibi Anishinabeg First Nation in Quebec.

She believes that most doula training in Canada highlights being professional and suppressing emotions. But Indigenous doula work emphasizes community relations and understanding emotions, she said.

"It helps us show up better for [our clients]," Armitage-Smith said.

In her eyes, doing this work — and incorporating traditional practices — is healing the damage caused by colonization, birth alerts and the Sixties Scoop.

"When you break the family up at its core, at the very start of life, that is the biggest way you can destroy people," she said. "And so that's really what this reclamation is all about … piecing ourselves back together."