Midwifes

In North, in the inuits communities, the midwives are very significant.

Midwives In North, in the inuit communities, the midwives are very significant. For a few years, the file of the midwives has been very active in Quebec. In Nunavik, the midwives always belonged to environment-health. It is particularly true on the coast of Hudson.

Puvirnituq, where the midwives sit at the CMDPSF

The Council of the doctors, dentists and pharmacists of the center of Inuulitsivik health, in Puvirnituq, is in Quebec to only include/understand midwives. The CMDP is there thus a "CMDPSF", a midwife sitting at the executive committee of the Council. The practice of the midwives, in Hudson Bay, undoubtedly constitutes what there is moreover inuit in the system of health of Nunavik. The remainder is entirely borrowed from the White. Since its creation, in 1986, the maternity of the Center Inuulitsivik (approximately 125 childbirth per annum) always had recourse to the midwives.

Its opening put an end "to this too long time of dispossession of lived family and cultural attaché with the pregnancy and the childbirth", according to the responsible doctor, at the time, of Community health, Dr. Jean-François Proulx. For the coast of Hudson indeed, towards 37-38 weeks of pregnancy, the women were to leave their family, to go in the South, a medium where their language was not spoken. In Kuujjuaq on the contrary, the childbirth always took place on the spot since the opening of the first hospital. Maternity makes it possible to keep in Puvirnituq a maximum of childbirth in North and not to separate the families more.

"To repatriate in Nunavik the childbirth made in Montreal or Moose Factory, in Ontario, is a request of the population", known as Nellie Qumaluk, midwife. She points out that the midwives, in Puvirnituq, existed well before the Law on the practice of the midwives within the framework of pilot schemes (March 1993). "And we will continue to exist independently of what it will occur of these pilot schemes" Except exception, the training of the Community midwives is done on the territory.

Some midwives of the Center of Inuulitsivik health and Dr. Anne-Marie Uhlir met to exchange.

How doctors and midwives they collaborate from day to day?

Isabelle Gascon: The doctors should not perceive us like a threat, because we deal only with the normal cases. Of refiler our problematic cases to the doctor it is not a question simply. We know our limits and we do not regard as a failure to entrust a woman to a doctor. That is done naturally. We do much prevention and we try to detect the problems as soon as possible. That inevitably brings us to a team work undoubtedly narrower than what occurs in the South From where our active participation at several multidisciplinary committees. We make visits in residence in the first week following the childbirth, which joined the concerns of the ambulatory turn. What désarçonne more the doctors, it is that the midwives received different formations. For them, it is sometimes difficult to be adjusted.

Akinesie Qumaluk: The community chose us to become midwives. By questionnaires of Association of the women autochthones and at the time of public debates, we wanted to know what the inuit women wanted. They want that maternity is directed by midwives. The practice of these last is quite former to the installation of the hospital. We wish that each village have its midwife. We can work in team with the doctors and the nurses. To reconcile the traditional practice with the best of technical medicine, it goes!

Dr. Anne-Marie Uhlir: To call upon the doctor is not seen like a failure on behalf of the midwife. It is as the nurses who see the patients in first line: that occurs well. Is the experiment of the midwives exportable in the South? Perhaps, but see how much people are demanding. For example, they ask to see not only one doctor, but also a doctor specialist. We collaborate narrowly with the midwives. When there are problems, they together were seen. Here, it is not a large hospital. Our principal concern is related to the fact that one cannot practise Caesareans. Most quickly that one can act, in the event of urgency, they is approximately three hours, and still, if there is a plane to transfer us to Iqaluit, which takes less time than to make come from the South the plane-ambulance.

Nellie Qumaluk: The women who will be confined in the South say us not there not to receive all the care which they need, in the direction where, for example, work being long, the woman is left all alone, without its family, accompaniment. However, that is incomprehensible in our culture. Why send the women in the South, if not for medical reasons? One expects that these women receive more services than here, which is not always the case. Then, why not leave them in their medium? Here at least, the woman in labour does not remain alone. Moreover, it is followed by people who include/understand his habits and his language. We do not have a problem to work with the medical team. For this reason, the experiment of Puvirnituq could be used for other mediums. But why the fact of having such a design of the things do would us of the outlaws in the South? Don't the midwives form part of the inuit company since always, well before the laws come from the South?

Isabelle Gascon: In the South, the word "midwife" is often associated "granola". But I ensure you that it is not reality here. The doctors call also upon us. To know some more about breast feeding, for example.

Dr. A.-m. Uhlir: Currently, the women of the villages of Hudson Bay come to be confined in Puvirnituq. They are in a hurry, says us one, to be able to do it in their village, but the doctors find that risky. The concept of risk is difficult to explain. There is a project so that the women can be confined in Inukjuaq, with midwives. That caused many frictions between midwives and doctors. Then one crosses the arms, but after all, it is a will of the population.

"The relations with the midwives are good"

"I appreciate my work with the midwives. I like their design of the pregnancy and the childbirth. For me, it is a very positive experiment. In the South, relations between them and doctors. so that I intend some to say, at least. are conflict. But in Puvirnituq, in what relates to me, the relations are good. We had an emergency of prolapsus cord. Time that I call Montreal, the midwife had already regulated the problem. In the South, one would have made a Caesarean»

Dr David Miller
Omnipraticien in Puvirnituq