Being a good relative: Indigenous doulas reclaiming cultural knowledge to improve health and birth outcomes in Manitoba

Abstract

Indigenous women are increasingly returning to culturally based birthing practices to assert their sovereignty over their bodies and their birthing experience generally. The impact of colonization on birthing experiences for First Nations women in Canada has been profound and extends into generations of families. First Nations women across Canada have traditionally birthed in their communities surrounded by families and community, observing many traditions around pregnancy and birthing including placenta burying and belly button ceremonies. These traditions and this circle of care and support resulted in resiliency, strength and a connection to the land and family. In Manitoba, Indigenous women are becoming trained and engaged in supporting their fellow Indigenous relatives and community members as Indigenous doulas or birth workers. This paper describes the experiences of the first cohort of Indigenous doulas trained in Winnipeg, Manitoba by the Manitoba Indigenous Doula Initiative (MIDI), also known as Wiijii'idiwag Ikwewag, and describes the specific contributions and impacts of Indigenous doulas who support Indigenous women during pregnancy and birth. Through qualitative interviews, our participants described various understandings of their work, purpose and their impacts on the women and families they support. Four recurring themes which emerged across the interviews included: prior negative birthing experiences, clashes with mainstream health and social services, the understanding of doulas as advocates, and empowerment and disempowerment. These themes all spoke to ongoing challenges Indigenous women continue to face during their pregnancies and births in mainstream healthcare systems, as well as highlighting the key forms of support that doulas can provide to ensure the self-determination and well-being of the women they work with.

Envisioning a culturally safe midwifery model from the perspective of Indigenous families: A case study of midwifery care in inner city Winnipeg, Manitoba, Canada

“…Along with this came the devaluing of the respected For much of the twentieth century midwifery was unregulated in Canada, thus Indigenous midwives and non-Indigenous midwives were both forced to practice in secret or to abandon their role as midwives. This, along with policies which removed birth from Indigenous communities, led to a struggle to maintain traditional knowledge surrounding pregnancy and reproduction (Skye, 2010, Cidro, Doenmez, Phanlouvong, & Fontaine, 2018.…”

“…Furthermore, to be more fully culturally safe, the MCC midwifery model must also include Indigenous-led supports to help their clients navigate CFS and the traumas caused by the impact of the child welfare system and ongoing assimilative policies in their families and communities (Manitoba Legislative Review Committee, 2018). It is elements such as these that would support Indigenous self-determination (Cidro et al, 2018;Ireland, Montgomery-Andersen, & Geraghty, 2019;Smylie et al, 2016;Yeung, 2016), and decolonize the midwifery model, such that new models of community-based, interdisciplinary maternity care can emerge to reach a greater number of Indigenous families, in even more empowering, respectful, and appropriate ways.…”

“…While access to Indigenous midwifery is very limited in Winnipeg, there is a growing movement toward Indigenous-led initiatives to train Indigenous birth workers to provide support to Indigenous families before, during and after the birthing process. These initiatives are intended to bridge the gap left by the interruption of traditional birthing practices in Indigenous communities to "provide a pathway back to retrieving women centered knowledge around women's bodies, infant care and parenting that promote resiliency in Indigenous families" (Cidro et al, 2018).…”

“…While Indigenous doulas are not discussed in this paper, they are introduced here due to a growing movement supporting their important role of restoring sacred knowledge and to highlight their work, which is becoming increasingly more accessible to Indigenous families and gaining credibility (Cidro et al, 2018;NAHO, 2004…”

“…In response to the IRSSA, the federal government also delivered a public apology for the abuses and traumas inflicted upon Aboriginal children in residential schools, and in 2008 formed the [Truth can Reconciliation commission of Canada] (TRC) to document the experiences of residential school survivors and their families" (p. 181).The TRC will be discussed further in this chapter in section 6.6., using the calls to action as a tool for creating a deeper understanding of what healthcare providers and policy makers can do to promote better healthcare experiences for the Indigenous people that they serve. The speakers made suggestions for additional supports the midwives could provide, including, giving clients an ultrasound photo, writing a letter of support letter to CFS, providing hygiene resources for clients (such as shampoo conditioner, razers, body wash), providing support outside of clinical care, providing resources involving Indigenous culture, providing community education about MCC midwives, and creating access to information about MCC midwives on the internet and social media (table 6.1).Certain recommendations that the speakers have, such as, incorporating the seven sacred teachings, sharing knowledge about traditional medicines, and leading a smudge with MCC midwifery clients, suggest that there would be value in having an Indigenous midwife, doula or support worker at MCC to provide midwifery clients with cultural support Abbott et al, (2014) Cidro et al, (2018,. and Smylie & Phillips-Beck (2019) provide examples of how Indigenous healthcare workers benefit Indigenous healthcare recipients.…”