Indigenous expectant mothers encounter dangerous hazards on their trek to Thunder Bay for maternity care. This backdrop highlights the ongoing health care disparities they face. These women routinely experience forced separation from their families during a time that is already transformative enough. They are forced to evacuate their communities just to get basic medical treatment. Recent administrative reforms are poised to enhance access for this vulnerable population. In reality, numerous providers still strike down barriers that contribute to maternal morbidity and mortality and eradicate cultural practices integral to the birthing process.
Alisha Julien Reid, who is a trained midwife and serves as co-chair of the National Council of Indigenous Midwives. She brings to light the emotional burden this separation costs mothers. “Often, lifegivers are no longer having access to their culture that they would normally have in community with a circle of grandmothers, aunties, uncles, family members who would naturally be there for them, creating that support circle,” she stated. This absence of cultural support contributes to negative health outcomes among mothers and their newborns.
In 2017, the federal government adopted a policy change to allow one person to join expectant mothers in the delivery room. Prior to this amendment, Indigenous pregnant people often faced traveling alone as a travel companion would not be considered as medically necessary. This key legislative change would ensure that mothers have emotional and practical support during a vulnerable and challenging period.
Dr. Naana Jumah is an obstetrician-gynecologist who practices in Thunder Bay. It’s a dream she advocates for vigorously — the development of facilities that would bring Indigenous patients and their families Indigenous health care. She recognizes the difficulties her patients endure when leaving their communities, such as Fort Hope First Nation, to give birth. “Patients typically leave home by around 36 weeks pregnant and stay in Thunder Bay until after they deliver,” Dr. Jumah explained.
The trip to Thunder Bay can be difficult and dangerous. Most patients then wait weeks in motels or hotels to have their babies. Indigenous peoples die due to this lack of health services simply because health services in Indigenous communities are either unavailable or very limited. Once these patients do arrive, Dr. Jumah tries to see them at least once a week. The prolonged wait is itself an additional source of stress and anxiety.
Even with the federal policy changes relief, barriers still exist. Increasing access to these drugs in Thunder Bay creates dangers for these vulnerable groups. According to Dr. Jumah, patients coming from northern communities can get caught up in gang violence and human trafficking while traversing the city.
Health care providers, such as midwife Lisa Bishop, are making concerted efforts to establish trust with their patients. They work to eliminate as many of the burdens that patients encounter as possible. “It’s just incredibly rewarding just to give someone the opportunity to have dignity in their birth,” she said. Ms. Bishop’s staff are uniformly cordial, responsive, and eager to assist. They respond to patient queries and help people adjust to life in Thunder Bay.
As health care professionals work to improve conditions for Indigenous mothers, the National Council of Indigenous Midwives has recommended significant funding allocations to bolster Indigenous midwifery services. The President’s proposed budget provides $422 million over five years and ramping up to $113 million annually by 2030. This investment will help to expand Indigenous midwifery services, increasing the support expectant mothers can access.
Health professionals advocate for better resources and networks for Indigenous mothers and their babies. Without these systems in place, without this evolution, they’ll keep on losing. Yet there’s almost no state support for them,” Anna Betty Achneepineskum said, putting a fine point on the desperate need for increased resources and culturally relevant care.
