Good afternoon. My name is Ellen Kanika Tsi Tsa Blais. I am an aboriginal midwife from the Oneida Nation of the Thames, which is one of the six nations of the Iroquois Confederacy. I am from the Haudenosaunee territory, the people of the longhouse, and I am honoured to be here today as co-chair of the National Aboriginal Council of Midwives, otherwise known as NACM. I want to thank the peoples of the Algonquin nation whose unceded territory I am visiting today.

Thank you, Mr. Chairman and committee members, for the opportunity to appear today to testify as part of the committee's study on Bill C-608, an act respecting a national day of the midwife. I would also like to thank the sponsor of the bill, member of Parliament Rosane Doré Lefebvre, who introduced this bill, and who has personally championed the cause of midwifery in Canada and is helping bring to light the challenges we face in our communities. We also extend our gratitude to member of Parliament Peggy Nash for the work she has done to establish a national day of the midwife in Canada.

NACM believes that Bill C-608 is an important step in showing appreciation for the vital contribution that midwives make to the delivery of maternity care in Canada. NACM also believes this bill will bring much needed visibility to the work of aboriginal midwives in supporting health and healing within our communities. Aboriginal midwives have always worked in the community, carrying the cultural knowledge for safe childbirth, yet our work has become almost invisible over the past 100 years due to the medicalization of childbirth. We are working hard to reclaim our role, and legislation such as Bill C-608 offers further support to this essential work.

We would like to thank committee members Dr. Colin Carrie, Dr. Hedy Fry, and members of Parliament Lois Brown and Peggy Nash, who have echoed this appreciation in their statements in the House of Commons. NACM is also grateful to all political parties for the unanimous support the bill has received to date.

NACM's vision is to see aboriginal midwives practising in every aboriginal community. We believe that aboriginal midwives working in every aboriginal community is a safe and cost-effective way to deliver maternity services. Our knowledge and role in protecting, caring for, and honouring women as life-givers are essential for community healing and connect us all.

NACM is a diverse group of indigenous midwives, midwife elders, and student midwives from all regions of Canada. Members include both registered midwives and midwives practising under certain exemption clauses of provincial health legislation. We promote excellence in reproductive care for Inuit, first nations, and Métis women. We advocate for the restoration of indigenous midwifery education and choice of birthplace for all aboriginal communities, consistent with the UN Declaration on the Rights of Indigenous Peoples.

Aboriginal midwives bring wellness back into the community and enable the creation of sacred, powerful healing spaces. An aboriginal midwife is a committed primary health care provider who is fully responsible for clinical decisions and the management of low-risk prenatal, intrapartum, and postnatal care. She promotes breastfeeding, nutrition, and parenting skills. She is a leader, mentor, and keeper of ceremonies. Aboriginal midwives work with other health care professionals, including doctors, pediatricians, or other specialists when needed, and advocate for culturally safe care.

In 2012, NACM was recognized by the Health Council of Canada as a promising practice in aboriginal health. There are currently 11 midwifery practices in Canada dedicated to providing care in aboriginal communities. Our work is promising, but the road ahead is long. Today, very few aboriginal communities have access to midwives, and most women give birth outside their communities.

I invite you to take a moment and imagine your families. You are about to become a grandparent for the first time. You are thrilled. You have been waiting for this moment for months, helping your daughter prepare for this beautiful time. You are eager to meet your first grandchild. Your daughter is nervous about the birth and you reassure her. You have made a small gift for the baby and you give it to your daughter when you see her off at the airport. She is flying to Thunder Bay to have her baby as per the evacuation policy, since the community you live in does not have maternity services. You bid her an emotional goodbye. You try to stay in touch by phone over the weeks while she waits for labour to begin and you worry about how you are going to pay for phone bills you cannot afford.

Your family gathers at the home of her husband and awaits the news of the baby's arrival. The next afternoon, you learn that the baby was born by C-section that morning. It's a girl. You and your daughter's husband long desperately to hold the baby, to welcome her. You are told that you will able to in about a week's time.

When your daughter returns, she is emotional and exhausted after a long and lonely four weeks away. She thought that she would breastfeed her baby, as she learned it was the best choice to make, but she was not able to find the support she needed while so far away. You know that she has started to formula-feed her baby, and you once again worry about the cost. You thought you would be overjoyed to meet your grandchild. Instead, you think about how much you have already missed.

This is what birth looks like today in most of our communities. Every day families are separated and women give birth alone, even as a growing body of research points to the health and social costs of this practice.

Developing maternity services closer to home is an integral part of the healing process in aboriginal communities. Aboriginal midwives respect birth as a healthy physiologic process, and honour each birth as a spiritual journey. We believe aboriginal women have the inherent right to choose our caregivers and be active decision-makers in our health. Working closely with women to restore identity and health from the time of birth enables us to heal from historical and ongoing trauma, addictions, and violence. When birth is absent, so is the power and joy of the birth story, and within it, the threads of connections to oneself, family, community, and the cosmos.

In many cases aboriginal midwives are the first and only health professionals a woman sees throughout her pregnancy. We have a unique opportunity to build trusting relationships with the health care system that have a ripple effect into the health of the family and the community. For example, the success of the Inuulitsivik Health Centre, one of three Nunavut birthing centres, has been recognized on several international platforms, including the World Health Organization. Since 1986, locally trained Inuit midwives have been providing cost-effective care along the Hudson Bay coast. Birth evacuations have since dropped from 91% in 1983 to just 9% in 1998, drastically cutting costs. Bringing birth closer to home is possible.

In federal jurisdictions such as reserves, communities face significant barriers when attempting to implement midwifery services. At this time there is no federal funding for midwives to practice on reserve except for reallocated funds transferred to the First Nations Health Authority in British Columbia.

I once had the honour of being involved in a young woman's healing through the transformative power of birth with aboriginal midwives in Toronto. This woman was from one of the Cree nations from western Canada. She had already given birth to several babies, each one apprehended into the child welfare system while living out west. She had sustained a childhood full of sexual abuse from family members who, while attending residential school, had not experienced a healthy and loving childhood but had experienced only sexual, physical, and emotional abuse from their teachers. She began taking drugs to numb the pain. When she arrived in Toronto she was pregnant, and was supported to connect with aboriginal midwives for her birth.

She was convinced she did not have the capacity to care for her baby, and was planning to relinquish him at birth to the Children's Aid Society. The aboriginal midwives surrounded her at the birth with care and compassion, singing and drumming her baby into the world. She told me that at that time she felt like all of her ancestors were there at this birth. Her baby was born at sunrise. Later on his spirit name was given to him by an elder who was not aware of the time of his birth but through the connection of spirit gave him the name “He who brings in the light”. From that moment on, she began to learn how to care for herself. After a year of hard work, inspired and supported by her aboriginal midwives, she brought her son home to stay.

Globally, NACM is among the first national professional associations of indigenous midwives. Worldwide, other indigenous midwives look to NACM as leaders. In 2017 the global midwifery conference will be hosted in Toronto, and NACM will have the opportunity to showcase our groundbreaking on the global stage.

Bill C-608 is a first step to recognizing the essential role that midwives play in ensuring the health of our communities. It is one action that continues to bring visibility to our work of creating strong identities for our children, strength for our women, deep bonds in our families, and a healthy future for our communities.

I want to close with a prayer by Katsi Cook, a mentor midwife, that we use in our medicine circle for blessing births: Relax where you are and feel your weight supported by Mother Earth. Breathe in the oxygen. It is part of the sky and part of each one of us. I give thanks, for peacefully you are born. I pray that peacefully your life will be ongoing, because as I think of you clearly, I know you will always be loved.

Thank you for the opportunity to appear before this committee, and I look forward to any questions you may have.

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