Nataasha Komakjuak decided to give birth to her third child in her home community of Arviat.
"I didn't want to leave my two younger ones, my four-year-old daughter and my son who was three. I didn't want to lose them for a long time, for three weeks," she said.
"I refused to leave. I refused to get on the plane. I made the choice of just staying here and hiding."
photo courtesy Nataasha Komakjuak
Komakjuak remained at the health centre for two to three hours after Ryley's birth, at which point she was discharged and went home with her family.
That was in January 2007.
Shirley Tagalik of Arviat's Aqqiumavvik Society explains the community has been working on getting a birthing centre for years, most recently with a 2017 Arviat Birthing Centre Proposal submitted to the Government of Nunavut, as well as to the feds.
"Years," she repeats. "When we first formed the health committee, I think it was in 1980, this was our burning issue, to get a birthing centre for our community."
Tagalik says women in the community were surveyed and 87 per cent would choose to give birth in their home community. Arviat currently sees approximately 60 to 70 births annually for an estimated population of 2,850.
The comprehensive 87-page Aqqiumavvik proposal has been with the Health Department since early 2018.
"The Department of Health requires sufficient time to review the proposal, as well as review and evaluate existing maternal newborn services in Nunavut. Once the department completes the review, Health will provide a response to the society," stated territorial coordinator of maternal newborn health services Carol Griffin by e-mail.
Griffin says there were 897 live births in 2017. In the last 10 years, 9,480 babies were born to Nunavut women.
"Approximately 50 per cent of these babies were born in the territory while the other half are born in southern hospitals," she said.
"Birthing services for low risk women are available in Rankin Inlet and Cambridge Bay birthing centres and Qikiqtani General Hospital. Plans to expand maternal services in the future are currently under review."
'A positive impact for women'
Former Health Minister Pat Angnagak says she truly believes in this issue and she wonders why community birthing is not in place and used as part of the system.
"When I was the Minister of Health, I made inquiries into how as a department we can push this area more. I met with various stakeholders over the matter and spoke with midwives in and out of the system," she said.
"It seemed there were a lot of people who support such a move and I'm hoping that the department will go forward in this area. I would like to see the Nunavut Arctic College provide training and certify Nunavummiut wanting to become midwives."
Angnakak says midwifery in communities is a great opportunity to intertwine the cultural side (Inuit Qaujimajatuqangit) of midwifery with today's way of delivering babies. Amittuq MLA Joelie Kaernerk is of the same mind, and has been a vocal proponent of community birthing since the people of Hall Beach and Iglulik elected him in late 2017.
"It would have a positive impact for women," he told Nunavut News.
Though federal funding for escorts for pregnant mums is welcome, removing Inuit from communities for health care is a stubborn holdover of colonial health policies and practices.
"Couples can travel now, but they have to leave their children and loved ones behind. And they're gone for a good one, two, three months at a time, and their children are left behind, taken care of by … I don't know, their sister or their grandma. It would really help the families to be in the community. They could go to the health centre, where an Inuk woman is helping them."
Kaernerk says community birthing would also help alleviate overcrowding in medical boarding homes and would create employment in the community
A common point, made by Tagalik and Kaernerk, is that communities as a whole would benefit from money being spent in the community rather than on the big budget for sending pregnant women away from home for weeks on end.
Arviat North-Whale Cove MLA John Main agrees.
"In my opinion, the closer to home we can offer maternal health services, the better. More accessible and convenient for families, and cheaper for the government," he stated by e-mail.
"Like many aspects of health care in Nunavut, the Health Department's staffing capacity will be a key challenge in trying to provide better maternal health services."
But Tagalik says, at one point, 12 community members were interested in taking midwifery training, and that Nunavut Arctic College refused to work with the health committee to make the training accessible locally.
The Health Department's Griffin says there are currently five midwives working in the territory.
"Three are Inuit midwives who obtained their education and training in the territory. There are vacant midwifery positions that are currently being filled by casual midwives. At this time, there is no active midwifery education program, however, the goal is continue to strengthen and support the existing midwifery workforce," Griffin said.