Advocates concerned midwifery services closing in Yellowknife

APTN News: The closing of midwifery services in Yellowknife due to budget cuts will affect smaller communities in the Northwest Territories, advocates say.

On May 24, the territorial government announced cuts to some services that included a $900,000 reduction in funding and closing the midwifery program in Yellowknife.

“The focus is not on just serving Yellowknife,” said Lesley Paulette, an Indigenous midwife in Fort Smith, N.W.T. “It’s on creating a strong core and a presence of midwifery in the territorial referral center, being able to reach out to communities and regions, and being able to welcome clients from those smaller communities when they come to Yellowknife.”

The 2024-25 budget, currently being reviewed by politicians, contains $48.4 million in reductions spread out among public departments. The reductions will have an impact on specific positions within the Department of Health and Social Services, including four midwife practitioners in Yellowknife, Behchokǫ̀, Dettah and Ndılǫ, a territorial manager and a senior midwifery consultant.

APTN News requested an interview with the department and received this statement by email.

“The health and social services system made the difficult decision to discontinue the Yellowknife expansion because of the significant challenges that have been experienced with regards to recruitment and retention,” said a government spokesperson. “Despite consistent, continual, and creative recruitment strategies, we have been unable to achieve the consistent staffing levels required for a Yellowknife program.

“Additionally, Yellowknife has other birthing options available, with midwifery being an additional choice to these services.”

Paulette said the cuts affect nearly half of all midwifery positions in the N.W.T.

“We’ve heard some misleading statements in the legislative assembly to the effect that nobody wants midwifery, that no midwives were interested in coming to work in the program, and that’s why the positions are vacant when we know that’s not the case,” said Paulette. “Midwives do want to come and work here to help build this program, but there’ve been systemic barriers that have resulted in midwives feeling not supported to implement the program the way they know how to do.”

Paulette is a member of the Midwives Association of the Northwest Territories, a group that has a survey on its website asking people about their experiences with and without midwives.

The territorial government said it’s focusing on improving midwifery services in smaller communities lacking access to the same level of care as Yellowknife. She assured that the current midwifery services in Fort Smith and Hay River will remain unaffected.

The midwives association said that they have urged the government to improve the midwife expansion initiative rather than ending all midwifery services at Stanton Territorial Hospital in Yellowknife.

“To sustain midwifery services in the North, we need to grow a midwifery workforce here in the North,” Paulette said. “When midwives provide continuity of care, it gives them the time and gives their clients the time to build relationships with one another, for trust to develop, especially for clients who maybe had previously had difficult encounters or experiences with the health system and have not felt that the care was safe for them.”

The association has compiled more than 60 stories from the public on how the presence or absence of a midwife shaped their journey from pre-conception to postpartum.

Clients who used midwifery services described how Indigenous midwives aided them in reclaiming traditional birthing rituals, and empowering families and communities.

Paulette who helped build the first ever midwifery program in Fort Smith said the community has long since enjoyed the benefits of parents being able to stay close to home to delivery babies.

“One of the fundamental tenets of midwifery is informed client choice, and that’s such an important part of decolonizing the birth process, which has been medicalized to a great extent,” Paulette said.

A decision regarding the anticipated funding shortfall is expected to be made in the coming days.