Terry Halifax
Northern News Services

Fort Smith (Oct 02/00) - Frustrated with a lack of territorial legislation and support from the local health centre, a Fort Smith midwife may open a birthing clinic in Alberta where her profession is legal and insurable.

Lesley Paulette has delivered about 150 babies in Fort Smith over the past decade, but says her midwife practice has met nothing but resistance from doctors in Fort Smith.

"I have been trying for about the past eight years to get discussions open about getting midwifery into the health centre and the doors are not open," Paulette said. "There has been a resistance there to exploring all the possible solutions."

"So I'm now turning my attention now to the possibility of opening a birthing centre on the Alberta side of the border" in Fort Fitzgerald.

Paulette said there are two physicians who have contracts to perform low risk obstetrics at the health centre in Smith. The centre delivers "maybe two or three" babies each year of the 45 to 50 babies born each year in the community.

"They have stated very clearly that they would rather not be doing obstetrics at all," Paulette said. "They would prefer not to; they would prefer that everyone went out" to Yellowknife.

Midwives are not recognized as autonomous professionals in NWT, which would allow them to have admitting privileges at hospitals and to prescribe medication. Although midwives have been charged for practising medicine without a license, Paulette is not concerned.

"There is no legislation that says it's a legal profession, but there is nothing that outlaws it either,"she said.

"I suppose if they wanted to, they could charge me with practising medicine, but I don't think they'd get very far."

Public pressure

Midwifery has become a welcome compliment to health care in the Eastern Arctic, Paulette said, due mostly to public pressure.

In Puvirnitq, a successful birthing centre forced the Quebec government to recognize the profession.

"It started because the health board decided they wanted to offer mid-wifery and they went ahead and did it; the legislation came later," Paulette said.

From that model, a birthing centre was created in Rankin Inlet. Prior to the opening of the Rankin Birthing Centre in 1993, mothers were flown to either Churchill or Winnipeg. Now the centre brings 70 to 80 mothers from all over the Kivalliq region.

Rankin midwife Chris Siksik said the centre was built at the request of the people.

"It really came about from local pressure," Siksik said. "The people wanted a birthing centre; they didn't always want to be leaving the community and leaving their families to go out."

Community competency

Paulette says the miracle of birth has always been a part of the community experience and provides a strength to the community through caring for it's own members.

"People have always birthed here," she said. "Traditionally, midwifery was one of the capacities, one of the competencies of the community."

She said it's only recently that people have been getting the message that birth is too dangerous to happen in the community.

"Outsiders came in and said, 'We know better than you, how to raise your kids and we think that it's best that we take your kids out of the community and raise them and educate them somewhere else,'" Paulette said.

"Now we have the same situation with people in positions of power and control saying, 'We know better than you, how your babies should be birthed.'"

The celebration of birth is a valuable component to the sense of community Paulette said and a natural part of the circle of life.

"For the most part, people aren't born here anymore, they just die here," Paulette said. "People just experience death as a community event, they don't experience birth."