A House for Wolves: by Melissa Cardinal-Grant, Registered Midwife
The rising popularity of building birth centres in Metis and First Nations communities across Alberta, why it shouldn’t be done, and the path ahead.
Perhaps one of the most well-known examples of a trophic cascade is the reintroduction of wolves into what is now known as Yellowstone National Park. In 1995, after being absent in the park for over 70 years, wolves were reintroduced in an effort to reduce the overpopulation of deer. The deer had over-grazed much of the park, resulting in sparse vegetation and stunted forests. Much to the marvel of the western world, it only took several years for the ecosystem to restore itself. As deer numbers declined, they also began to avoid areas where they were more likely to become prey, such as valleys and gorges, which quickly became more lush and forested. The vegetation and forest increased the song bird and beaver populations. The beavers created more habitats for other animals. Berries from regenerated shrubs fed the bears who in turn helped the wolves keep the deer population in check. Astoundingly, unexpectedly, regenerated forests stabilized the banks of rivers by reducing soil erosion, fixing their course. This event was hailed as a success, a “discovery”, and a victory in the field of ecosystem restoration.¹
Except that it was not a success, more than it was a return to balance after human-led destruction. It was not a “discovery” of modern science. Rather, it was science catching up to Indigenous knowledge, critical thinking, and practices. It was the maintenance and promotion of a healthy land using methods that are thousands of years old. Nor was it a victory, as the natural world is not something to be conquered, a fact which runs contrary to colonial and capitalist paradigms.
It is also the analogy I’ll be using to discuss the re-awakening of Indigenous midwifery across Treaties 6, 7, and 8, and where the focus needs to shift.
A general lack of understanding re: the midwifery scope of practice is common in the province. Unfortunately, and due to the compounding effects of colonization and health care injustice, this extends to Indigenous communities as well. Nonetheless, recent years have seen a rise in Metis and First Nations communities who are showing interest in building birth centres, some who have even secured the funding to do so and have broken ground. Unfortunately, there are no midwives, Indigenous or non-Indigenous, who are being meaningfully consulted, let alone who are agreeing to work at these sites. It is not for lack of love or urgency, as we know that culturally-safe midwifery care plays an enormous and pivotal role in the health of a community. It is the simple, hard truth that there are currently 186 [active] Registered Midwives (RMs) in Alberta², the majority of whom are practicing in the major cities, a small number of whom identify as Indigenous, and an even smaller fraction of whom are practicing in the communities that raised them. Numbers aside, there is also the potential to inadvertently bring in a care provider who may not be prepared for the reality of working in an Indigenous community, or who is outright harmful in their perceptions and treatment of Indigenous people. It is a simple yet complex human resources issue; there is no one to staff these prospective birth centres.
There is also a fundamental misunderstanding of what happens at a birth centre. A false assumption that it is a hospital in all but name, requiring hundreds of thousands of dollars in equipment and state-of-the-art architectural design. When in reality, out-of-hospital birth is chosen for the physiological management of low-risk pregnancy, labour, and birth. This renders most of the equipment and instruments normally associated with a multi-million-dollar obstetrical facility obsolete. When in reality, a safe, low-risk, out-of-hospital delivery requires a trained professional (i.e. a midwife) or two, a home birth kit that includes a fetal doppler, neonatal resuscitation equipment, and emergency obstetrical medication (all of which a Registered Midwife is required to bring), and a clean space. Pool or tub optional.
The urge to bring birth home is strong. Indigenous people, families, and communities have been calling out for culturally safe maternal-newborn care for far too long. To end evacuations and state-sponsored child abductions. To be treated like a human being. It is more than just birth preferences and accessibility; it is the reclamation of bodies, language, and culture. It is the battle for sovereignty of nations. The vision of a shiny, glistening birth centre on the land has somehow become a physical representation of this need.
But a building is a building. It is not a teaching, a ceremony, or a skilled healer. It has the potential to be an expensive, empty building. Planned with good intent, but nonetheless with the colonial mindset that all things can be bought. Under the false pretense that physical manifestation is the only marker of success and progress. Not only would it be a misuse of resources to plan and build a birth centre without addressing significant staffing issues or understanding out-of-hospital delivery, but it potentially reinforces harmful ideas that birth can only take safely place in a facility, and that it needs to look a certain way.
Instead, why not invest in the community-based training and retention of Indigenous midwives, and re-awakening the teachings of pregnancy, birth, and postpartum?
The wolves of Yellowstone did not need a house to go back to. The prerequisite for their return was to no longer be feared or controlled, but instead an acknowledgement, understanding, and a deep respect for their role. Like the wolves, the role of the midwife has the potential to transform a community. From the most obvious effects - improved access to care, informed choice, cultural safety, etc. - to the immense benefit(s) that we do not fully understand yet. Imagine what would happen if that role were to return in a good way…because it is coming.
The re-establishment of a community-based Indigenous midwifery education curriculum in Alberta has already begun, with the explicit goal of achieving midwifery care that serves Indigenous people and communities. It should be ready for review within a year.
This is a love letter to Indigenous communities across Treaties 6, 7, and 8. It is an invitation to come and sit around the fire. To remember what was and what could be again. A call to gather the wicihtasiw and support them on their journey to learn and reclaim their role.
Then, when they are ready, set them free.
About Author
Melissa Cardinal-Grant is a mother of two, a life partner, Auntie, friend, and Registered Midwife practicing in Amiskwaciwâskahikan and Kehewin First Nation. She was among the final BHScMid graduates of Laurentian University in 2021, and has since devoted her career to the re-awakening and growth of Indigenous midwifery. Over the course of the next year, Melissa will be working with Kihew Awasis Wakamik Cultural Society (KAWCS) as they develop and reintroduce an Indigenous community-based midwifery education curriculum, going to more music festivals, learning more nêhiyawêwin, and applying to begin doctoral studies.
Sources:
¹National Geographic. Wolves of Yellowstone. https://education.nationalgeographic.org/resource/wolves-yellowstone
²Alberta Association of Midwives. Personal communication.