Authors: Kayla Serrato & Nicole Gibbons

The journey of bringing birth closer to home and into the hands of women has resulted in a two midwife model of care supporting perinatal services in Haida Gwaii. On February 18, 2016 at Haida House in Tlell, partners celebrated the ceremonial signing of two alternative payment plan contracts allowing two midwives to practice and support pregnancies and birth in a rural and remote environment, enhancing maternal and child health programs and services for all women on Haida Gwaii. These midwives are linked to local physicians, nurses, doulas and community program staff and have the ability to support labor and delivery at the homes of women or at the Queen Charlotte Island General Hospital. The realization of this model was a result of collaboration between the communities of Skidegate and Old Massett, First Nations Health Authority, Northern Health, the local Medical Advisory Committee, the Midwives Association of BC and midwives Celina Laursen and Shannon Greenwood.

The vision and perseverance of Skidegate and Old Massett made this Community-Driven, Nation-Based model a reality. In this model, both midwives offer regular midwifery care to all women on Haida Gwaii who choose this service, while also supporting maternal child health programming offered in community, on-reserve. One midwife primarily supports the north island and works with Old Massett and one midwife primarily supports the south island and works with Skidegate. Having a midwife present and available in community to connect with women thinking about having a baby, pregnant women, new parents and infants is intended to improve access to care and enhance services received.

During the ceremonial signing, the group was grateful to have Elders present from both Skidegate and Old Massett, who shared kind words to open and close the day.  The history of giving birth on Haida Gwaii was talked about and the work of previous midwives and physicians over the years was honoured.  All partners involved had an opportunity to share their reflections about the importance of this work. Many acknowledged the discussions and negotiations involved in finalizing this model were emotional and challenging but emphasized the common passion and personal and professional growth that resulted.  Personal birth stories, traditional birth practices and a Haida song were shared. Celina and Shannon both shared their journeys in deciding to become a registered midwife. The strength and meaning of being able to have family present to play an active part of a baby's welcoming, on traditional territory was celebrated. Following local protocol, after the ceremonial signing of certificates gifts were shared with witnesses.

Midwifery care and maternal child health are areas of work that link closely with FNHA's vision of Healthy, Self-Determining and Vibrant BC First Nations Children, Families and Communities. A big congratulations goes out to the communities and all partners involved in making this two midwife model on Haida Gwaii possible. It is hoped that this work will inspire other First Nations communities, regional health authority partners and primary care providers to consider new ways to provide maternal child health care that better meets the needs of communities and continues to move forward the priority of bringing birth closer to home.

For more information about midwives:

http://www.bcmidwives.com/what-a-midwife

For more information about considerations in developing a collaborative maternity care model:

http://www.perinatalservicesbc.ca/Documents/Resources/SystemPlanning/CollaborativePractice/CommunityBirthProgramManual2013.pdf

Read more on FNHA Maternal, Child and Family Health here: http://www.fnha.ca/what-we-do/maternal-child-and-family-health