FNHA midwife Marijke deZwager (left) with doula Laura Joe, who was trained through the FNHA's Kwakwaka'wakw Maternal & Child Health Program, and her nearly 6-month-old daughter Tyla. Laura has been inspired by Marijke to become a midwife as well.
Marijke deZwager is an FNHA midwife who works with Kwakwaka'wakw First Nation
2020 is the International Year of the Nurse and Midwife. In celebration and recognition, we will feature stories all year long of nurses and midwives from across the province and the great work they do for BC First Nations people and communities.
It's not common to speak to somebody whose goal it is to work themselves out of a job. But in speaking with Marijke deZwager, an FNHA midwife who works with the Kwakwaka'wakw First Nation on Vancouver Island, it's clear she's being sincere.
“I want to find and encourage and eventually, hopefully, train midwives from these communities," said Marijke, who has been providing antenatal and postpartum care for the Kwakwaka'wakw for the past two years.
Prior to arriving in Port Hardy, Marijke spent several years working as midwife in Penticton and Vancouver, doing “outreach midwifery," something she describes as providing maternal care for families without the means or support to access the services. With maternal and infant mortality rates statistically worse in Indigenous communities across Canada, she was drawn to the opportunity to be part of the change through midwifery.
However, in many respects Marijke's arrival on the north of Vancouver Island was one of serendipity. A graduate from UBC's Midwifery program in 2009, she had always been passionate about outreach midwifery, but landing a job in Port Hardy wasn't something she went looking for.
After giving birth to her own son in 2016, Marijke decided to put her career on hold. She and her partner moved to Port Hardy in March of 2018 and she soon began volunteering her time at the North Island Building Blocks community centre. The facility provides family and maternal health services, and Marijke was keen to help out, but didn't immediately tell anybody she was a midwife.
“When I first moved to Port Hardy I didn't want to assume that my version of midwifery care and what I had to offer was what the community was looking for," she explained.
But in May of 2018, the centre received government funding for a pregnancy outreach program. Marijke mentioned she was available to volunteer as a midwife for the summer so the Kwakwaka'wakw First Nation could see how midwifery might benefit their community. And so began a two-year process of learning—for both Marijke and her Kwakwaka'wakw clients.
In many respects, midwifery is a return to old traditions within Indigenous cultures. By connecting with Elders and Knowledge Keepers and Birth Keepers, those ceremonial rites could be blended with the at-home midwifery care provided by Marijke and her team.
“I think for a lot of people they didn't really know exactly what midwifery was but as we learned about it together, they realized that it was something that was always in the communities, just under a different name perhaps from an Elder or an Auntie or grandmother," she said.
For Marijke, her goal is to provide culturally relevant and culturally safe care, and to pass on her knowledge to Kwakwaka'wakw doulas, some of whom may be interested in becoming midwives themselves.
One the main benefits of bringing midwifery to a community like Port Hardy is that it prevents expectant mothers from having to travel far away for birthing, and that means having the community be more involved in the life of the child from the very beginning.
From left: Roberta Williams, an indigenous doula attending her first birth; Dr. Sophie Waterman, a Port Hardy based GP training to be a second attendant for home births; Crystal Childs, providing fill-in locum support; and Marijke. The new mother is Jennifer Johnson, north Island's first home birth baby in 30 years.
Marijke said that in Kwakwaka'wakw tradition, the grandparents are supposed to be the first ones to speak to and welcome the baby into the world, something that was more difficult when seeking a hospital birth.
In January of 2020, the Sacred Wolf Friendship Centre (in collaboration with the FNHA and Pregnancy Outreach Program from North Island Building Blocks) hosted a celebratory baby welcoming for all the children born since the FNHA Kwakwaka'wakw Maternal and Family Health program began in 2018. Marijke said that between 40 and 45 families were welcomed, with blankets for the babies and cedar bracelets for the parents.
For some families it was an opportunity to celebrate the Hitlugwila (10 moons) Ceremony—in Kwakwaka'wakw culture, once a baby has been with the community for 10 moons (months), the child can be formally named and welcomed into the community. This is one of the many traditions surrounding birthing which is now being restored after nearly being lost during the years of the Indian Residential Schools and the Sixties Scoop.
When asked why Marijke chose a path of midwifery, she says that nothing else brings a person “into being completely present" as witnessing a new life coming into the world.
“I'm really grateful to be invited into that really intimate time and place when people are creating their families and when their families are growing."
In the end, however, Marijke says it's really not about her. She repeats her goal of wanting to work herself out of a job, passing the knowledge on to others just as it was once passed to her. She credits the work of Arlene Clair, a nurse from the Kwakwaka'wakw Maternal Child and Family health program and a couple of the indigenous workers from the Pregnancy Outreach program.
“They're coming forward as a community to highlight the importance of Maternal Child Health and valuing the work that our Life Givers do. That's what really matters."
September: A Calling From Childhood
August: Community Health Nursing in Akisqnuk
May: The Power of Voice to Advance Culturally Safe Health Care for First Nations Communities
April: Líl̓wat Health & Healing Shifts Advance Care Planning for COVID-19