'A sacred experience': Indigenous midwives revive birthing traditions to deliver babies at home

On the shore of Kehiwin Lake, four mothers cradle their babies' placentas in a ceremony held along a newly cleared trail in the bush of the Kehewin Cree Nation in northeast Alberta.

Each baby is swaddled in a different coloured fabric and tied with ribbon as part of an inaugural birth camp, a week-long event to share teachings about traditional birthing and family customs. 

In a thicket of trees next to the mothers, a group of men dig a hole for placentas to be placed on top of sage and buried with an offering of tobacco. 

"When we do that, the kid is grounded and is with Mother Earth," Elder Doreen Moosepayo said.

The babies were delivered at the hospital in the town of Bonnyville, Alta., 20 kilometres northeast. But the goal is that future generations can enter the world on the Cree Nation.

The initiative is part of a federal pilot to increase the number of Indigenous midwives in reserve communities, including Kehewin, Opaskwayak Cree Nation in Manitoba, and Sturgeon Lake First Nation in Saskatchewan. 

Trainees study the practices of past generations of Indigenous midwives along with medical training.

Four women are training to become midwives in Kehewin, and the First Nation recently received $500,000 in capital funding to build a midwifery birthing centre to foster future opportunities.

It will take up to four years for trainees in Kehewin to complete their studies, but the hope is that this birth camp will be one of many.

Jodi Gadwa-Cardinal, a doula and midwife in training, entered the program to keep traditions alive within her family.

When Gadwa-Cardinal's niece Maelan Tsatoke had a baby, the family kept Tsatoke in labour at home for as long as possible. When the baby was born at the hospital, they sang the family's welcoming song to him in Cree.

"This is why I'm in this Indigenous midwifery program, because I want the whole experience," she said, adding the ultimate goal is for the women to have their babies born in their communities.

"For them to have [the] baby at home in Kehewin where they're from ... It's such a sacred experience for mom and baby," Gadwa-Cardinal said.

"Baby hears the language from the kokums [grandmothers] right away so that he knows this is where he belongs, this is your family, and this is who you are." 

Inaugural birthing camp

The week began with an all-women pipe ceremony and ended with an actor and midwives recreating a live birth, as it would have happened before colonialism. 

"This is an opportunity for people to reconnect to those teachings," said Anthony Johnson, a midwifery revitalization project co-ordinator who organized the camp.

Connecting with cultural practices is also an opportunity for people to heal, he said. 

Johnson has heard from families who have experienced poor treatment by medical professionals, the inability to smudge and not reclaim placentas after giving birth in hospitals.

The National Council of Indigenous Midwives, which supports autonomy regarding birthing practices, highlights continued oppression as birthing practices were suppressed in the past century.

"The silencing of Indigenous midwifery occurs as a result of colonization and the ongoing medicalization and systemic racism in the Canadian health-care system," its website says.

Moosapayo performed her first placenta ceremony two years ago when her granddaughter was born, based on what Moosapayo's elders taught her decades ago.  

"I always remember Grandma saying, 'One day you have to do it,'" she said. "'You can't run to somebody. If you believe, connect yourself to the Creator.'"

Indigenous midwifery pilot

Kehewin Cree Nation was approved for its midwifery pilot in 2018 and received part of the federal grant in 2019. But the COVID-19 pandemic delayed the initiative, with trainees starting online midwifery courses this year. 

Johnson said it was challenging finding resources given systemic barriers in health care. This situation is also the case for other participating First Nations attempting to recruit practising midwives.

Despite this effort, Johnson said that Opaskwayak Cree Nation's job posting has gone unfilled for four years.

He noted that Kehewin also advertised for a job two years ago but has not seen any applicants. The closest midwives to Kehewin are in the hamlet of Plamondon, over 175 kilometres northwest. 

In Opaskwayak Cree Nation in northern Manitoba, people with high-risk pregnancies are flown to hospitals in communities like Winnipeg and Brandon.

"It's hard having them flown out … and have to go to the hospital by themselves without their family," said Helene Sinclair, with the Opaskwayak Cree Nation Maternal Child Health program.

First Nations also need more communication and clarity from regulatory bodies to negotiate red tape and address funding grey areas between the provincial and federal governments.

"It's a battle between Indigenous Services Canada, who's responsible for federal jurisdiction, and then there's the provincial health-care system," Johnson said.  

Due to bureaucratic challenges, First Nations can struggle to access resources.  

The National Council of Indigenous Midwives, created in 2008, was recently tapped to help Kehewin Cree Nation with its program. Despite receiving national grant funding, Johnson said additional work was needed to connect with the council due to a lack of information.

Reconnecting with roots 

The placenta ceremony at the birth camp was one of the first times Deanna Smith, a doula and one of the midwives in-training in Kehewin, saw afterbirth in person. 

Smith said the branching segments of the placenta are significant because they resemble the roots of a tree. 

When Smith gave birth to both of her children through a C-section, she didn't see the placenta after her deliveries. Smith said it wasn't until she began working for Kehewin Health Services eight years ago that she learned more about cultural teachings. 

During the ceremony, Smith felt a connection as she walked the lakeshore while elders spoke and lit a tobacco pipe. 

She and other attendees sang Grandmother's Song while the families wrapped their placentas like newborns. They sang, "Âsaweyminan nimâmâ," meaning "Bless us my mother," in Cree.

"I could feel that positive and powerful energy and the sacredness from the area," Smith said.