If you’re an Indigenous Canadian woman who lives on a remote or rural reserve, federal regulations require you to leave your home at 36 to 38 weeks—or earlier, if you have a high-risk pregnancy—to await the birth of your baby in an unfamiliar city. This means that across northern Canada, hundreds of heavily pregnant women board buses, planes, boats and snowmobiles to travel hundreds of kilometres from home.
“I wanted to have my babies at home.” Brenda Atlookan rubs her nine-months-pregnant belly, soothing a Braxton Hicks contraction. Atlookan is three days away from her due date and 360 kilometres from home, at a hostel in Thunder Bay, Ont. Three weeks ago, she got on a small plane at Eabametoong First Nation, accessible only by plane (or, for a few months of the year, by ice roads), for the four-hour flight south. (The trip takes a while because the route stops at several other small communities on the way.) Her husband, Waylon, and her three kids—two sons ages 4 and 19, and her two-year-old daughter—are all back at home. In the meantime, she’s posting brief “Still waiting…” updates on Facebook, and trying to keep in touch with phone calls. Her chats with her four-year-old, while amusing, leave her feeling wistful: “Mom, did the baby come out yet? No? OK, bye!”
She’s one of at least 40,000 Canadian women each year who have to travel from rural and remote areas, mostly in the North, to have a hospital birth. And if you’re an Indigenous Canadian woman who lives on a remote or rural reserve, federal regulations require you to leave your home at 36 to 38 weeks—or earlier, if you have a high-risk pregnancy—to await the birth of your baby in an unfamiliar city. This means that across northern Canada, hundreds of heavily pregnant women board buses, planes, boats and snowmobiles to travel hundreds of kilometres from home.
Instead of provincial health care, Atlookan, like all Indigenous people who live on reserves, receives federal health care through Health Canada’s Non-Insured Health Benefits (NHIB) program. The evacuation policy, as it’s commonly known, became commonplace by the 1960s and 1970s, and the cultural, social and health effects of this practice have been far-reaching and profound.
We're seeing people passing on and we honour them with funerals here, but we're not celebrating birth. That should be a joy in our community.
While there’s still lots to be done, there have been some promising recent changes to prenatal and obstetric care in Northern communities. The overarching goal is to make giving birth in the North less stressful, more joyful and better linked to Indigenous culture.
The evacuation policy, sometimes also referred to as confinement, plays out differently across Canada. NHIB pays for travel and in some cases—like births—for accommodations and meals for people travelling for health care, but options for that room and board vary greatly (and sometimes, there’s no choice at all). Pregnant women awaiting their due dates can be limited to one designated motel, boarding house or hospital, often sharing space with people who are pretty sick. Atlookan is staying at Wedequong Lodge in Thunder Bay, a 52-room, 110-bed non-profit hostel funded by First Nations and Inuit Health (a branch of Health Canada), for Indigenous people travelling for health care. It has a no-frills motel feel to it, with a common room with a couple of TVs and computers, a cafeteria area, staff to assist with travel arrangements and vans to shuttle people to medical appointments.
Image Credit: Kathleen Bluesky, Manitoba Indigenous Doula Initiative