The Politics of Obstetric Care: The Inuit Experience

Abstract

ONeil and Kaufert examine how the Inuit in remote communities of northern Canada have undergone the transition from home births to births in clinics attended by nurse-midwives to births in hospitals with attending physicians. This chapter discusses obstetric policy as 1 aspect of the penetration of southern Canadian institutions and controls into peoples lives in northern Canada. Data are drawn from archival data governmental reports and statistics on place of birth and transcripts of community meetings and interviews with nurses physicians administrators and Inuit women. High infant mortality rates led to construction of nursing stations in the 1960s. These stations were staffed by foreign trained nurse-midwives. The eventual shift to hospital birth was facilitated by improvements in transportation which made evaluation to a hospital easier. Better communication systems allowed physicians and administrators in the south closer oversight of the nurses work. Changes in obstetric technology also increased the gap between the obstetric ward and the nursing ward. Also midwifery had few supporters outside of women in the communities. The demise of midwifery resulted in the communitys loss of confidence in nursing staff. Nurses who cannot deliver babies are perceived as being unqualified to provide primary health care. The Inuit see the medicalization of birth as a threat to culture and political autonomy. The demise of the northern midwife is part of a competition for control over childbirth between the medical profession and women and midwives. The authors suggest that until northern nurses and Inuit see themselves as victims of the same processes the trend towards medicalization of health and childbirth will continue.