New Midwifery Program at U Manitoba Includes Indigenous Practices

In 2021 the University of Manitoba will launch its new Bachelor of Midwifery program. It’s starting with six seats, three of which are for Indigenous students to support the program’s special focus on Indigenous practices. It’s all part of the University of Manitoba’s mandate to strengthen relationships with Indigenous communities and to support the return of birth and Indigenous midwifery to communities in the north, and to support Indigenous midwifery students and midwives to strengthen their skills, knowledge, and abilities.

Kellie Thiessen, RM, RN, PhD is Director of the new Midwifery Program. She was in Nunavut hard at work when we talked.

“How can I witness this and not respond to it?”

CAM: What are you doing up in Nunavut at the moment?

Kellie: There was a real need for some staffing support up here. As part of COVID-19 planning, [the local midwives are] working with seven communities and vetting all the prenatals to Rankin. And we’re having to triage those and then manage all the care around. Whatever happens, low, intermediate, higher risk, travel and other logistices,. It’s such a massive undertaking.

And I thought we should be involved in this because our new education program is northern focused and Nunavut’s in our catchment. Manitoba needs to step up. So I said, OK, there’s three of us faculty midwives. We will rotate X amount of time from April through August.

But in being up here, I have realized the reality of the crisis and the magnitude is so much bigger than what people can imagine. And I know we’re in a crisis, but this was happening before the current pandemic. And I think we have to start really asking ourselves: Why are we not responding in the way that we need to support people to build capacity without coming in as a bulldozer and taking over?

The Inuit midwives are saying, we can’t sustain this, we are overwhelmed, burned out, and they are taking this to the administration and the administration is saying, deal with it. What are your birth numbers like? They’re simplifying it. And it is so alarming to me. And it just makes me feel like: how can I witness this and not respond to it?

CAM: Is that all part of the new program as well? Is this sort of a shared mandate?

Kellie: I think it’s hand in glove. It’s taken years to resurrect the program. [A previous midwifery program in partnership with University College of the North was cancelled in 2016. Ed.] The whole mandate of it to be a northern focused program means that we actually have to have relationships in the north and we have to have an extension to the north that supports what’s happening within the community as the community leads.

So I think building those relationships and using the university in this way is key. The university is an innovation tank and you have some different flexibilities. And if you play your cards right, you can leverage that to really do some innovative things.

“We were able to take NACM’s Framework of Competencies”

CAM: So what are some of the program highlights?

Kellie: Because we’re a new program, we were able to take The National Aboriginal Council of Midwives’ (NACM) Framework of Competencies and say at the outset this is the standard and thread it through the curriculum. [Throughout 2018, NACM undertook a process to articulate the core competencies of Indigenous midwifery. The nine core competencies provide a framework which can be used to start growing and teaching Indigenous midwifery to increase the pathways to education for Indigenous midwifery students, decolonize training experiences, remove barriers to midwifery practice in communities, and support retention. Ed.]

Darlene Birch, has been a key stakeholder in developing the curriculum.

[Darlene: “A midwifery program integrating Indigenous content that is committed to self-determination has been the hope of Indigenous Manitoban communities for many years. This program will graduate competent midwives who will contribute to the healing of communities and are well-prepared to practise in under-resourced areas.” – Darlene Birch is a Métis Elder and Indigenous midwife, and has been practicing traditional midwifery since 1981. Ed.]*

Kellie: The next step will be to develop, how does this get taught? And we’ve done some of that work. How does it get evaluated and who needs to be in there teaching?

We don’t have a lot of midwives in our community so we can only initially take six students in annually. 50 percent of those seats are allocated to Indigenous students. And we hope to expand that. But you have to start small and do something well and not shoot so high that we don’t do anything.

We want to support our students personally as well as academically. We have Elders in residence. We have our own Indigenous space on campus. So I’m really optimistic that we have resources to appropriately support Indigenous students to succeed.

“We have to start thinking about things differently.”

CAM: I think that’s an amazing definition and understanding of the role of the midwife and the future of what midwifery looks like for Indigenous communities in Manitoba. Do you think that those lessons can be applied to a larger discussion in terms of an urban setting as well?

Kellie: I’m an opportunist, so I always see a way forward. And I think that if we can sink our teeth into understanding the system that we work in, we can navigate it better ­– because that’s the reality that we do work in a system that’s extremely challenging. And I think our population health needs have changed. And so I think that we can’t work in isolation. I think we have to look at physician colleagues and engage them in discussions of how they can be more supportive of us and how we can be more supportive of them.

And if we don’t start thinking creatively about how we tap in and sort of amalgamate resources to create a stronger foundation to continue to expand midwifery, then we’re going to constantly be drowning with our exhaustion.

We have to start thinking about things differently.

CAM: And what does different look like?

Kellie: I think it looks different for different contexts. By having an openness to saying maybe in Manitoba our scope looks different or our model looks different because of this context and not feeling judged by that.

CAM: So for a student coming to Manitoba, obviously the program sounds incredible. But what about Manitoba itself?

Kellie: I grew up in the prairies in Kansas. So I love the prairies. It speaks to my soul. There’s a ton of beauty. It’s not the mountains. It’s not the ocean. But we have the lakes and the big open skies and we have northern lights, the great winter activities. And we have French culture and a certain French flair.

CAM: Do you have a little favourite spot that you go to?

Kellie: There’s a place called Steep Rock and it’s limestone cliffs and this beautiful, blue-green lake. That’s beautiful. And we have a meteorite lake. That’s crystal clear and ice cold. One of my favorite spots is a ranch that we’ll just go rent a cabin and ride horses.

You know, working with Indigenous populations has helped me be more introspective about my own story and my own place. I have felt respected and heard. I think Indigenous people aren’t saying that your story doesn’t matter. They’re just saying, listen, listen to us. And they’re just as interested as in hearing your story and hearing what makes you you, what creates your fabric. And it becomes very powerful. Who am I? And where did I come from and what does that mean and how has that shaped me?

 

For more on the new midwifery program at the University of Manitoba, visit their website.

The National Aboriginal Council of Midwives (NACM) is a leading voice to promote excellence in reproductive health care for Inuit, First Nations, and Métis women. It advocates for the restoration of midwifery education, the provision of midwifery services, and choice of birthplace for all Indigenous communities consistent with the U.N. Declaration on the Rights of Indigenous Peoples.

* May 13, 2020. https://news.umanitoba.ca/midwifery-degree/

Steep Rock, Manitoba