A message from Melanie and Nathalie:

Indigenous communities face a range of well-documented barriers to access culturally safe medical care, including perinatal care. At present, Indigenous communities across most of Vancouver Island only have access to Western models of perinatal care. These are devoid of and often discriminatory against Indigenous values and practices during pregnancy and childbirth, a time of immense cultural significance. The perinatal period presents an opportunity as families reattach to the medical system, potentially reassessing their perspectives on healthcare, and whether they make different personal and family lifestyle choices that lead to better overall personal and societal health outcomes. When faced with Western health care systems that often include racism rather than culturally relevant care, many Indigenous peoples turn away from receiving the healthcare they require. Currently, in Victoria 1/5th of pregnant people remain unattached to a primary care provider during their pregnancy and are receiving care at Victoria General Hospital. A movement towards Indigenous-led and community-based midwifery care avoids overburdening acute care settings, which ultimately decreases costs to the health care system, and provides a trauma informed approach that supports reconciliation within the health care system.

The SIIMS provides the right resources, to the right people, at the right time, and in the right place. The SIIMS was born through a collaboration between Nathalie Pambrun and Melanie Mason, the only Indigenous registered midwives currently in Victoria, and Indigenous partners who co-developed their model of care and began to implement it through a pilot project supported by a federal grant. Over the year of the pilot (April 2023 to March 2024), the leadership of these Indigenous midwives (sharing 1.0 FT) in collaboration with a UVIC research team documented the outcomes of the pilot and its success. Examples of major outcomes included:

• culturally safe and anti-racist care: patients expressed a profound sense of safety; reduced child apprehensions; increased family cohesion; support with substance use and complex mental health, etc.

• birth evacuee care: provided care for Indigenous people from across Vancouver Island evacuated to the South Island to access specialist services at VGH, the only tertiary perinatal site in Island Health. Created a safe space for integration into Victoria-based tertiary care and health and support services.

• medical knowledge translation: the Indigenous midwives used their cultural knowledge and specialized training to help Indigenous clients navigate Western medical systems and processes.

• Wrap around care: The Indigenous midwives integrated their service delivery within a larger wrap around model of care – with doctors, nurses, and other practitioners – that aided clients navigating the health care system and receiving the complex care they required.

• Major gap in Indigenous primary care access closed: the SIIMS increased opportunities for equitable access to primary perinatal health care and identified the need to develop a sustainable model moving forward.

 The SIIMS has built considerable trust with Indigenous peoples, partners, and Nation, and support their health care needs as they define them. Central to the success of this approach is that the midwives bring together Western medical practices with Indigenous cultural knowledge, values, and understanding of health ways to create a respectful, credible, and integrative service that resonates with community. The midwives provided outreach care at community partner organizations including Her Way Home, the Victoria Native Friendship Centre, Songhees Wellness Centre, and the delegated urban Indigenous agency, Surrounded by Cedar Child and Family Services. Clients are now self-referring for this Indigenous-specific care, and the SIIMS is poised to expand and continue to innovate with additional support.

Maarsii (Thank you) for your advocacy and support!

Nathalie and Melanie

HOW YOU CAN HELP:

Write a letter to your MLA and MP- Sample letter HERE:

Create a post on social media, tag @vanislandhealth, @foundryvictoria, @vnfccommunications, @songheesnation, #esquimaltnationwellnesscentre, #herwayhomeyyj, #Y-STARVictoria, Your MP (ex @laurelndp), @BCNDP