Keeping birth at home: Community and service provider visions for perinatal wellness and continued Inuit childbirth in Nunavik.

PROBLEM

Childbirth on traditional territories is unattainable for many Indigenous peoples living in remote communities in Canada.

BACKGROUND

In Nunavik, Inuit territory in northern Quebec, rapid population growth risks exceeding local midwifery capacity. This poses challenges to community-based childbirth in a region recognized for reclaiming Inuit midwifery and local birthing.

AIM

To explore community views on protective factors of maternal and family perinatal wellness and continued local birthing.

METHODS

In ten communities, Inuit families and perinatal service providers created a total of 54 fuzzy cognitive maps on protective factors for (1) birth in a good way in Nunavik, (2) maternal and family perinatal wellness, and (3) community-based birthing in Nunavik. We used fuzzy transitive closure to examine direct and indirect connections and collated individual factors into categories using inductive thematic analysis.

FINDINGS

Well-equipped local medical facilities and services, community birthing centres run by Inuit midwives, and Inuit perinatal traditions had the strongest influence on experiencing birth in a good way in Nunavik. Inuit youth perspectives featured instrumental and emotional support for mothers and families, along with health and self-care in pregnancy as the most influential factors on maternal and family perinatal wellness. Prominent protective factors for community birth in Nunavik included maternal-infant health and wellness, local Inuit midwifery services, and well-resourced medical facilities.

DISCUSSION

Fuzzy cognitive mapping was helpful in informing community visioning of local childbirth and maternal and family perinatal wellness in Nunavik.

CONCLUSION

Inuit-led midwifery services are essential to continued local childbirth in the region.