Episode 42 - Dehga and Sabrina: Reclaiming Indigenous Birth Knowledge

Dehga and Sabrina are co-founders of the Northern Birthwork Collective. Today's conversation centers the experience of Indigenous people and reproductive healthcare, specifically Indigenous people of the Northwest Territories of Canada. The discussion acknowledges the damage colonization has caused in healthcare, and the need for building a network of resources and to provide inclusive and uplifting care for those who are in need of reproductive care at any stage.

Content Warning: This episode discusses pregnancy loss, and forced and coerced medical sterilization.

[ID: A beige background and orange semi-circle. Text reads: The Intersectional Fertility Podcast Episode 42: Sabrina Flack @northernbirthwork and Dehga Scott @northernbirthwork.]

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Episode Transcript

Disclaimer: This is an automatically generated transcript edited to be more readable. It may not be 100% accurate.

[00:00:00] Josie: I am Josie Rodriguez-Bouchier, and this is the Intersectional Fertility Podcast, where ideas and identities intersect to deepen our understanding of fertility and ultimately our Whole Selves.

[00:00:32] Dehga Scott is a Tłı̨chǫ Dene born and raised in the Northwest Territories. She's one of the co-founders and project manager for the Northern Birthwork collective. She's a mother of three children and one angel. She comes from a long line of strong leaders, including her great-grandmother, who is a traditional midwife throughout the Tłı̨chǫ territory.

[00:00:56] She has been interested in birthwork from a young age and originally wanted to become a midwife. Her path led her to work in healthcare at various jobs where she saw many systemic gaps for Northern Indigenous families. Witnessing this inspired her to want to create change. This spurred her dream to develop an Indigenous birthwork training.

[00:01:16] She's also completing her Indigenous governance degree with Yukon University. These studies provide an important framework for developing Indigenous programming for the North. 

[00:01:26] Sabrina is a mixed race settler living in Denendeh, Northwest Territories. She moved to Yellowknife from Ontario, early 2020, and swiftly fell in love with the North. In her professional role, she's a full spectrum birthworker and the project director, co-founder of the Northern Birthwork Collective, a reproductive justice advocacy project in the Northwest Territories. 

[00:01:51] She's passionate about creating safer, more inclusive and affirming reproductive health spaces, and centers her work around folks who identify as Black, Indigenous, and People of the Global Majority.

[00:02:11] Welcome back to the podcast everyone. Sabrina and Dehga, welcome. 

[00:02:17] Sabrina: Hey, Josie. Thanks for having us. 

[00:02:20] Dehga: Yeah, thank you for having us. 

[00:02:21] Josie: Absolutely. So will you, will you share with us where each of you are, are joining us from today, and then what your pronouns are? 

[00:02:29] Sabrina: Sure, I'll start. My name's Sabrina Flack. My pronouns are she/her, but they/them is fine too. I am calling in, calling in- do people say that on podcasts? I'm here from Denendeh, which is Yellowknife in the Northwest Territories. So it's Chief Drygeese territory and it's the traditional lands of the Yellowknives Dene First Nation. 

[00:02:54] Josie: Beautiful. I like the term calling in. It makes me feel like I'm on an old radio show. 

[00:03:00] Sabrina: Yeah, that's what I was going for. 

[00:03:04] Josie: Yeah. Dehga, what about you? 

[00:03:07] Dehga: So my name is Dehga Scott, originally from Yellowknife, but I am actually calling in from Calgary, Alberta. So Treaty Seven territory. Yeah and I live here with my little family. 

[00:03:18] Josie: Aw. And what are your pronouns Dehga?

[00:03:20] Dehga: Sorry, my pronouns are she/her. 

[00:03:23] Josie: Okay, cool. All right. So I would love to know from each of you, what is your story that led you to become a birth worker? 

[00:03:30] Sabrina: Dehga, do you wanna take this one first? 

[00:03:32] Dehga: Okay. So I'd like to say that, it's kind of in my blood. You can say that. My great-grandmother was a traditional midwife within the Tłı̨chǫ region, so within Behchoko and surrounding areas. 

[00:03:48] When I was about 17 years old, 17 or 16, I was very young. I attended about four births with friends all, lovely teenage pregnancies in the small northern communities. From there on, I realized that I really wanted to be involved in birth work and I just didn't know how.

[00:04:11] And originally I thought I would be, I would go to nursing school cause at the time you'd had to go and get your degree and then you could do a Masters in midwifery. And my big plan was to become a midwife and go to move to New Zealand. And that didn't happen. Life turned completely the opposite direction and eventually I just became, I guess what you call a traditional auntie and helped family members and friends through their birthing experience.

[00:04:43] And eventually led me here, I guess you could say. I don't know if we can talk about our, how we came together as a Northern Birthwork collective afterwards, but yeah. 

[00:04:55] Josie: Yes, yeah. I can't wait to hear that story too. 

[00:04:58] Sabrina: Yeah. And on, on on my end, the first birth I actually attended, I'll start the story there. It was around when I was, when I was a teenager too.

[00:05:08] It was when I was 15. It was a good friend of mine who I stayed with often, like lots of sleepovers as a teenager. Her mom was a single mom and she was pregnant. And so it kind of like, that was the first pregnancy I really had witnessed. And when she went into labor my friend and I, like, she asked us to come with her and we were like, yeah, sure.

[00:05:30] I dunno. 15 we're just hanging along. She was like, kinda our caretaker, so we might as well go. So we went and she had a pretty fast and furious labor, but, the baby. I just remember either the physician or the nurse being like, "we can see the head." And I just like jumped in front and was like, baby! And saw the head and then her mom started laughing and the baby just like came out really fast.

[00:06:01] So that was funny and positive and beautiful first experience. And then like life carried on and I studied holistic nutrition and have always been really curious about bodies and how we can be more well in our bodies outside of the western medicine model. And took quite a big interest in all of the modules we did that explored stuff around reproductive health, having had to navigate my own reproductive health issues.

[00:06:38] And yeah, it was in one of my classes at the Holistic Nutrition college that I was going to, that I learned what a birthworker, or like at the time, what a doula was. And it just, yeah, lots of sparks went off. And I booked the first training that I could find, which I don't recommend doing. I recommend doing some research before you book a training.

[00:07:02] But I booked the first training I could find and I took it and have since done many other trainings, which Josie that's how we met through one of king yaa's trainings. And then moved to Yellowknife two and a half years ago. And this is where I did like a few births in Toronto, but this is where I really started my practice. 

[00:07:28] Josie: I love it. And Dehga, I was reading a little bit about you and I loved reading about the story about your grandfather and how he was born and how that inspired you to do the work you do.

[00:07:38] Will you share that story with our listeners? 

[00:07:41] Dehga: Yeah, sure. So the stories of my etseh Joe Susie Mackenzie, and when he was born, he was born in mid-April and his parents were out on the land hunting. And that's when my great-grandmother went into labor and they were traveling by dog team. So if you think about it, you're traveling on the land and you're traveling through trails and you're on a dog team, and she's sitting in the back in the sled with all their gear and they're going over tons of bumps.

[00:08:10] So her labor progressed really quickly as they were trying to get back to the village to get some help. But. Because it was so bumpy and her labor progressed so quickly, they had to stop. And they had to set up camp almost towards the end of the night. So it was dark and pretty cold, I guess you could say.

[00:08:33] Mid-April in the Northwest Territories is not warm. It's not spring. So they ended up setting up camp before it got too dark. And so they were able to lay out a tent and lay down spruce boughs on the ground just in time for my etseh to be born. And at that time, I guess if you think about it, it's like two people traveling by dog team in like supposed to be late spring, but in the north that's still pretty much winter.

[00:09:13] And you stop everything you're doing. You set up camp and then you have my great-grandmother going into labor and it's just the two of them. And she was able to obviously give birth and from what I remember and from what I remember being told, they didn't really take that much time to rest because you're in the middle of nowhere.

[00:09:36] So after that they had to pack up their camp and travel back to the village where they were able to seek help from other traditional midwives at the time. And that's the story of how my grandfather was born. 

[00:09:50] Josie: Oh my gosh. That is so incredible. 

[00:09:56] Dehga: Yeah. It definitely puts a lot of perspective into like, I think even how I grew up and how I viewed my own birth and what I was capable of as a person, it was always in the back of my mind. Like I've had four babies and every single one of them, I'm just like, if my grandparents can do this out on the land I could definitely do this. No problem. 

[00:10:21] Josie: Yeah. What strength in your ancestry.

[00:10:25] Dehga: Yes, so it just shows how like strong indigenous people are, especially. Even like people around the world when there isn't a Western medical system involved, you can give birth anywhere and still have a healthy, beautiful experience. 

[00:10:45] Josie: Totally, totally. Ugh, I love that story so much. Thank you for sharing that. So I would love to hear from each of you just kind of how the Northern Birthwork Collective was born and its mission. 

[00:11:01] Sabrina: Yeah, so the Northern Birthwork Collective, so Dehga and I are co-founders. Dehga is a project manager focusing mostly on the development of an Indigenous birth work training and working with our committee of knowledge keepers.

[00:11:14] And I am the project director, so I'm based in Yellowknife and run a lot of our Yellowknife based programming. And then we both kind of share the role of our advocacy role. So we started the Northern Birthwork Collective. The first meeting was the first time Dehga and I met.

[00:11:31] I was living here, I had been living here for about six months and Dehga was back visiting for the summer and it was June 2020. So I know we can all place ourselves in that time in the world. Not an easy time, very early pandemic, lots of fear and confusion around a lot of things, but also how pregnant people and birthing people were gonna be impacted by these changes in our healthcare system.

[00:12:06] So we came together as a community. I invited some folks to sit on my front yard, who I had met in the short five months that I had been there, who were, kinda involved in the reproductive health area. And we just kind of had a discussion around like, what is it we can do with the skills we have to help in this moment?

[00:12:30] And for me it was really like I had come up here and like I said, it was where I started really my birthwork practice. And there was just not anything available here for birthworkers in terms of like mentorship or in terms of resources to support clients or, yeah, there's just not a lot of access and not a lot of resources.

[00:12:57] So my dream was just to create a collective so that we could find funding to provide care to pregnant and birthing people here. And then I'll let Dega share more about what her dream was and how they kind of like, obviously like meshed really well together. 

[00:13:16] Dehga: Yeah, so back in June of 2020 like Sabrina said, I've worked in the healthcare system quite a bit. Like I mentioned earlier, I started nursing school, but with like life events, I ended up quitting nursing school in my third year. And decided that, It wasn't for me and it wasn't for my family. 

[00:13:41] I have always had a huge interest in indigenous governance and native studies and whatever. It's kind of what I grew up with and it's like a huge part of me. So I was working as a clinical assistant in one of our medical clinics in Yellowknife at the time. And I decided to quit my job, my government job, cause I hated it. 

[00:14:08] And I saw, I saw a lot of discrepancies, like when it came to People of Color, Indigenous people, immigrants and how they were being treated in the healthcare system.And it drove me absolutely insane. 

[00:14:24] And so then I ended up on a whim applying to the University of Alberta. And I was like, if I get in, I'll go, if not, whatever, I'll figure something out. And within like three weeks I found out that I got into the program. So within three months I decided to pack up my family and move to Alberta.

[00:14:47] It was just on the whim of a lot of things and just needed a huge change in my life. So I left the North and I was in school and the year prior, the pandemic, I decided to do online university. So I switched to Yukon College just because it was hard as a single mom with two kids, in Edmonton with no support and trying to figure out the academic world and yeah, trying to get through it.

[00:15:23] So I ended up transferring to Yukon College at the time, and part of that program with my indigenous governance degree was to create a capstone. And with our capstone, I've always had this dream of creating a network of birth workers in the Northwest Territories because it was like Sabrina said something that was hugely lacking in the Northwest Territories.

[00:15:50] Yeah. And there was no resources available. There was nobody to help you. So with my capstone in my little brain, I was just like, oh, I'm gonna create this like idea, give it to somebody and they're gonna go and do this. And then in June of 2020, when I met Sabrina, I was like, well, this is what I'm trying to do.

[00:16:11] I am trying to create an Indigenous birthwork training program that can be brought to the north and utilized in the North because there was nothing available. And with like a lot of the education pieces in the Northwest Territories, you have to leave and you had no access to obtain education. But even within your community, depending on what you wanna do, you have to either leave to Yellowknife or Fort Smith or go further south.

[00:16:38] And I wanted to create something that was available and we could bring to the communities. And that's where I met Sabrina and our dreams aligned and somehow we created the Northern Birthwork collective. 

[00:16:54] Josie: Oh, amazing. I love that. I love hearing conception stories on how things got started. 

[00:17:01] Sabrina: Do you want me to share our mission? Is that a second part of the question?

[00:17:07] Josie: I love that. Yes, please. 

[00:17:08] Sabrina: Yeah, so we created the Northern Birth Work Collective and did a lot of that preliminary work that happens in organizations in their very early stages of figuring out who exactly we wanted to be of service to and how we wanted to be of service.

[00:17:26] So our vision for the Northern Birthwork Collective is that all families, pregnant and birthing people from underserved communities would've access to holistic and dignified support that is respectful and free of oppression and racism. 

[00:17:41] And then our mission was to provide cost supported program and services for all stages of the reproductive journey, including conception, pregnancy, birth, postpartum, miscarriage, loss, abortion and parenting.

[00:17:54] And that we intend to provide continuous education to members of our community and grow a territory-wide network of birth workers who are able to provide collective care that is grounded in our values. And then that we acknowledge that colonization has had a great impact on our bodies and our traditions, and believe that revitalizing traditional knowledge is a crucial step in our collective healing.

[00:18:14] So what's not in there is all of the advocacy work we ended up doing a lot of the time. Just cause that we realized we, we were just kind of started as like, let's develop a training and let's provide a service. But there was no reproductive justice advocacy organization in the Northwest Territories either. So we took on that role as well. 

[00:18:36] Josie: Right. So both. Yeah, oh, that's so beautiful. I got goosebumps when you read that mission. So powerful, so necessary. So I would love to talk to you both about reproductive health in Northern Canada also, so folks can kind of get an idea of what it's like. Will each of you share about the uniqueness of being a birth worker in Northern Canada and Dehga, will you share specifically about the indigenous experience of that?

[00:19:05] Dehga: Sure. Do you wanna go first? 

[00:19:08] Sabrina: Okay. Yeah, I'll go first. So yeah, it, it's a very unique experience. I mean, I attended two births in Toronto and a lot of my trainings I've done have been not northern based, cuz there isn't a northern base one. So context is completely different. I came up here and started practicing.

[00:19:28] One very unique part of it is the evacuation policy. And this happens outside of Northern Canada, but it happens just for all remote northern communities. So it's a policy that I think Dehga can go into more detail cuz she's done so much research around it. But where people have to leave their home community for labor and birth, but for any, for most reproductive health matters in general. 

[00:19:59] Medical travel for most health matters happens here, but it's especially unique for people who are leaving for labor and birth because they need to leave at 36 or 37 weeks.

[00:20:10] And we know that someone can go up to like 42 weeks in their pregnancy before they give birth. So that's like, can be up to five, six weeks of being away from home. And being, being away from family, being away from older children, you might not be able to bring an escort or support person with you because they might have to stay back and look after your older children.

[00:20:34] So yeah, it's, you're supporting people who are often here alone and very under-resourced. And there's the other element to it is that because of this policy and because of the way the health system works up here, there is not a lot of continuity of care. So someone's not really seeing the same care provider all the time, and there's not a lot of trust being built there.

[00:20:59] There's a lot of low income positions coming up. Very few midwives as well, so. Even the time they have with these low income positions is like quite short and no one really knows who's gonna be at their labor and birth. So you end up kind of being that like one person that the person is consistently seeing for support.

[00:21:21] So that's like one of the reasons why I think birthworkers here are so essential and so important. There's just not the same access here to, like, I, like we said, like we created this because there were not really any programs. I know I hear a lot in, in like more southern birthwork spaces of like, If you can't do it, refer out, refer out. 

[00:21:44] Which I think is a beautiful idea. Like, yeah, if you don't have that capacity, refer out. But here there's just like not a lot of things to refer out to. So you end up having to really work with your clients and like troubleshoot and like, sometimes like a client will express a certain need and I'll end up taking a course for it.

[00:22:00] Or like how to support them in that because there's just not a way to really refer a lot of the times when you're living here and when somebody's already dealing with like, so much lack of trust within the system because there's so many care providers that are coming and going.

[00:22:17] They meet you and they wanna work with you and then they don't really often want to be referred out to a bunch of different people. Especially if that has to be something that they're doing like virtually or online. And a lot of people don't have access to internet, which is another thing.

[00:22:33] So many unique things that are happening here. That's kind of been my experience. And like all of those unique things combined create a lot of room for creativity though, and the way that we are developing our programs and the way that we are providing a service and all of that. 

[00:22:53] Josie: Yeah. Wow. That's incredible. What about you Dehga? 

[00:22:57] Dehga: For the most part, like I said, a lot of the births I've attended have just been family members and friends. But when it came down to it prior to Covid, years ago when an indigenous family was about to have a baby, it wasn't just the person in labor, their immediate family and their like little support team. It literally was a community of people. That would show up. 

[00:23:28] When my friends went into labor at 17 years old, it was all of us. Like all of her friends gathered, all of her aunties and all of her grandmothers gathered and we were there taking turns. We were there supporting each other. We were there making sure people were fed, making sure that, you know, her mother was okay. 

[00:23:51] Cause sometimes it's a lot harder for a mother to see their child in pain and they can't handle it. And then as my siblings started to have babies and close relatives I was a go-to, I was like, Dehga, you know what to do.

[00:24:12] And then when. My, one of my younger sisters. So I come from a very big family. I have five sisters and two brothers, and half of us, more than half of us have kids. So when one of my younger sisters had her first baby, she's two years younger than me, so I think she was what, 25 or so. And she lives in a smaller remote community.

[00:24:38] Luckily, our family still lived in Yellowknife. And so we were able to support her and be there for her and had that realm of support. But that also meant she had to travel from her current home or now home in her life. And that's an eight hour drive. Wow. And she had to show up at about 36 weeks and was. Offered to stay in a boarding home. 

[00:25:13] But luckily, because literally everybody in my family still lived in the North or in Yellowknife, she was able to stay with us or with my parents and wait for her labor. And so that was my younger sister and she had a realm of supportive people and had the ability to stay with us and had the ability to have that comfort in the, and I guess the easiness of traveling to another place to have a baby.

[00:25:40] But I also remember watching my 15 year old cousin who lived in a smaller community, but was originally told she had to go stay in a boarding home and she didn't have the access to have support with her. So her mother wasn't allowed to stay with her. And if you think about it, you're a young 15 year old about to give birth and your main person, depending on what your relationship is, obviously is, it's usually a parent. 

[00:26:10] AKA, their mother or grandmother or auntie, and she wasn't able to have that. So her mother phoned my mom and asked if she could stay with us. So she ended up staying with us for about four weeks and at least she had the ability to have relatives with her and then her auntie.

[00:26:28] But I remember thinking, I'm just like, this is my cousin. And I felt so bad for her and thinking this is ridiculous. She shouldn't have to be 15 years old going through, waiting for her labor to start on her own in a boarding home. And luckily she only lived an hour outside of our community. 

[00:26:50] My sister lived eight hours outside of our community. But there's other people that fly in from Nunavit. Other people fly in from all over Northern Canada to come to Yellowknife to give birth. And that leads into like the evacuation policy and how harmful it is to a lot of indigenous families. 

[00:27:10] And it really not fair when you think about it, I don't know if you want me to talk more about the evacuation policy cuz it's, yeah. 

[00:27:19] Josie: Let's get into it. We're here. We're at the evacuation policy. Yeah. I want to know more cuz I don't know much about this at all. 

[00:27:27] Dehga: So. With the evacuation policy. It was developed in 1892 by the federal government to ensure that Indigenous families were separated from their core support systems, brought into a Western medical view of hospitals, birthing centers, whatever, to give birth.

[00:27:50] And like Sabrina was talking about, you have to leave at about 35 weeks gestation. And wait out your pregnancy until you give birth. And you can be waiting up to a month, a month and a half. Yeah. If there are complications afterwards, I guess. And then you could be even waiting longer. 

[00:28:07] And the main idea or thought behind the evacuation policy was to assimilate indigenous people and to break that barrier of the connection at birth when it comes to your culture and your traditions. It also. Breaks that family, your connection of family. Indigenous families especially, are very big. Mm-hmm. And supported with a lot of people, right? 

[00:28:40] And if you think about it, in the past, we travel together as families and travel through the land as families and support. So you'd have your grandmothers or your elders, and then you have your grandmothers and elders supporting the younger generation while the parents, the fathers would be out on the land hunting further, the mothers and older siblings would be taking care of the camp, or hunting smaller animals depending on like the time of year or where they were camping and what they needed or getting firewood.

[00:29:17] So you constantly had that support and you had that strong connection of culture and tradition. And the federal government really saw that if they implemented this policy and took a baby away from their connection of family culture and traditions, they would be able to assimilate them and take them away from who they are as a people. Which also leads into the access of abortion, access of basically anything related to reproductive health and reproductive justice.

[00:30:01] And the increase of forced sterilization within our indigenous people across Canada. The evacuation policy doesn't only affect Northern Canada, it affects all of Canada. It also affects a lot of Indigenous communities in the States. There's a lot of work to be done to kind of mitigate this policy and get rid of it and bring traditional birthing practices back into our communities. 

[00:30:27] And have people understand that birthing in your community and birthing with a birthworker, slash doula, or midwife, or a traditional midwife is not a bad thing. I can't remember what I was listening into or what conference I was at, but I remember somebody talking about, especially in our indigenous communities now, because they took birth away from us.

[00:30:57] Mm-hmm. Which means you take a lot of celebration and you take a lot of happiness and joy, what a new life brings to a family and a community, which are healthy things. But now all of our communities, all we see are death and sadness. So they don't balance out. So you have communities filled with so much death and sadness and suicide and everything else, that once you start to bring these birthing practices back into our communities, and once you start to bring in the joy.

[00:31:33] The happiness, the connection, the celebration, you'll be able to start balancing these realms of like happiness in our communities. Which in turn will also start to heal our communities. A lot of our communities are struggling. A lot of them are in a place of like full of addictions, alcoholism, hard drugs are in all small communities throughout the north and they don't have the hope.

[00:32:11] And. I strongly believe that if you bring traditional birthing practices back into our communities and birth into your communities, you will build these connections and people at a younger generation will be connected to their culture and the tradition and have these ceremonies brought back, and you'll start to heal these communities and you'll start to see the joy in communities again instead of just having filled with like death and sadness and disparity.

[00:32:44] Josie: Yeah, yeah. Absolutely. Oh my goodness. Yeah. Oof. I just feel like pausing for a minute and like holding space for that, that is really huge and makes me so sad. Yeah, and just so important that you two are doing this work.

[00:33:10] Sabrina: Thanks Josie. And I think what's really complicated about the evacuation policy as well is because traditional midwifery practices and midwifery was made illegal. Like the evacuation policy is both harmful and essential. Like people do need to leave their communities to safely birth sometimes if there's any high risk situation.

[00:33:44] There aren't care providers that are skilled to attend birth in, in communities because of midwifery being made illegal. And then having only been made legal again in like, I think the early nineties. And then this very slow process of the territory implementing a midwifery program.

[00:34:10] The lack of sustainability because there's so few options to train as a midwife in Canada in general, but like none in the north. And so it's, it's hard because like the evacuation policy is terrible and what's created for really terrible reasons, but it's also not going anywhere anytime soon. So we're in this position of like, okay, how can we understand that this thing is really terrible, but also right now without all the resources essential, and what can we do to help?

[00:34:43] Mitigate some of the harm that it's causing and the impacts of that. 

[00:34:48] Josie: Right, totally. Yeah, that's, that's really interesting, that nuance there, that it's both necessary or in some cases necessary and then also so harmful with such a harmful history. Yeah, and I guess I didn't realize this was going on at all, and I didn't realize it was going on in the states as well.

[00:35:11] I just, I didn't know that. So it's not that someone can choose to stay at home, this is just, they have to, it's against the law to stay at home and birth. 

[00:35:21] Sabrina: Yeah. I mean, someone can, they can like, I mean there's like the free birth movement and people can do it, but I think there has been so much fear implemented into people around birth. And or about disobeying. Which is a ridiculous word, disobeying what the government or what your healthcare providers are suggesting to you. 

[00:35:46] Because if you don't, if you choose not to go, then is your community health nurse gonna say that you're, you're responsible in putting your child at risk then if social service is gonna get involved, and then are you at risk of losing your children? Right, so it's a very like, scary and, and often dangerous for families that path that they can go down. So, there is, I guess, and they like, A choice, but like is there really a choice? No. 

[00:36:17] Dehga: That's also like say, and especially in the north, I know for a fact because my sister's last baby, she decided she did not wanna leave at 37 weeks. So she waited until the last minute to go, but she had to sign over like a consent form, stating if anything happened, she is liable and she's responsible for any medical costs. 

[00:36:39] Which is absolutely ridiculous, right? Because she doesn't have the option to give birth in her home community. She didn't have the option to be there with her family, with her older children, with her spouse.

[00:36:55] And it was, you have to leave and you have to leave now. But she also knew her body. She also knew what she was capable of and knew how long it would take her to get to and from if needed be. And she decided to wait until she was about 39 weeks pregnant. And then she drove over and waited, I think about a week.

[00:37:20] She gave herself that much time, but it was just, she didn't wanna leave home. She didn't wanna leave her children, she didn't wanna leave her spouse. She wanted to be comfortable in her own space and people should be allowed to do that. And unfortunately with the evacuation policy, a lot of people aren't.

[00:37:42] So they're put up in a boarding home. They're put up in a hotel. It's not a comfortable place to be at when you're waiting for the birth of your child and super pregnant and uncomfortable and miserable. 

[00:37:58] Josie: Yeah. Oh my God. 

[00:38:00] Sabrina: I mean, I hate leaving my house on like any given day. Right? 

[00:38:03] Josie: Totally, totally. Exactly. I'm like, I don't even like going to run errands. 

[00:38:14] Dehga: Yeah.

[00:38:15] But like to even put it into like a completely different or same context, but with my last child, I gave birth to her here in Calgary and I had access to a midwife. I had the availability to give birth at home. I chose not to because our house was packed with like people and it was like right before Christmas.

[00:38:35] Which was not happening. But I didn't have to leave home. Like I literally went to the hospital, gave birth, waited four hours and came home. And I was in my own space. I was in the comfort of my spouse and my older children and like in-laws that were staying with us as well, who were able to provide those nourishing meals and support me and take care of me, and take care of our infant while I was healing.

[00:39:09] Where you don't have that option. And it's like such a beautiful experience to be able to know the difference, and experience the difference. Cause my first three children were born in the north. Yeah, I lived in Yellowknife, so I didn't really have to go anywhere, but it was just a different dynamic, having that support of a midwife. 

[00:39:31] And the capability to make your own decisions and understand what you can do as a birthing person and what you can say no to. Cause a lot of people don't know their rights when it comes to birth and like we were talking about earlier, a lot of people are instilled with fear when it comes to western medical systems, especially when it comes to birth.

[00:39:57] They're given one option. They're not really explained what is happening and they're told this is the best thing to do. So they trust in that process because it's a stressful event. When it comes down to it though, when you have a birth worker or a midwife, somebody that's able to talk to you and explain what's happening and your options, you can make that best choice for you and your family, 

[00:40:24] Josie: Right, yeah, absolutely. I mean, I feel that fear here, just, being someone who has access to a hospital or a birth center or giving birth at home, you know, when I had my kids it was definitely like, oh, you have a choice, but not really. Like you said, Sabrina, I mean, it's just like, yeah, you're indoctrinated with so much fear around childbirth and mine were high risk, and so I lost those options of birthing in a birth center kind of early on. 

[00:40:57] But like, yeah, you, you really do. I felt that at several different points with both of my pregnancies of losing that autonomy and that power or that ability to really know what my rights were and what I could say no to. And that's, and you know, I was in such a much more you know, privileged position in terms of my access. So I just can't even. Yeah, that's wild. 

[00:41:26] Sabrina: And it's so interesting because when I think of like when I close my eyes and when I like picture the people I've witnessed in labor and birth and when I like picture birth and just like, that's like such a time of such like strength and power and supposed to be a time of such like autonomy.

[00:41:43] Of just being so in your body and like knowing what your body needs. And to have that experience kind of shrouded in that lack of autonomy and that lack of choice is Yeah. Yeah. Really just like counterintuitive and just, so frustrating.

[00:41:59] Josie: Traumatizing. 

[00:41:59] Sabrina: Yeah. And traumatizing. 

[00:42:01] Dehga: Very much so.

[00:42:04] Josie: Yeah. Yeah. I'm, so, I'm wondering what is the solution that you all are working towards to turn this ship around? If people, are they allowed or more quote unquote, allowed to stay home if they have like a trained midwife with them or a birthworker? Is that the kind of workaround to this evacuation policy?

[00:42:28] Sabrina: Yeah, so I think like what the workaround is, is definitely more midwives. And we do like the territorial government, so midwives work a bit differently here. They don't have like, specific midwifery clinics that they're working in. They're all employees of the territorial government. 

[00:42:45] And there is a midwifery program in two communities right now that's running out of all the communities in Northwest Territories. And then they're hiring more for Yellowknife. And then the ones in Yellowknife are gonna travel out to communities a bit. But I think once they have a Yellowknife program, then they're gonna look at what's the next community.

[00:43:07] So it's slowly being implemented, but again, it's not gonna be very sustainable if they don't train people who are from the North and dedicated to staying in the North. Because right now it's the same as the physicians and nurses. You're getting a lot of people who are coming up from the south and are locum here.

[00:43:25] So, I mean, that's one solution. What we're sort of working on, on our end, so we have a program that supports people who are being evacuated from their home community for birth or reproductive health matters. And what we are kind of looking at is like, okay, where are the gaps? So if someone comes here, they have to stay in a boarding home.

[00:43:48] That boarding home is usually, there's only enough room for you and your one escort. So we meet with people to discuss like, what are your needs? Do you need to bring more than one escort? We will help pay for those flights. Okay. Now you're here with more than one escort. The boarding home isn't an option anymore.

[00:44:07] We will help pay for hotel and accommodations. Okay. You're here, we're helping pay for hotel and accommodations. We're helping pay for flights. What else are your, like, what do you need? So we have like a gift card program for the grocery store and where we're providing that to them. So they have access to food while they're here.

[00:44:27] And we also help them access support from birth workers. So they have that emotional support as well. And connecting them to other resources like pelvic health physiotherapy and mental health resources and stuff like that. So the program our community care program is centered around like where are the gaps.

[00:44:47] Because when someone comes here for medical travel, if they're not staying at the board home where they have their food and room covered, they only get a reimbursement. So it's a reimbursement program to start. And a lot of people don't have, like, credit cards that they can put a bunch of expenses on.

[00:45:02] And medical travel only reimburses like for you and your escort $50 a night for a hotel. So if you're here alone, $50 a night is covering less than half. If either if your escort, it's still not covering the whole thing. And then $18 a day for food, you go anywhere for a meal in the north, it's costs at least $20 for like one meal alone.

[00:45:30] So it doesn't, it barely covers anything. So we looked at that and we're like, okay, where are the gaps and how can we support filling those in? So that's kind the solution that we've been able to come to so far. Around the harm of the evacuation policy.

[00:45:52] Josie: Okay. Yeah, that makes a lot of sense. It's like coming at it from short term and the long term. Yeah. 

[00:45:59] Sabrina: Yeah, exactly. 

[00:46:00] Josie: Yeah, I love that. Ugh. So there's a couple other topics that we haven't touched on that I would love to talk about is abortion access and how this influences and impacts abortion access, and then also forced sterilization among indigenous communities.

[00:46:20] So I would love to hear just the, the details of how that evacuation policy is affecting abortion access, and then maybe we can move on to the other topic. 

[00:46:33] Sabrina: Sure, yeah, that sounds good. Big topics. 

[00:46:38] Josie: I know.

[00:46:42] Sabrina: Yeah. So for abortion access, yeah, it's well, so we only have one abortion clinic in the entire territory, and it's in Yellowknife. And again, because of the lack of care providers across the North midwives specifically, or people who are trained in providing abortions, it means that there is less access to medication abortions as well because usually if people are coming to Yellowknife, they're just doing the surgical abortion. Because if they do the medication abortion, they'd have to stay here longer to wait for the medication abortion to happen and to make sure that it was complete.

[00:47:23] So yeah, people are having to leave their communities to come here to get surgical abortions. I think there's like a couple communities where there is a care provider who can provide, like the ones where there is midwives, they can provide medical abortions and handle that there. But it's complicated because, often you have like,a couple care providers working in your community and there's, as we know, so much stigma around abortion and maybe you don't trust that care provider that's in your community, to help you get a referral or to discuss the need for need for an abortion.

[00:48:00] So, you know, you can just call the abortion clinic in Yellowknife here and they'll arrange your medical travel for you to get here, but say there's complications after the abortion, then you need to get checked when you're in your community. That can feel really unsafe for some people. And so often, like the easier thing for them is to just not get an abortion, even if the pregnancy isn't unwanted.

[00:48:23] Right. And then, yeah. So those are some complicated factors for sure. Yeah. 

[00:48:31] Dehga: But even in the north, so they don't see people until after they're about 12 weeks pregnant. And even if you have any questions, it's really hard to even state that you want an abortion. So if somebody that like just found out they're pregnant and they don't know whether or not they wanna keep the pregnancy or whatever the case may be, you still have to call the clinic.

[00:48:55] And they're like, okay, I just found out I was pregnant. They're like, okay, call us back in like when you're about three months, 12 weeks or whatever. But they don't even give you that option to be like, but this is what I need. And they don't have that information of like, where to access this information.

[00:49:13] And we just started developing all of our pamphlets and websites to like provide this information. But a lot of times, most people don't even know how to access an abortion. Or even where to turn to. And like Sabrina was talking about in smaller communities, like some of these communities are like 500 people.

[00:49:35] People that work as like, say, the receptionist at a medical clinic is a relative or somebody that you had like conflict with and you don't wanna show up at the clinic and be like, this is what my appointment's for. Because in reality it's a small town. People do talk and somebody in that clinic has access to that information. 

[00:49:59] On the flip side of things, when say a miscarriage has happened and you need a medical abortion for that miscarriage, and because our locum doctors and nurses and there's not the continuity of care when it comes to communities, when it comes to traveling to Yellowknife, information's not always quite shared properly.

[00:50:23] There's like sometimes where unthinkable things happen and point in case, like I know of somebody that had a miscarriage, they were pregnant with twins. They lost one twin and didn't know about it. And they thought they were pregnant. And at 20 weeks when they came for an ultrasound, that's when they found out that they weren't pregnant with twins anymore.

[00:50:49] And like it killed them. Like it absolutely destroyed them. And they went through a spiral of like mental health issues. And on top of that, you don't have the mental health support when it comes to like even discussing these and grieving that process. When it comes to access to abortions, and even if it's medical, or even if it was like a miscarriage and you needed a medical abortion, There's a lot less access to people, for people that live in smaller remote communities. And it's a lot harder for people to even have these conversations. Where they feel confident and cared for and supported. 

[00:51:42] Josie: Yeah, yeah. That makes sense. And then the forced sterilization. This is something that I've been more aware of recently and just realizing how current this is and it just seems like, oh, this is something that used to happen. But this is, my eyes have been opened, you know, just like, oh, this is happening like right around us right now, present day. 

[00:52:08] Could you speak a little bit about that, Sabrina? 

[00:52:10] Sabrina: Yeah. So I mean, like forced or coerced sterilization is just one of the many violent harms and injustices that make, that make up a lot of the history of like, this country's attempt to eradicate indigenous culture and indigenous people.

[00:52:34] And so there's a very long history of this, this happening of of indigenous people being like test subjects for procedures and yeah. It's a very frustrating thing to talk about. But you know, and I think more presently, like it definitely still happened.

[00:52:59] And I think also more presently, like we can look at really poor communication on like, the part of physicians and we can look on at like, people not understanding what proper informed consent is and what consent means, and if someone's actually consenting to something being done. So the poor communication. 

[00:53:21] And also physicians thinking they like, know better than somebody does about their body and making choices for them based on what they think is best for their health when they're not the authority on that person's health.

[00:53:35] I think these, all those things combined can lead to these things still happening. And the person not consenting, but the doctor doing the sterilization. There is a case going to court. Maybe there is someone being sued in the NWT over this and there is a class action that's taking place like across Canada as well.

[00:54:04] Because there are so many people still to this day who are suing doctors for this. And like, and you think of how many people aren't speaking up. Like for there to be a class action. And to know that there are so many people who probably aren't sharing about this experience that has happened to them, is just like, it's immeasurable how many people that have probably experienced forced or coerced sterilization, and it's just such, yeah. It's really hard to talk about and it's really sad. 

[00:54:40] Josie: Yeah, totally. So I would love to wrap up and talk about how folks can support you all and your mission. Not only, you know, how can folks support Northern Birthwork collective specifically, is what I wanna know. And then also just how can we support indigenous led birth work and midwifery efforts, you know, across North America? 

[00:55:04] Sabrina: Yeah, I mean, like the direct support is easy to share, like donate to our programs. That's like one of the best ways to support so that we can continue to provide those, not only just birth work care to people and families. But like I mentioned for the evacuation, for birth support, we're paying for hotels, we're paying for flights, we're paying for groceries for people.

[00:55:31] And like those are, as anyone knows, travel especially in the north, like look at flights from northern, small, northern communities to Yellowknife, it's like nuts. So those are big finances, right? So financial support is always really great. And we're really grateful for anyone who's able to provide that.

[00:55:51] And just share about these issues. I feel like the North is often like left out of a lot of conversations. And people forget about the, like, situations that are happening up here. So yeah, just to be able to have this conversation and for people to be able to like, talk about these, these things more.

[00:56:11] And I'll let Dehga answer the other question about like, supporting indigenous birthwork across like Turtle Island in general. 

[00:56:19] Dehga: In general is not only just supporting us, but also look at all the other Indigenous birthworkers out there. There's quite a few. And hire them, to be honest. But a lot of us are, well, A lot of the birth workers I know are definitely overworked and underpaid when it comes down to it.

[00:56:38] And birthworkers in general, and even midwives. And like Sabrina said, I think talking about all of the issues we talked about. So when it comes to forced sterilization, when it comes to abortion access, when it comes to not just Northern Canada, but Canada and the states and birthing practices in general.

[00:56:57] I think it's very important that people understand traditionally, as an Indigenous person, we gave birth out on the land since time of Immorial. And our ancestors are strong and they were able to have traditional medicines and practices that allowed them to give birth, but it also allowed them to understand medicines that we're able to give them or for people to have abortions as well for unwanted pregnancies. 

[00:57:34] And those are things that aren't talked about. So I think understanding that this knowledge does exist and this knowledge is there I like to say that it's sleeping. And it will take time to waken up and be fully present in today's society, but it will get there.

[00:57:55] And for an Indigenous person or anybody that's interested in birthwork, it's just to ask those questions. And not be afraid of it. I think it's very important to keep these conversations going and to have an honest, open dialogue about what's available and why these things were taken away from us.

[00:58:19] And why we should have these in our communities and how much it would actually put a lot less strain on our hospital systems. When people are able to have births within their communities or within their homes and with birth workers and midwives. It will take up a lot less money. Honestly. 

[00:58:41] Josie: Right. Yeah. Yeah. I love that.

[00:58:45] So where should we direct folks? To your website? 

[00:58:50] Sabrina: Yeah. They can go to northernbirthwork.com and there is lots of info on all the programs and everything to know about us there. And we have an Instagram @northernbirthwork and a facebook, slash Northern Birthwork. I think that's pretty much all the social media.

[00:59:12] Okay. We have so yeah, you can find us there. 

[00:59:15] Josie: Okay. And is there an explicit place to donate on the website? 

[00:59:20] Sabrina: Yeah, we have like a donate button at the top of the page. Okay. I think there's a few donate buttons sprinkled throughout. I think depending if you go to like certain program pages, there is the option to donate to specific programs.

[00:59:34] But if there isn't, then you can always like on the donation funding page. You can leave a little note if there's a specific program you wanna donate to. 

[00:59:44] Josie: Okay, perfect. Awesome. I will include all of that in the show notes so folks can access that easily. So I just wanna say a huge thank you to both of you for being here today.

[00:59:55] This is such an important, powerful conversation. I can't wait for everyone to hear this and to keep this dialogue going and to support you all and your incredible work. So thank you. 

[01:00:10] Sabrina: Thank you for having us, Josie. It's always so nice to be in space with you. So yeah, this has been lovely. 

[01:00:16] Josie: Likewise.

[01:00:17] Dehga: Masìcho. It's definitely been a great conversation.

[01:00:20] So, masì.

[01:00:25] Josie: Thanks for listening to the Intersectional Fertility Podcast. To get customized fertility recommendations based on your Whole Self Fertility Method element, joined by mailing list at intersectionalfertility.com, and get immediate access to my two minute quiz. 

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All content offered through The Intersectional Fertility Podcast is created for informational purposes only, it is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.