Land acknowledgment: This meeting was held on the traditional, ancestral, unceded homelands of the xʷməθkʷəy̓əm (Musqueam) Nation.
Provincial leaders in reproductive, public and primary health care met at the Musqueam Cultural Centre on June 26 for a Forum on First Nations Birthing Sovereignty hosted by the First Nation Health Authority's (FNHA) Office of the Chief Medical Officer (OCMO). The Forum was co-led by Dr. Unjali Malhotra, FNHA Medical Officer, Women's Health, and Dr. Nel Wieman, FNHA Chief Medical Officer; guided by T'it'q'et Elder and Cultural Advisor Lucy Barney, retired FNHA Clinical Nurse Specialist, Perinatal Care. Among the approximately 60 participants were Dr. Bonnie Henry, Provincial Health Officer, and Dr. Danièle Behn-Smith, Deputy Provincial Health Officer, Indigenous Health.
The Forum focused on how the various organizations represented will answer Calls to Action from First Nations Lifegivers in BC to improve the reproductive health care journey for them. The Calls broadly address four key issues: 1) upholding the inherent rights and self-determination of First Nations in BC, 2) increasing the availability of services in-community or closer to home, 3) addressing Indigenous-specific racism and discrimination, and 4) prioritizing the social determinants of health in reproductive care. Each discussion table was guided by direct quotes – some of the “Calls to Action" – gathered through the OCMO's widespread community engagement with BC First Nations Lifegivers over the past year.
“The OCMO was gifted stories ranging from the vital role of Elders, the impact of the toxic drug crisis, and the need for longitudinal primary care and social supports before, during and after pregnancy, including knowledge translation, and seamless transitions of care in reproductive-age people," said Dr. Malhotra. “Many spoke about the social determinants of health, and we were able to raise awareness and look for opportunities for collaboration."
Elder Lucy Barney opened the forum and shared this memory.
“I remember growing up in T'it'q'et, where all the people sat outside when the Lifegivers gave birth," she said. “We all knew our role as family and community at that time, whether midwife, grandmother, mother, auntie, uncle, or cousins – and every Lifegiver was fully supported to give birth. Things have changed – but now we're here to answer the call of our Lifegivers. To have each one cared for as they should be. To determine how we can build upon the good work already being done."
Dr. Wieman then shared a story about a First Nations couple who were able to access prenatal care and birthing classes, participate in their traditional ceremonies, and have their baby safely in the urban setting where they live.
“They had no fear that their baby would be apprehended by child protective authorities. They brought their baby home, surrounded by the support of their extended family members. They gave the baby a traditional name and a cedar cradle that has been passed down for generations. The baby and parents will thrive as they continue to connect with ancestral knowledge, culture and love."
The Forum culminated with health system leaders making a number of vocal and written commitments specific to their unique roles and workplaces in response to the Calls to Action. When enacted, these collaborative movements forward are intended to lead to stigma- and racism-free, culturally safe care.
The FNHA's report, Answering the Call, is expected to be available in 2024.
