For generations, the women in Keisha Charnley's family gave birth on tribal land, surrounded by their extended families and midwives, who would lead the spiritual and medical aspects of the birthing ceremonies. That all changed with her grandmother: She delivered her daughter, Keisha's mom, in a Canadian hospital in the 1960s.
This shift was the result of a new government policy, under which indigenous women in rural and remote areas of Canada are routinely "evacuated" to urban areas to complete their pregnancies and give birth. "My grandma's generation and those earlier were born on the land," Keisha, who is from the Katzie First Nation, explains. "When we were no longer allowed to be on our territories to birth, it made maintaining and passing down our ceremonies to future generations challenging."
In her work as a doula, Keisha is working to change this: In 2015, she co-founded the Vancouver-based ekw'í7tl indigenous doula collective with three other women in order to bring back lost knowledge and empowerment to indigenous communities through birth work—a term that encompasses doulaing and midwifery, and a practice that's always been key within their cultures. "From the stories I've heard from my family and community, there's immense power in the ceremony of birth. Our ancestors want us to be here, sending us here from the spirit world with gifts," Keisha explains. "My role as a birth worker means I support a family bringing a spirit into the world. It's a big responsibility, but a big honor."
For centuries, indigenous communities considered the power inherent in birth as an extension of the power inherent in women. Although each nation varies in its specific beliefs around birth, many traditionally revere women as bearers of life and "nourishers of all generations." In particular, midwives are thought to be the authoritative embodiments of these values. Charged with passing down moral and ethical values through birth work, they're meant to share their knowledge with the rest of the community and future generations, therefore ensuring that each birth is spiritually meaningful.
However, this all started to change in the 17th and 18th centuries, when the English and French colonized Canada. "Part of what colonization tried to do here was compartmentalize certain things in our communities which were way more fluid—and that certainly applies to things like birth, sexuality, and gender," Keisha explains. In 1876, Canada passed the Indian Act, a law that gave colonialists authority over First Nations peoples. The point was to gain territory by downsizing Indigenous territories to small, government-managed reserves, but also to force indigenous peoples to assimilate through various methods, most notoriously through residential schools (church-run boarding schools indigenous children were forced into, now known as sites of mass sexual and physical abuse).
There's immense power in the ceremony of birth. Our ancestors want us to be here.
For women, the Indian Act severely undermined their roles in indigenous societies in myriad ways—often focused on reproduction. In general, according to an article published in A Journal of Aboriginal and Indigenous Community Health, the Canadian government "exerted state sanctioned medical control over First Nations women" in order to end traditional pregnancy and birthing practices as a form of coerced assimilation. Evacuation is one such example of this, according to critics of the policy: Though it's ostensibly"founded on concerns for First Nations' health and wellbeing," some indigenous activists say the policy intentionally disregards centuries of autonomy, tradition, and expertise.
"Family was such a big part of indigenous birthing practices," Keisha explains. "Your extended family is your close family. When you're forced to have your birth in an unfamiliar place without your family around, that's a violent act against our birthing practices and goes right along with the institutionalization of birth."
By the middle of the 20th century, midwives' practices had been delegitimized by the federal government, brushed off as "old wives' tales" and evidence of a "savage culture"—despite the fact that Indigenous peoples had considered them medical authorities within their communities for centuries beforehand. "Before colonialism, it was normal that the midwife would lead a birth in an indigenous community and the young people in the family would go with her to support," Keisha says. "The midwife would be the knowledge keeper and would pass down teachings about how to support a birth to her helpers."
The evacuation policy is still in place today; an estimated 29 percent of indigenous mothers in British Columbia currently travel away from home to give birth. "The evacuation policy is one of the things that our collective is focused on changing," says Keisha. "Although it's generally assumed the government is doing it for the benefit of the health of indigenous women and children, it's been proven that it doesn't work."
The removal of births from many aboriginal communities has had profound spiritual and cultural consequences.
Despite the evacuation policy, the infant mortality rate among indigenous women remains twice as high as the national average, and critics say it comes with severe psychological consequence for mothers and indigenous communities alike. According to a 2012 analysis written by an aboriginal midwife and a professor at the University of Ottawa, indigenous women can struggle with feelings of isolation and loss of control in the aftermath of evacuation. "Evacuation extinguishes the considerable contributions that community birthing offers, such as emotional, physical, psychological, and spiritual supports," they conclude.
According to a 2008 report on aboriginal midwifery in Canada, "The removal of births from many aboriginal communities has had profound spiritual and cultural consequences, which are difficult to quantify. The loss of traditional birthing practices has been linked to the loss of cultural identity."
"Knowing about these policies makes you realize that our people aren't inherently unhealthy," says Keisha. "These policies have forcibly led us there, so now we want to put supports in place to revive and share birth knowledge hidden for generations—knowledge that is proven to strengthen our communities."
For Keisha, reviving that birth knowledge has been an extremely powerful process. "When we learned about birth in school, it was positioned as this ugly, scary thing with lots of blood and pain," she says. "It wasn't until I started talking to elders that I found out it's a really powerful and dignified process that our bodies are capable of doing as women."
Beyond birth work, Keisha says, there's new momentum in indigenous activism, although it's all interconnected. "There's definitely a direct link between momentum in the land protection movement and momentum in the indigenous birth work movement," she says. Right now, thousands of aboriginal peoples across Canada, the US and Latin America are gathered to protest the Dakota Access Pipeline, a project which would directly threaten the Standing Rock Sioux Tribe's public healthcare, water supply, and cultural traditions.
The gathering is so large that a camp complete with schools and health amenities has been set up—and on October 17, indigenous midwives delivered a baby on the site. As one of those midwives, Carolina Reyes, told Democracy Now, "Sovereignty for indigenous people is only going to come about through the support of women and women's health. The same way that we defend and protect Mother Earth is the same way that we need to defend and protect women and the next generations of children being born."
In fact, this mentality is precisely the one that powers the ekw'í7tl indigenous doula collective. "The birth that happened at the Dakota Pipeline Protest is a very clear message being sent to the powers trying to destroy that territory," Keisha states. "If indigenous peoples can have babies on the land in a so-called 'camp' in a culturally relevant and healthy way, then we can take care of ourselves. We can do anything and be anywhere." For the ekw'í7tl collective, birth was never meant to be an institutionalized activity. Instead, it's a meaningful catalyst for cultural ownership, sovereignty, and healing from years of colonialist oppression.