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Continuity and Change in Wemindji Cree Childbirth Experiences and Practices: Past and Present

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Continuity and Change in Wemindji Cree Childbirth Experiences and Practices: Past and Present CONTINUITY AND CHANGE IN WEMINDJI CREE CHILDBIRTH EXPERIENCES AND PRACTICES: PAST AND PRESENT Ieva Paberžytė Department of Anthropology, McGill University, Montreal, Quebec 2019 A thesis submitted to McGill University in partial fulfillment of the requirements of the degree of Doctor of Philosophy in Anthropology ã Ieva Paberžytė TABLE OF CONTENTS Table of Figures............................................................................................................... v Abstract............................................................................................................................ vii Geographical locations mentioned in the thesis……………………………………….. x Cree vocabulary used in the thesis…………………………………………………….. xii Abbreviations………………………………………………………………………….. xii Acknowledgements......................................................................................................... xiii CHAPTER ONE: INTRODUCTION............................................................................. 1 1.1 Longing and pride…………………………………………………………… 1 1.2 Structure of the thesis……………………………………………………….. 4 1.3 Ethnographic context and anthropological research in Wemindji……………… 5 1.4 Methods…………………………………………………………………….... 9 1.4.1 Interviews with mothers and their families………………………. 14 1.4.2 Interviews with Elders………………………………………….... 15 1.4.3 Interviews with medical staff…………………………………..… 18 1.4.4 A final note on methods………………………………………..… 18 CHAPTER TWO: HISTORICAL CONTEXT……………………………………..…. 21 2.1 Subsistence strategies and the fur trade…………………………………..... 21 2.2 Iiyiyuuschii from the 1850s to the early 1900s: The beginnings of colonial policies……………………………………………………………………..…… 22 2.3 Establishment of the Old Factory post (1935-1959)……………………..…. 25 2.4 The beginnings of the medicalization of life in northeastern James Bay…... 26 2.5 The beginnings of childbirth evacuations from Wemindji………………..… 28 2.6 The childbirth evacuation policy and childbirth medicalization in Canada: Federal policy shifts and attitudes towards Indigenous birth………..…………... 29 2.7 The implementation of the evacuation policy in James Bay and Wemindji.... 33 CHAPTER THREE: UNDERSTANDING CREE COMPLIANCE WITH THE EVACUATION POLICY………………………………………………………..……….. 36 3.1 Colonialism at work: evacuation policy in action……………………………. 37 3.2 A case study: Elizabeth’s birth story…………………………………………. 39 3.3 Adaptive strategies: superficial compliance as a form of survival and resistance 40 3.3.1 Ilira…................................................................................................ 42 3.3.2 Panopticism....................................................................................... 42 i 3.4 The manifestation of superficial compliance in different contexts..................... 44 3.5 Internalized colonialism...................................................................................... 47 3.6 Indigenous resurgence........................................................................................ 48 CHAPTER FOUR: PREPARATIONS FOR CHILDBIRTH............................................ 53 4.1 Family planning in the bush................................................................................ 54 4.1.1 When to marry?................................................................................. 54 4.1.2 Whom to marry?................................................................................ 55 4.1.3 How often to have children?.............................................................. 58 4.2 Family planning in town...................................................................................... 60 4.2.1 Voices of single mothers: expectations and fulfillments.................... 60 4.2.2 The impacts of the Indian Act on Cree family planning patterns....... 66 4.2.3 Finding out about pregnancy and breaking the news to the family.... 69 4.2.4 Abortions.............................................................................................. 74 4.3 Advice during pregnancy...................................................................................... 80 4.3.1 In the bush........................................................................................... 80 4.3.2 In town................................................................................................ 82 CHAPTER FIVE: CHILDBIRTH IN THE BUSH............................................................. 92 5.1 Bush birth stories................................................................................................. 94 5.2 Woman who attends birth (iskwaau kaa uutinaat awash), man who attends birth (napaau kaa uutinaat awash)..................................................................................... 97 5.2.1 Who is the midwife?............................................................................ 97 5.2.2 Acquiring midwife skills...................................................................... 103 5.2.3 Going to delivery – midwife’s equipment and preparation................ 105 5.3 Pre-labour preparations........................................................................................ 108 5.3.1 Preparing the bedding........................................................................ 108 5.3.2 Setting up the teepee, preparing baby clothing.................................. 110 5.4 Participation in birth............................................................................................. 112 5.5 The process of labour........................................................................................... 115 5.5.1 Self-reliance during labour................................................................ 115 5.5.2 Pain management............................................................................... 115 5.5.3 Labouring positions............................................................................ 118 5.6 Ishkwaashimunsh (placenta/afterbirth)................................................................. 118 5.7 Utispikun (caul/amniotic sac)............................................................................... 121 ii 5.8 Caring for the newborn......................................................................................... 122 5.8.1 Breastfeeding....................................................................................... 124 5.9 Birth complications: deaths, miscarriages, premature births................................ 128 CHAPTER SIX: BIRTH IN THE CLINIC.......................................................................... 133 6.1 Collaboration of midwives and nurses at the nursing station (1962 - 1980)........ 140 6.1.1 When the clinic was closed or too far to reach – home births............ 142 6.2 Normalization of evacuation and decrease of births at the clinic (1980 - 2000).. 145 6.3 Reflections of nurses on occasional local births................................................... 146 6.4 The reasons for and circumstances of recent clinic births (2000 - 2013)............. 146 CHAPTER SEVEN: HOSPITAL BIRTHS........................................................................ 156 7.1 Prenatal appointments at the clinic in Wemindji................................................. 159 7.1.1 Ultrasound testing and due dates....................................................... 165 7.2 Pre-labour preparations........................................................................................ 168 7.2.1 Departure dates and flights................................................................ 169 7.2.2 Boarding homes and Friendship Centers........................................... 174 7.2.3 In evacuation: waiting for births........................................................ 178 7.2.3.1 Challenges of waiting: loneliness and longing, boredom and financial issues....................................................................... 178 7.2.3.2 Embracing the waiting and dealing with challenges............. 183 7.3 In the hospitals: delivery and postpartum stay...................................................... 188 7.3.1 Early births in the hospitals (1965-1970s): Elders’ experiences and their point of views on the best place for birth............................................. 189 7.3.2 Common issues women faced in the hospitals..................................... 197 7.3.2.1 Health care models and the prevailing approach to childbirth in Val d’Or hospital.............................................................................. 198 7.3.2.2 Cases of epidurals.................................................................. 202 7.3.2.3 Cases of C-sections............................................................... 208 7.3.2.4 Postpartum stay: miscommunication, coercion, explicit and implicit bias ..................................................................................... 216 CHAPTER EIGHT: MANIFESTATIONS OF CREE BIRTH IN THE HOSPITALS....... 227 8.1 Homogenization, indigenization and medical pluralism....................................... 228 8.2 Quiet and self-reliant labour................................................................................. 230 8.3 Shifting roles and responsibilities during birth.................................................... 232 iii 8.3.1 The birthing coach.............................................................................. 233 8.3.2 Family support.................................................................................... 236 8.3.3 The role of the partner/husband -“What
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