The role of African Canadian immigrant Midwives: A historical perspective on community homebirth.

PROBLEM: There is limited scholarship on homebirth practices and social networks of African Canadian immigrant community midwives during times of strained healthcare.

BACKGROUND

Community care planning left gaps both during Canada's historic nation building phase and the recent COVID-19 pandemic.

METHODS

Semi-structured interviews were held with Afrodescendant family members and storytellers who knew community midwives who practiced between 1800-1960 in Nova Scotia, Ontario, Saskatchewan and Alberta. Transcripts were triangulated with archival searches and key community informant consultations with genealogists and historians.

FINDINGS: Participants, key informants and archival searches provided evidence for eleven migrating community midwives who provided culturally inclusive care in Nova Scotia, Ontario, Saskatchewan, and Alberta settlements between 1800-1960. Themes that emerged included: the Ancestral Community Midwife Role, Drivers of Community Birth, Drivers Promoting Access, and Migration Resilience. Midwives used homebirth to help immigrants access culturally inclusive responsive care in isolated, low-resourced immigrant communities in Canada.

DISCUSSION: Common sub-themes were midwives' survival, resistance and prioritising health of the community. The Ubuntu or communitarianism framework ties individual health closely to community health, which is highly valued by many immigrant families and midwives. Findings support current midwifery trends where culturally sensitive and integrated care are offered as interventions to facilitate flourishing in immigrant communities.

CONCLUSIONS

We concluded that community midwifery provided access to homebirth and mitigated the challenging healthcare gaps during Canada's historical and current healthcare crises. We encourage continued deployment of midwives, especially during the current times of scarcity.