The Inuulitsivik Maternities: culturally appropriate midwifery and epistemological accommodation.

This is a literature-based historical analysis that uses Michel Foucault's technique of tracing epistemological change over time to understand the epistemological changes and their outcomes that have occurred in Nunavik, the Inuit region of Northern Quebec, with the introduction of modern techniques and technology of childbirth in the period after the Second World War. Beginning in 1986, in the village of Puvurnituq, a series of community birthing centres known as the Inuulitsivik Maternities have been created. They incorporate biomedical techniques and technology, but are incorporated into the Inuit epistemology of health, in which the community is the final arbitrator of medical authority. This epistemological accommodation between modern biomedicine and the distinctly premodern Inuit epistemology of health has led to the creation of a new and profoundly non-modern approach to childbirth in Nunavik.

Childbirth among the Canadian Inuit: a review of the clinical and cultural literature.

BACKGROUND: This study reviews the historical, anthropological and biomedical literature on childbirth among Canadian Inuit resident in the Canadian Arctic. The modern period is characterised by increased tension as southern intervention replaced traditional birthing with a biomedical model and evacuation to metropolitan hospitals for birth. Inuit concern over the erosion of traditional culture has confronted biomedical concern over perinatal outcomes. Recently, community birthing centres have been established in Nunavik and Nunavut in order to integrate traditional birthing techniques with biomedical support. OBJECTIVES: To review the literature on Inuit childbirth in order to suggest avenues for future research. STUDY DESIGN: Material for this review was gathered through combining library searches, database searches in ANTHROPOLOGYPlus, MEDLINE, CINAHL and Science-Direct, and a bibliographic search through the results. RESULTS: Epidemiological studies of Inuit childbirth are outdated, inconclusive, or inseparable from non-Inuit data. Anthropological studies indicate that evacuation for childbirth has deleterious social and cultural effects and that there is considerable support for traditional communal birthing in combination with biomedical techniques and technology. CONCLUSIONS: Investigation of alternative solutions to maintaining acceptable perinatal outcomes among the Inuit seems desirable. Epidemiological and comparative qualitative studies of perinatal outcomes across the Arctic are needed to reconcile the cultural desirability of communal birthing with claims of its medical feasibility.