Funding Cuts Are Shutting Down This Successful Indigenous Midwifery Service

An Indigenous-led midwifery service on southern Vancouver Island that reduced child apprehensions says it has had to close due to a lack of provincial funding.

Last week, the co-founders of the South Island Indigenous Midwifery Service held a rally at the B.C. legislature calling on the government to fund their program.

Between 75 and 100 people attended the rally, which was an “amazing turnout,” said Nathalie Pambrun, co-founder of the midwifery service and a Franco-Manitoban Métis registered midwife. “The community really showed up for us.”

This closure affects the lək̓ʷəŋən (Lekwungen) peoples, on whose traditional, unceded territory Victoria is built, urban Indigenous communities on the South Island and Indigenous people flown to Victoria during their third trimester, Pambrun said. She added that people who need to be transported out of their communities to a larger city to give birth are known as “birth evacuees.”

Since 2022, the South Island Indigenous Midwifery Service, or SIIMS, has shown its services reduced child apprehensions by the Ministry of Children and Family Development by around 70 per cent. The service has increased prenatal care access and postpartum followups and reduced the burden on acute care settings, Pambrun said.

Child apprehensions disproportionately affect Indigenous parents. Today, six per cent of B.C.’s population is Indigenous, but around 68 per cent of kids in government care are Indigenous.

Pambrun said SIIMS’s success comes from being able to work with culturally rooted housing supports, collaborative wraparound programs for people who use substances, respectful and trauma-informed care that addresses long-standing health inequities, early engagement with Indigenous-led child and family supports, and transparent communication about rights, choices and legal processes.

The Ministry of Health told The Tyee it is reviewing the program’s application for funding submitted by Island Health, the health authority for Vancouver Island. In the meantime, Island Health “continues to support this service through an interim contract while the review is underway.”

But Pambrun said provincial funding ended on May 30, and they were told “two days before the funding was to run out” that the contract wasn’t going to be renewed.

The providers were also not given a reason for the funding halt, Pambrun told The Tyee.

“We’ve been asking for over a year for this funding to be sustainable,” she said. “Pregnancy care can’t run on care that’s episodic. We can’t wonder how we’re going to pay our bills, or if we can care for someone throughout the whole course of their pregnancy.”

Pambrun said funding for SIIMS has always been pretty piecemeal. Starting in March 2023, they were given a year’s worth of federal funding for two part-time midwives. Then they had bridge funding from Island Health for three months in 2024 for two part-time midwives, and five months in 2025 for one part-time midwife.

SIIMS also focused on community outreach. The program had clinics at Foundry Victoria Youth Clinic, the Songhees Wellness Centre and the Camas Lelum Primary Care Clinic. Staff also did a walk down Victoria’s Pandora Avenue, home to many unhoused people, every Friday, Pambrun said.

With those resources, SIIMS was able to support 130 clients. With dedicated funding, Pambrun said, she’d like to build partnerships between Indigenous midwives, Indigenous doulas, social workers and other support services to offer wraparound support for clients.

The goal is to “pull in supports to make sure the birthing person is strong, but also that they’re well surrounded by a strong community,” she added.

The Ministry of Health said it recognizes the importance and value of Indigenous people having access to culturally appropriate maternity, delivery and followup care for both parents and babies.

The ministry pointed to a number of programs that are working to improve delivery of maternity and reproductive care across the province, including its 2023 investment of $2.5 million for the Indigenous Maternity Planning Committee, and the Maternity and Babies Advice Line, which supports primary care providers serving expecting or new parents in rural and remote communities, including First Nations communities.

The importance of Indigenous midwifery

“Indigenous midwifery is essential to the health and well-being of the communities it serves and offers culturally grounded, relational care that fosters physical health, community connection, cultural continuity and healing,” the Indigenous Midwives Council of BC told The Tyee in an emailed statement.

The council said it didn’t have details about contracts for the South Island Indigenous Midwifery Service but that “programs such as SIIMS play a vital role in delivering safe, respectful perinatal care on Vancouver Island.”

“Perinatal” refers to the period from when a person becomes pregnant to up to a year after birth.

Indigenous people having babies today may have been raised in families with parents who were residential school survivors or who were taken away from their families during the ’60s Scoop, Pambrun said.

The ’60s Scoop was a government policy that saw 20,000 Indigenous infants and children taken away from their homes and put into foster care or adopted out to non-Indigenous people.

“There’s a lot of restoration and healing that needs to happen intergenerationally but also with the immediate family we serve,” Pambrun said. “The work Indigenous midwives are doing is, in part, understanding some of those challenges and trying to help families work through what that means for them.”

Being a safe and trusted care provider is also important because pregnancy is a time when many Indigenous people are re-engaging with the health-care system, where they may have previously experienced racism or trauma, she said.

Anti-Indigenous racism is well documented in health-care settings across Canada.

“A big part of what we’re doing is transforming that narrative and changing that experience by being a safe and trusted care provider, who can help teach health-care navigation, medical knowledge translation, and making the care make sense so people can become active participants in their own health care,” Pambrun said.

The South Island Indigenous Midwifery Service works with people experiencing intersecting marginalizing factors, Pambrun said, for example being young, unhoused or using substances on top of being Indigenous.

“There can be a lot of barriers to getting to the hospital and actually accessing care there,” she said.